Problems With the Birth Control Pill: Why the Pill Isn’t the Solution to Your Hormonal Problems
“Fun” fact: nearly 150 million women worldwide take the birth control pill. While there’s no doubt that the pill prevents unwanted pregnancy, it’s also handed out like candy for almost every known female hormonal condition. Do you have PCOS / acne / heavy periods? You’ll likely be given a birth control prescription to ‘balance out your hormones’ until you’re ready to get pregnant. While the pill may help with your symptoms in the short term, it’s doing so by profoundly (and sometimes irreversibly) disrupting your natural hormonal output.
Disrupted Hormonal Feedback:
Research shows that it can take up to 12 years for your ovaries to establish a strong and consistent feed back loop with your brain. The reason the pill is so problematic when it comes to achieving balanced hormones is because it impacts an area of your brain called the pituitary gland. This gland secretes various hormones to control estrogen and progesterone output through the female reproductive organs. Birth control pills supply your body with high doses of synthetic hormones to override the important communication pathways between this area of the brain and your own natural hormones. The pill prevents pregnancy by shutting down the body’s endogenous hormone production and inhibiting your ability to regulate your own hormone levels.
You’re particularly at risk of being able to achieve regular cycles if you’ve been put on the pill as a teenager. So many of my young patients are placed on the pill to “regulate” periods when they first start cycling even though it’s completely normal to have irregular & heavy periods in the first few years of menstruating. When we interrupt natural feedback patterns in the reproductive cycle we set women up for serious hormonal problems when they are ready to come off the birth control pill.
Not only does the pill interrupt natural hormone output and your ability to achieve regular natural cycles, it also prevents you from dealing with the imbalances at the root of your symptoms. Acne is typically a sign of too many male hormones, or not enough progesterone. While heavy periods likely indicate estrogen dominance. If you take a pill to correct these symptoms you’re not giving yourself a chance to develop a lifestyle and diet that helps you balance things out, naturally.
The hormones provided by the pill are synthetic compounds that are not the same as your body’s natural hormones. They’re structurally similar enough to your hormones to shut down ovulation, but they’re not bioidentical and therefore don’t offer the same benefits as natural hormones.
Natural progesterone is a beautiful hormone; it can help reduce anxiety, promote restful sleep and balance the harmful effects of having too much estrogen in your system. Instead of progesterone, birth control pills contain high levels of progestins. These are synthetic progesterone-like compounds that can trick your body into thinking that you’re already pregnant. They inhibit ovulation but they do not offer the same health benefits as progesterone. They may even cause dangerous side effects like breast cancer, blood clotting and cardiovascular disease.
Taking oral synthetic estrogens from birth control pills can be an even bigger problem. We already have so many estrogens coming in from our environment via plastics & personal care products, so when you add additional oral estrogens to this already dangerous mix you’re left with an accumulation of harmful xenoestrogens. Your body is well equipped to detoxify and balance your own natural estrogens but there are not enough liver cells in a jewish deli to deal with the crazy high levels of estrogen in the birth control pill (chopped liver joke, get it?). When there is an excess of any hormone in your body’s intricate endocrine system it will always lead to unwanted symptoms. This is particularly true when the body has too much estrogen and not enough progesterone to counteract it (and remember, progestins are NOT progesterone). The pill creates a situation called estrogen dominance which can lead to weight gain, leaky gut, headaches, mood swings and worsening of conditions like PCOS, endometriosis and fibroids.
Future Fertility Troubles:
Using the birth control pill to treat ‘hormone imbalances’ can also cause serious problems down the line when it comes to your fertility. So many of my fertility patients were told by their doctors that the pill would solve their hormone problems and balance their periods. 5 – 15 years later these women finally come off the pill in order to have their babies, only to find that their cycles are just as irregular / heavy / painful as they were before going on birth control. This is absolutely devastating to women that took the pill with the false belief that they’d have balanced regular cycles when they decide to discontinue these hormones.
I sadly see tons of women in their mid to late 30’s stopping the pill and expecting to have perfect cycles and get pregnant right away when this is often far from the truth. It can take years to regulate hormones after coming off the pill, especially if you had difficult cycles to begin with, or if you’ve been on it from a very young age. After stopping the birth control your fertility will go right back to what it was destined to be. This is great news for women with balanced hormonal cycles before going on the pill, but for those of you who were placed on birth control to regulate hormonal symptoms it means that you’re likely to have these same problems when you come off.
Let me be clear, I am not “anti-birth control”. Some (rare) women experience very few side effects, and it can be an inexpensive and effective way to prevent unwanted pregnancy. I do, however, have a problem with the lack of informed consent expressed to patients prior to starting the pill. The pill has well documented effects on a woman’s nutritional status, thyroid health, weight and mood. It prevents your from developing normal hormonal feed back rhythms and in no way helps to “balance” your hormones. If you are taking birth control pills for a reason other than contraception, I urge you to consider other options. Want off the pill, but you’re not ready to have a baby anytime soon? The following alternative forms of contraception can prevent unwanted pregnancy without the need for a daily high dose of systemically-absorbed synthetic hormones:
- Copper IUD (99.9% effective): This is a small t-shaped device that your doctor will place in your uterus to prevent implantation and pregnancy. It contains 0.6%: copper ions which act locally to inhibit sperm and prevent implantation. Pros: it’s inexpensive, contains zero synthetic hormones and allows you to still ovulate regularly. It’s also extremely cost effective at around $100 for 3 – 5 years. Cons: it can cause heavier periods, especially in the first 3 – 6 months, and should typically be avoided if you struggle with anemia or already have heavy and painful periods. IUD users were also found to have higher serum copper compared to non-users. This is similar to levels found in women on the pill which also raises copper levels significantly beyond normal levels and can be corrected with zinc supplementation (please test first and work with your ND to ensure the correct form and dosing).
