Birth control is a very sensitive subject, and often thorny, especially for young women who wish to be at peace with their sexuality, safe, and without fear of running into an unwanted pregnancy. According to statistics, only 16.2% of Italian women use birth control pill between 15 and 44 years of age, which is a very low percentage. However, the problem is that many women still rely on unsafe methods of contraception and to “do at your place”. The reason? Probably a lot of misinformation. To learn more we had a chat with Dr. Elena Zannoni, Head of Conservative and Endoscopic Surgery and Specialist Fertility Center Humanitas.

Contraceptive Pill with English Instructions.

What is the birth control pill and how does it work?

“The pill is a hormonal combination (estrogen and progesterone) that involves the suppression of ovulation, resulting in the inability to conceive. According to the gynecological class, it is the contraceptive of choice, and combines, for contraceptive effectiveness, a number of other benefits. In fact, it regulates the cycle and makes it less painful and plentiful. For this reason, the birth control pill is also used by women who do not have a need for a contraceptive as well as for dermatological problems caused by hormonal dysfunctions. The contraceptive action of the drug is completely reversible and does not create any problem in terms of fertility after cessation of therapy. On the contrary, as soon as the administration is suspended you can immediately try to conceive a child.”


Is it true that the pill can cause thrombosis or phlebitis?

“The pill has a potential to be thrombogenic, but it is a much lower risk than that caused by pregnancy which can be extremely more dangerous than the pill from this point of view. The potential of the pill for thrombosis is mainly the prerogative of certain categories of persons who already have a predisposition to hypercoagulability and of most interest in persons who also have other risk factors such as smoking, hypertension and obesity.”


Is it true that the pill makes you fat and causes water retention?

“This is a question that can not be answered with either “yes” or “no.” From personal experience, I can say that theoretically a drug type of estrogen-progesterone can promote some retention, but normally not fattening, because the doses are reduced, and often you cannot even figure out whether you have got fatter or there has been a change in eating habits. In conclusion, the pill would cause a modest water retention in the first few months, but not beyond.”


Is it true that in the long run the pill can cause infertility?

“No, this myth should be dispelled. The birth control pill does not cause infertility; on the contrary, theoretically it preserves fertility, because prevention of chronic ovulations prevent small monthly inflammation that can be harmful to the pelvic area. The pill also helps in prevention of certain diseases that are enemies of fertility, such as endometriosis or ovarian cysts.”


Is pill-provoked amenorrhea dangerous?

“Absolutely not, this is another myth to dispel. The pill contributes to make less endometrium whereby the cycle is not abundant, but this does not involve any problem or rather, in some cases, as we said before, is a factor wanted. And as soon as you stop taking the pill, the cycle is back, exactly as before.”

Is it true that the pill helps prevent ovarian cancer?

“Theoretically yes, because it is considered that quiescent ovary is itself a prevention factor. But this of course does not mean that women who take the pill are assured of not getting this specific form of cancer.”


Pill and loss of desire, is there any relationship?

“Sometimes the pill can alter sexual desire because it suppresses estrogen stages. It is as if the pill flattens the curve of sexual desire. In fertility stage indeed, the woman has phases associated with the reproductive desire, for example, so it is clear that during ovulation there is a higher sex drive because there is an instinctive reproductive desire. The pill actually removes these phases and puts the woman in a state which is always the same, which could result in a lower libido. If the woman ovulates, it is more likely to have a sex drive because she knows she can reproduce. There may be other existing psychological blocks, as in the case of women who have a repressed desire for motherhood and when they are taking the pill reluctantly, this could even lower the subconscious desire. In this case, too, it is not a direct chemical action of the drug. It is not a question, so to speak of “chemistry” due to the drug.”


Which are there are other benefits to report beside the contraception?

“Of course. As we said before, the extra benefits of the birth control pill are regulation of the cycle, decrease in the extent of the flow and menstrual pain (dysmenorrhea), as well as absorption of some ovarian cysts. The reduction in blood loss and regulation of menstrual cycles affect positively on blood parameters, with restoration of anemia in many cases, and consequent improvement of the quality of life.”