Did you know that the pill does not make you fat? Women’s Wellness and Health Book responds | Pre-publication

… the thrombotic risk is higher in the first year of using the hormonal method or after a break lasting more than a month?

We know that the risk of a thrombotic event associated with a hormonal contraceptive is increased at the beginning of its use, namely in the first 12 months, and then reduces over time. Likewise, the thrombotic risk after a break that exceeds one month is also increased. It is one of the reasons why, if a woman is adapted to her method, it makes no sense to take “rest breaks”, advice that was commonly heard a few years ago, but which currently has no clinical justification.

… the pill does not cause infertility?

Contrary to popular belief, the Pill has no long-term impact on female fertility (nor does any method other than surgery). Most women will resume their ovulatory cycles within three months of stopping hormonal contraception. The only exception is the injectable progestin method: full recovery of fertility can take up to 6 to 9 months.

… the pill does not lead to considerable weight gain?

The fear of weight gain is one of the most frequent concerns of users, but the truth is that, in most studies, no obvious weight gain was found; as a rule, it is not expected that there will be more than a slight change in weight (± 1 to 2 kg) in women who start using both combined and progestative pills. I remind you that men and women tend to gain weight throughout their lives, which is why this fact is a common confounding factor in this perception that you have gained weight after starting hormonal contraception.

… most antibiotics don’t interfere with the effectiveness of the pill?

Contrary to what was advocated in the past, we know today that most of the antibiotics used (with the exception of rifampicin and rifabutin, used in the treatment of tuberculosis) do not directly interfere with the effectiveness of the contraceptive pill. The only exception will be if your intake causes severe diarrhea. In this case, it will be necessary to associate an additional method, such as a condom, if there is sexual intercourse during therapy and in the following seven days.

… the effect of the pill on libido is controversial?

One of the main questions regarding the use of the pill is whether or not it has an impact on libido and female lubrication. It is crucial to make it clear that sexuality, especially female sexuality, is extremely complex, which is why it is quite difficult to assess this type of parameter in an exhaustive way, without confounding factors. However, a review of the scientific literature points out that, as a rule, 85% of women report a null or positive effect on sexual desire, while 15% report a decrease. It is important to approach sexuality in a holistic way, and consider suspending or changing it, with the attending physician, if complaints arise.

… you should never use two condoms at the same time?

Neither two male condoms, nor a female condom and a male, or two female condoms should not be used simultaneously, due to the risk of adhesion, which can cause rupture and/or expulsion, and consequent failure of the method.

… isn’t there a limit to the number of “morning after pills” a woman can take?

The idea that a woman can only use emergency contraception two or three times is rooted, but there is no scientific basis for such a belief. This false conception became one of the buzzwords of Sexual “Education” (although “doctrine” was a more faithful designation to the truth) that was once practiced in some schools, with the aim of frightening and promoting celibacy and sexual abstinence. What the science tells us, however, is that these methods have no long-term effects on women’s health or their long-term fertility. They should not, however, be used as a contraceptive method recurrently, not least because they are not 100% effective in preventing unwanted pregnancies.

… virtually all sexually active adults will have HPV in their lifetime?

The vast majority of us — an estimated 80% by age 45 — will have HPV (one or several types). Fortunately, most cases are harmless and do not result in pathology. This sexually transmitted infection is particularly prevalent because, although its transmission can be minimized by the use of barrier methods, such as condoms, during sexual intercourse, it can happen through skin-to-skin contact in the genital and anal regions. It is important to make it clear that having HPV does not mean, at all, that you will necessarily have cervical cancer, even if they are of the most oncogenic types, 16 and 18. There are other factors, namely genetics and environmental exposure (as in the case of tobacco consumption, which substantially increases the risk) that play a relevant role in the genesis of this cancer.

… is vulvovaginal candidiasis not considered an STI?

There is sometimes some confusion as to whether or not candidiasis is a sexually transmitted infection. The truth is that candidiasis results from the excessive proliferation of fungi that are already part of a woman’s normal flora (usually candida albicans), by imbalances in the pH and/or in the number of beneficial bacteria, the lactobacilli. This explains why even female children and young people without sexual activity also have vulvovaginal candidiasis.

… a urinary tract infection can’t be “caught” in a toilet bowl?

Contrary to common belief and which still prevails in many people’s minds today, urinary tract infection is not something you get from using a public toilet: virtually 99.9% of urinary tract infections in healthy young women result from ourselves, or better, of microorganisms that usually reside in our intestines, and that, for some reason, ended up in the wrong place.

… is it advisable to use sun protection even inside buildings and cars?

If you carry out activities near a window, UVB radiation will be filtered, but the same does not happen with UVA radiation, which passes through the glass, and will continue to exert its effects in terms of aging and the development of spots. Therefore, it is recommended to use sunscreen with UVA protection, even inside buildings, if they have natural light sources. An illustrative example of this paradigm can be found on the faces of most taxi drivers: the left side, more exposed to UVA radiation, usually has a more aged appearance, with more pronounced wrinkles and more sunspots (if they are not driving in the UK). Kingdom, where, for obvious reasons, the “older” side will be the right).

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