You shouldn’t be afraid of hormonal birth control. But here’s how to evaluate the risks.

News on women’s health is, more often than not, insane, fearmongering, or totally science-free.

For example, this latest video — from the usually high-minded Guardian — hypes the harms of hormonal birth control by featuring the heart-wrenching stories of a handful women who have gotten sick or died after using these medications. What the video failed to dwell on, however, is the overwhelming majority of women who use contraceptives every day with no trouble at all.

The Guardian should have done a better job of weighing the risks and benefits of hormonal contraception. Of course all women should be aware of any potential side effects, which include a small risk of blood clotting. But the way the news outlet handled this fact is like suggesting that every man who takes Viagra for erectile dysfunction is going to suddenly end up with some of its rare side effects, too, losing his vision and having a heart attack.

When it comes to health — and particularly women’s health as it relates to menstruation and pregnancy — it’s not unusual to read stories that are screechingly alarmist and absent of any context or even science.

Always keep this in mind: All medicine has risks and benefits. There is no miracle drug that’s free of side effects. Even something as safe as Tylenol can kill people.

But some risk isn’t high risk. When a doctor writes a prescription for a treatment, he or she should be doing under the proviso that it’ll likely help far more than it’ll hurt.

Whenever you fill a prescription, you should be well-versed in the tradeoff you’re making. Do the risks of not taking the drug or having the surgery outweigh the chances of harm? Is the benefit really clear? Do I have other health issues that could increase my chances of experiencing a particular side effect? What is my personal risk profile, given my health and family history? Only you and your doctor can decide whether the tradeoff is worth it.

For hormonal birth control, the bottom line is this: these pills, patches, and rings can increase the possibility of a blood clot, which if left untreated can sometimes cause serious health complications, including death.

But in the vast majority of women, this side effect never, ever materializes.

“To put the risk in context,” as NHS Choices, a fantastic medical information service from the UK government, pointed out, “you are far more likely to develop a blood clot in pregnancy than by using a combined contraceptive.”

The last time the media amped up the harms of the Pill, the NHS service broke down what this looks like in absolute terms. There are about five to 12 cases of blood clotting per 10,000 women who use oral contraceptives for a year. This is a small boost compared with women who are not on the Pill and who generally have two blood clot cases per 10,000.
There’s research that shows this risk of clotting is slightly elevated with newer forms of birth control, such as Yaz or the Nuvaring.

Again, though, what’s important to remember here is that an increased risk isn’t a high risk: most women can use these forms of birth control without ever worrying about severe side effects.
However, some folks are at higher risk for clotting. These risk factors include smoking, being over 35 years old, being overweight, and having diabetes, high blood pressure, or a family history of blood clotting. If you have one or more of these risk factors, there’s a higher chance that you could get a blood clot while on birth control.

Clotting risk also increases, in general, with prolonged lack of physical activity, like if you’re ill and bed-ridden or you’re taking lots of long-haul flights.

All women should talk with their doctors about their individual risk and, if necessary, discuss other potential contraceptive options (the IUD, for example, is even more effective than the pill at preventing pregnancy and doesn’t necessarily use hormones). But no one should be needlessly afraid of a medicine that can potentially help with little or no harm.

Read more: Check out the NHS Choices website for more details here, this Cochrane Collaboration review, and this American Heart Association guideline.