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When the FDA approved the first oral contraceptive pill in 1957, pregnancy prevention was only listed as a side effect on the package. Many women used it at this point specifically for contraception, but the FDA had technically only approved it to treat gynecological disorders and regulate menstrual cycles.
Three years later, the FDA eventually approved the birth control pill specifically for contraception, but many women today still use the pill for much more.
Birth control use: Not just pregnancy prevention
A study from the Guttmacher Institute in 2011 found that of the 1.5 million women taking oral contraceptive pills, 58% took them, at least partly, for noncontraceptive reasons. Only 42% used it exclusively for contraception. And, a 2024 study from KFF found that 14% of women using general contraceptives used them exclusively for noncontraceptive reasons.
“Birth control pills offer a wide range of benefits beyond just preventing pregnancy,” says OBGYN Dr. Caledonia Buckheit, who often prescribes the pill in her practice for noncontraceptive reasons. “For the right patient, they can safely and effectively manage menstrual problems, improve skin and hair conditions, and even lower the risk of certain cancers.”
So, while social media is full of people trying to convince you birth control pills are probably going to kill you (they won’t), the tiny pill can do so much more than prevent pregnancy. We’re here to break down how they work and some of the more unexpected benefits they can provide.
So, how do birth control pills work to prevent pregnancy?
“Birth control pills prevent pregnancy mainly by stopping the body from releasing an egg,” says Dr. Buckheit.
The pills often contain 21 days of synthetic versions of both estrogen and progesterone (or in some cases, just progesterone). Packs also typically contain one week of placebo pills without hormones during which your uterine lining sheds and you get your period.
Taken daily, Dr. Buckheit says the pills change the balance of the hormones that already dictate the menstrual cycle to give the brain negative feedback and prevent ovulation — if there’s no egg released, there’s nothing for the sperm to attach to, and no resulting pregnancy.
The pills also work to thicken cervical mucus (more commonly known as vaginal discharge and thin the lining of the uterus. This makes it less likely for sperm to reach the egg and, if it does become fertilized, it makes it more difficult for the fertilized egg to attach to the lining of the uterus and grow.
Unexpected benefits of birth control pills
But, as we all know, our menstrual cycles can come with much more than our bodies simply releasing an egg. The acne, pain, mood swings, and more marked by our bodies prepping for a potential pregnancy are also controlled by hormones, making hormonal birth control pills an effective way to get a handle on some of these symptoms. Let’s talk about it.
Regulating irregular periods
Dr. Buckheit says conditions like polycystic ovary syndrome (PCOS) are the most common reason women have irregular or infrequent periods.
Women with PCOS typically produce higher-than-normal amounts of the hormones called androgens, which are normally found in greater amounts in men than women. This can cause irregular periods and other symptoms like cysts, acne, excess body hair, weight gain, infertility, and more.
If you are struggling with irregular periods from PCOS and not trying to get pregnant, birth control pills are one way to regulate your period — “with cyclic use, the pill will produce regular withdrawal bleeds or periods,” Dr. Buckheit explains.
Improve acne and lessen excess hair growth
Combination pill methods containing both estrogen and progestin increase a protein called sex hormone-binding globulin that binds with androgens to make them less active, decreasing oil production in the skin and lessening acne and excessive hair growth. Progestin-only methods, including IUDs, implants, and injections, have fewer benefits in this case.
For those concerned about the side effects of birth control, treatments like topical acne medications or oral medications can also help manage these problems. “For many women, the benefits outweigh these risks, but it’s important to discuss your personal history with your provider,” says Dr. Buckheit.
Managing heavy or painful periods
The pill can further reduce symptoms found in women with endometriosis, dysmenorrhea, and menorrhagia.
Women with endometriosis can experience severe pain and heavy periods due to tissue similar to the uterine lining growing outside the uterus. Endometriosis can often cause secondary dysmenorrhea, or painful periods. Primary dysmenorrhea, on the other hand, typically involves a chemical imbalance in women that affects the normal contractions of the uterus, and menorrhagia, or extremely heavy periods, can be caused by a variety of problems with the uterus or other hormone imbalances. Oral contraceptives are a common way to treat all of these conditions.
“Oral contraceptive pills reduce pain by stopping ovulation and thinning the lining of the uterus,” Dr. Buckheit explains. “This thinning leads to less stimulation of the endometrial tissue, both inside and outside the uterus.”
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With a thinner uterine lining, there’s less to be shed during your period. For many women with these conditions, this can mean less pain and lighter bleeding.
Ease PMS symptoms
Premenstrual syndrome, or PMS, symptoms occur for many women before they get their period, typically including bloating, headaches, migraine, and mood swings. Researchers believe this to be caused by the drop in estrogen and progesterone that typically happens after ovulation and before your period. By changing the balance of these hormones, the pill can help ease these symptoms for some women.
Other benefits of the pill
Dr. Buckheit says the pill can also help with uterine fibroids and support bone health for some women. The pill can even reduce the risk of developing certain cancers, specifically endometrial and ovarian cancer, by thinning the lining of the uterus in the long term.
The full value of birth control in women’s health
So, while the pill continues to be attacked online for ruining your hormones (and attacked politically by those wanting to stamp out any method by which women can choose when to start their families), it’s not just for pregnancy prevention, and it’s not just a bandaid either — the pill can effectively treat multiple health issues, and overall make conditions that feel unmanageable manageable.
But just like any other medication, there are still potential side effects and risks. “It’s important to have a detailed discussion with a healthcare provider to determine which option works best for you,” Dr. Buckheit says.
Birth control may not be for everyone, but it certainly remains a valuable tool for many women in taking control of their health.
Eliza Mattson is a journalism student at Northwestern University and a Rescripted editorial intern. She is primarily interested in health and science writing, but she also studies history and economics. When she’s not writing or studying, you can find her rewatching Speed for the millionth time or baking cookies.