Did you say something about lies?
We don’t mean to suggest that the labels are designed to mislead—but they’re not necessarily totally accurate, either. The FDA’s job is to make sure that the medicines used in the U.S. are safe and effective, and that the people who make medicines use truthful advertising. It has never been their job to keep up with all the latest research on how a medicine can be used—that’s the responsibility of health care providers. The FDA knows that doctors and nurses sometimes recommend using drugs in ways that are not listed on the label, and they have no problem with that. For example, birth control pills are approved for contraception, but doctors sometimes recommend them to treat acne or make periods more manageable. There’s research to back up the use of certain hormonal methods for those things, too. So why isn’t all that on the label?
To add a new use for an approved contraceptive to its label requires big scientific studies involving thousands of women, years of work, and tens of millions of dollars. Sometimes the companies that make contraception just don’t think it’s worth the trouble. So labels that are just a few years old can be out-of-date, which can be really confusing if you’re reading one on your own.
These are a few lies labels tell, and the truths we now know thanks to rigorous research.
Lie: Women with high blood pressure shouldn’t use the implant or the shot.
Truth: The estrogen hormone in the pill, the patch, and the ring is associated with increased risk of heart attack or stroke when women have high blood pressure to begin with. The implant and the shot contain no estrogen, and there’s no evidence that their ingredients (progestins) cause these problems.
Lie: Antibiotics will make the pill less effective.
Truth: The only antibiotic that makes the pill less effective is called Rifampin, or Rifampicin. It’s used very rarely for only the toughest cases of tuberculosis and methicillin-resistant Staphylococcus aureus (MRSA) infections. No other antibiotics change the effectiveness of the pill.
Lie: Using the shot for too long weakens your bones.
Truth: There is no evidence linking the shot to broken bones. The World Health Organization and the U.S. Centers for Disease Control have reviewed all the evidence about this question, and they agree it’s safe for women to use the shot for as long as they like.
Sooo…should I care what the label says?
Yes and no: labels can sometimes contain important information, but they can also be totally out-of-date. The first time you use a new prescription birth control method, your health care provider should go over the information on the label with you. Some clinics have created their own forms that show the information on the label in a font size you can actually read. Either way, it’s their job to translate any jargon into plain English and answer all your questions. If you have a specific medical condition, ask your provider to go over relevant information under the heading “Contraindications.” If you are taking any other medication, including herbal supplements, ask your provider to go over the “Drug Interactions” section.
The bottom line? Labels can be helpful sources of information, but they’re not usually reader-friendly. And if you’re looking for the most up-to-date information, they’re not so hot. If you want the latest evidence-based information about birth control, the U.S. Medical Eligibility Criteria for Contraceptive Use is up-to-date, but sometimes jargony. This chart provides a good jargon-free summary. We’ve said it before, and we’ll say it again: your nurse or doctor is the best source for more information!