Test your pill knowledge

More than ten million women in the U.S. take some form of birth control pill. But how many of them know what the pill really is and how it works?

Here’s a quiz to test your pill IQ. It was devised with the help of Dr. Livia Wan, a gynecologist who directs the Division of Family Planning and Reproductive Choice at NYU Langone Medical Center in New York. (Answers appear at the bottom.)

True or false:

1. All birth control pills work by stopping ovulation.

2. The mini-pill has fewer hormones than combination pills.

3. The 28-day cycle of the combination pill is medically necessary.

4. The pill causes weight gain in women who take it.

5. The pill permanently affects fertility in women who take it for an extended period of time.

6. Women who take the pill are slightly more likely to suffer blood clots.

7. The pill increases cancer risk.

8. The pill has been available in the same forms since its invention in the 1950s.

Answers:

1. False. While the hormones in all birth control pills help prevent pregnancy, different pills go about it differently. All cause thickening of the mucus in the cervix and thinning of the uterine lining. The former makes it harder for sperm to enter, and the latter makes it more difficult for the egg to attach. However, mini-pills don’t always stop ovulation, whereas combination pills do.

2. True, in multiple senses. Mini-pills only have progestin (a synthetic form of the hormone progesterone), whereas combination pills also have estrogen. Also, mini-pills have less progestin than combination pills.

3. False. The number of active pills comes from efforts to make the pill seem “natural” — by having it mimic a woman’s menstrual cycle — and is scientifically arbitrary. So, fewer periods are possible, just talk with your doctor about it.

4. False. In studies, an equal number of women gained weight on the pill as lost it; participants were just more likely to report gaining weight as a side effect than losing it. It is important to note that studies have shown the pill to be less effective in women who are already obese when they start taking it. While some researchers blame this on the increased metabolism of overweight people, a more recent study found that obese women and the pill don’t get along because they take it less consistently than women of normal weight. The reason why remains a mystery.

5. False. Most women will resume their period four to eight weeks after stopping the pill. However, if a woman 35 or older is taking birth control, her fertility may be naturally reduced due to age.

6. True. Most women have a very low risk of blood clots whether they’re on or off the pill. Still, the pill has been shown to slightly increase the incidence of clots. Therefore, women who are heavy smokers, over 35 or who have diabetes should be mindful about the using the pill because they are already at a greater risk for blood clots and the pill can add to that risk. (Clotting usually occurs in the lower leg and can cause pain when the affected area is moved.)

7. False. Today most researchers believe that the use of the pill does not affect breast cancer risk.  Older versions of the pill used larger doses of hormones and increased breast cancer risk slightly. Also, some doctors do refer to the pill as “chemoprevention” because women who have taken the pill for an extended period of time are less likely to get ovarian cancer.

8. False, for multiple reasons. The original pill, approved by the Food and Drug Administration in 1957, is not the same pill that’s on the market today. Older versions had much higher doses of hormones and, therefore, worse side effects. According to NYU’s Wan, studies that examined the side effects of the old birth control pill are often mistakenly used to explain the risks of the modern-day pill.

How’d you do? Whether you scored 100 percent or something lower, remember to share the wealth. Let your friends know about this quiz, and let’s see if we can turn pill knowledge into common sense.