It doesn’t take much to be prescribed hormonal birth control from a doctor. PMS, heavy periods, painful periods, irregular cycles, PCOS, acne and of course pregnancy prevention are all seemingly reasonable cases for it.
I' m afraid I don’t agree. Chances are your doctor won’t even enquire about what your monthly cycle looks like, because regardless of this the only solution conventional medicine can offer you is hormonal birth control, in whichever form you would prefer to have it. Oral contraceptive pill (OCP), NuvaRing, contraceptive patch, implants, injections or the Mirena.
Don’t get me wrong, the development of hormonal contraception marked a revolutionary step in social change that has improved the lives of women and families worldwide. However, 60 years on, despite huge leaps in the world of science and technology we are still using an outdated method of contraception.1 To the point that it is so ubiquitous, it barely requires a brand name.
Pill Bleeds Are Not Real Periods
Of all the women who take the pill, 1 in 3 take it to regulate her period.1 The pill forces you to have a bleed (if you choose to have it) which is reassuring for both you and your doctor. However, a pill bleed is not a real period, meaning you will have made no progress in regulating your period. Pill bleeds are pharmaceutically induced bleeds as a result of moving from active pills on to the sugar pills. There is no medical reason to bleed monthly when using hormonal birth control, but having the occasional pill bleed is necessary for preventing break through bleeding.2
60 years on, despite huge leaps in science and technology, we are still using such an outdated method of contraception.
False Sense of Security
The real problem here is that women with irregular cycles, myself includes, are led to believe that once we take the pill are periods become regular. And that when we want to eventually fall pregnant we simply stop taking the pill. However, we now know that it takes approximately 12 years for a girl to mature her hormonal system from when she starts to menstruate. Therefore, when the average age of menarche (the first period) is 13 years old, and many girls start taking the OCP at 16 years, by the time they come off it they will be 9 years behind the eight ball. If you were irregular before you went on hormonal birth control, chances are you will still be irregular when you come off it.
Pill Hormones Are Not Real Hormones
Our ovarian hormones are estradiol and progesterone. Not only are they essential for reproduction but also for mood, bones, thyroid, muscles and metabolism. In contrast the steroid drugs, or “pseudo-hormones” found in hormonal birth control, are ethinylestradiol, drospirenone, levonorgestrel and others.1
Levonorgestrel is a progestin and works similarly to progesterone in that it is primarily responsible for preventing pregnancy. Both suppress ovulation, thin the lining of the uterus, and thicken cervical mucus making it difficult for sperm to enter the uterus.3,4 However, these different chemical compounds have different effects on the rest of the body. Whilst progesterone improves brain health and cognition and is great for hair health and growth, progestin has been linked to depression, anxiety and hair loss.1,5,6
If you were irregular before you went on hormonal birth control, chances are you will be irregular when you come off it.
Risks and side effects of hormonal birth control
Cancer – The risk of breast cancer is slightly higher among women who are currently using or have recently used contemporary hormonal contraceptives, including low-dose pills, implants and the hormonal IUD.1,7
Blood Clots – All hormonal birth control carries a risk of blood clots.
Depression – Girls and women who use hormonal birth control are significantly more likely to be diagnosed with depression. It makes the nervous system more sensitive to stress and alters the structure of the brain.6,8
Loss of libido and sex drive – This can be caused by a reduction in testosterone.
Hair loss – Progestins with high androgen indexes (aka high testosterone) can have devastating effects on normal hair growth, particularly for women who have a history of hair loss in the family.9
Weight gain – Due to its interference with insulin, promotion of sugar cravings, and prevention of muscle gain expected from regular exercise.1
Nutrient deficiencies – Including folic acid, vitamin B2, B6, B12, vitamin C and E, magnesium, selenium and zinc.10
Ultimately, hormonal birth control works by shutting down your ovaries and switching off your own sex hormones which are crucial for optimal health and vitality. It’s essentially the same as telling a man that we will switch off his testosterone until he wants to have children. Now that would never be allowed! So let’s work to support our ovaries naturally instead of suppressing them chemically.
Ultimately, hormonal birth control works by shutting down your ovaries and switching off your own sex hormones which are crucial for optimal health and vitality.
In what situations is it OK to be on hormonal birth control?
I believe there are only two situations in which someone should consider being on the pill:
You understand the physiological reality of the pill, you are aware of your other options, and you decide that it is the best option for you.
You have a serious condition such as endometriosis or adenomyosis and as a result suffer from debilitating symptoms.
If you have a regular cycle there are only a few days in the month that you are able to get pregnant and so hormonal birth control is quite possibly completely unnecessary for you. If you don’t have a regular cycle things can be a little cloudier in terms of pregnancy prevention, but this is a very clear message from your body that your priority should be to work on regulating your period without using hormonal contraception.
References
1Briden, L. (2018). Period Repair Manual. Sydney: Macmillan Australia.
2Wright, K. P., & Johnson, J. V. (2008). Evaluation of extended and continuous use oral contraceptives. Therapeutics and clinical risk management, 4(5), 905-11.
3The American College of Obstetricians and Gynaecologists. (2018). Progestin-Only Hormonal Birth Control: Pill and Injection. Retrieved 21 November 2018, from https://www.acog.org/-/media/For-Patients/faq186.pdf?dmc=1&ts=20181120T2340358901
4Cooper, D. B. & Adigun, R. (2017). Oral Contraceptive Pills. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430882/
5Pletzer, B. A., & Kerschbaum, H. H. (2014). 50 years of hormonal contraception-time to find out, what it does to our brain. Frontiers in neuroscience, 8, 256. doi:10.3389/fnins.2014.00256
6Skovlund, C., Mørch, L., Kessing, L., & Lidegaard, Ø. (2016). Association of Hormonal Contraception with Depression. JAMA Psychiatry, 73(11), 1154. doi: 10.1001/jamapsychiatry.2016.2387
7Mørch, L., Skovlund, C., Hannaford, P., Iversen, L., Fielding, S., & Lidegaard, Ø. (2017). Contemporary Hormonal Contraception and the Risk of Breast Cancer. New England Journal of Medicine, 377(23), 2228-2239. doi: 10.1056/nejmoa1700732
8Petersen, N., Touroutoglou, A., Andreano, J., & Cahill, L. (2015). Oral contraceptive pill use is associated with localized decreases in cortical thickness. Human Brain Mapping, 36(7), 2644-2654. doi: 10.1002/hbm.22797
9American Hair Loss Association. (2010). Oral Contraceptive. Retrieved 21 November 2018, from http://www.americanhairloss.org/women_hair_loss/oral_contraceptives.asp
8Palmery, M., Saraceno, A., Vaiarelli, A., & Carlomagno, G. (2013). Oral contraceptives and changes in nutritional requirements. European Review for Medical and Pharmacological Sciences, 17, 1804-1813.