- Progestin-Containing IUDs (99.9 – 99% effective): There are 3 types currently available with varying levels of progestins. Mirena is the most commonly prescribed and has been on the Canadian market the longest. It releases the most progestins at a level of 20 μg / day and results in a 20% patients losing their monthly cycles. Kyleena releases 9 μg / day with 12% of it’s users loosing their ability to ovulate and cycle. Skyla has the lowest level of progestin at 6 μg / day. It prevents menses and ovulation in only 6% of women but is slightly less effective than the other 2 methods at 4 pregnancies per 1000 users (vs. 2 pregnancies per 1000 users for the first two options). Pros: Effects of synthetic hormones are mostly local. Progestin IUDs are highly effective and can reduce excessive flow in women with endometriosis and fibroids by up to 90%. Cons: This form of IUD is much more expensive than the copper version at around $400 for 3 – 5 years. There’s also a 10% chance of progestin-related side effects including acne, nausea, headaches, cysts in the breast and ovaries, vaginal discharge (local progestin changes your cervical mucous frequency and consistency) and mood changes.
- Fertility awareness method (Efficacy varies between methods – symptothermal method has studies showing 98% effective): This type of birth control uses no synthetic hormones and has no negative impacts on your natural fertility. With fertility awareness you work with a practitioner or doctor to track your main fertile signs (cervical mucus, basal body temperature, and cervical position), to identify which days of your cycle are fertile. This is a great way for women to reconnect with their natural cycles since it involves a lot of observation and collection of objective data about your body’s own hormonal signals. Pros: all natural, preserves fertility, and helps patients develop an important understanding of, and connection to their reproductive cycle. Cons: not as effective as the pill or IUD since there’s a bigger chance for human error, and it will take up to 6 months for you to get comfortable enough with this method in order for it to be effective. Barrier methods (aka condoms) should also be used with learning FAM and during fertile times of the month.
- Condoms (98% effective): When used correctly, condoms and other barrier methods are a great choice for preventing unwanted pregnancy. Unfortunately, when used incorrectly they are only 85% effective. How to use condoms ‘effectively’: never use oil based lubricants like coconut oil as it will degrade the latex in condoms, and make sure you partner is always using the correct size condom (sorry guys but you’re not all a size XL). Pros: Condoms can be an excellent and convenient choice for preventing pregnancy when you use the correct fit and appropriate lubricants. They’re cheap, non-invasive and contain no synthetic hormones. They are also way more effective than any of the other methods of birth control at preventing STIs. I see so many women with incurable sexually transmitted infections like HPV and herpes because being on the pill gave them a false sense of sexual security, so they never got into the habit of using condoms. Cons: less effective than the pill or IUDs and some women find the latex in condoms to be irritating to the vaginal mucosa. Fortunately there are many companies now making non-latex based condoms. Important note: If your partner complains or refuses to use condoms because he “doesn’t like them” or “they don’t feel good” then he’s a selfish idiot and you should ditch that dude pronto. Condom technology has come a long way in the past decade and brands like Kimono & Sir Richards are thin, comfortable and unlikely to cause irritation to both partners.
- Plan B / “The Morning After Pill” (95% effective if taken within 24 hours): Plan B is definitely not a great stand-alone option but can be taken within 24 hours of an accidental condom breakage to prevent pregnancy. Plan B works by delivering high levels of synthetic progestins to stop the release of an egg from the ovary, prevent fertilization and to stop a fertilized egg from attaching to the uterus. Pros: cost-effective at $30 – 40 and easily available at your pharmacy. It can be a good ‘safety net’ for occasional condom-breakage but is not a good first line agent for preventing pregnancy. Cons: See problems with progestins above! Regular use of plan B can disrupt natural hormone cycles and cause side effects like excess bleeding, mood swings and acne.
Bottom line: the pill can prevent pregnancy and may be effective at clearing symptoms of hormonal imbalances like acne and irregular cycles. Unfortunately it does this by overriding your natural cycles and essentially shutting down your endocrine system. The pill doesn’t actually address the imbalances at the root of your irregular periods, acne or cramps. These symptoms are your body’s way of telling you that something is not right in your hormonal system and taking the pill for hormonal imbalances is like putting a bandaid over a bullet hole. Sure, you may stop the bleeding for a while and you can no longer see the wound, but you’ve clearly not solved the problem. Out of sight does not equal out of mind when it comes to women’s hormones and this one-size-fits-all approach is not a good enough solution for your hormonal issues.
If you live in the GTA and want to developed your own personalized hormone balancing protocol, or want help coming off the pill with limited side effects, you’re welcome to book in for an initial consultation or contact me via my website for additional information.
*Note: online services provided by Dr. Sarah to those of you living outside of Ontario are delivered as a Certified Functional Medicine practitioner consult and not as an Naturopathic doctor appointment & as such they will not be eligible for reimbursement through private insurance.
- Petit MA, Prior JC. Exercise and the hypothalamus: ovulatory adaptions. In: Warren MP, Constantini NW, editors. Sports Endocrinology. Totowa, New Jersey: Humana Press, Inc.; 2000.
This information is not intended as a substitute for the advice provided by your Naturopathic doctor or primary care physician. Do not use the information in this document for diagnosing or treating a health problem or disease. Always speak with your Naturopathic doctor before taking any medication or nutritional or herbal or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read online.