Why I ditched the birth control pill.

Did you know that by 2013, two-thirds of American women ages 15 to 44 used some kind of contraception, most commonly the oral contraceptive pill? And for a while, I was no exception: Iโ€™ve been on the birth control pill twice in my life, both times at the recommendation of my doctorโ€”once when I was 16 to help control my acne, and then again at 21 for my hirsutism. 

In neither instance did I find that it helped much, and in the latter case, it only exacerbated my issues and even brought new ones to the surface. But it wasnโ€™t until much later in my health journey that I fully grasped why the pill was not the answer to my problems, despite the assurance of multiple medical professionals. If youโ€™re struggling with PCOS or hormonal imbalances of any kind, Iโ€™m willing to bet itโ€™s not the answer to yours either. So, without further ado, I give you the main reasons I ditched the pill (and never looked back):

My symptoms got worseโ€”and new symptoms appeared.

At the time, this was the main reason I stopped taking the pill. It simply wasnโ€™t doing anything for my symptoms, and since my acne and hirsutism were why I was prescribed the pill in the first place, I decided to quit based solely off of this observation alone. I also began noticing other symptoms crop up as well, including daily headaches, fatigue, and digestive issues. In fact, during my second go-around with the pill, I didnโ€™t have a bowel movement for seven whole days at one pointโ€”a major no-no as far as health goes, and not to mention super uncomfortable!

I didnโ€™t want to shut off my hormones, I wanted to heal them.

Before we go any further, itโ€™s important to understand how the birth control pill works, so that I can better explain why it didnโ€™t work for me.

According to Dr. Jolene Brighten, the leading expert in post-birth control syndrome, there are a couple of options when it comes to the pill: 1) combination and 2) progestin-only. The combination pill contains both the synthetic forms of estrogen and progesterone (more accurately called progestin), whereas the progestin-only pill does not contain any estrogen. Regardless of which kind you take, they both work by โ€œsuppressing the signals from your brain to your ovaries and altering natural function of the reproductive system.โ€

Simply put, the pill shuts down your bodyโ€™s natural process of producing hormones and replaces those helpful hormones with contraceptive drugs (that, I might add, do not have the same molecular structures or provide the same benefits as real hormones) in order to trick your body into thinking itโ€™s already pregnantโ€”or, as Dr. Lara Briden puts it, in a sort of โ€œchemical menopause.โ€

Just typing that makes me shudder.

The reason the pill didnโ€™t work to balance my hormones or even temporarily quiet my symptoms? Come to find out, I was struggling with low progesterone (aka estrogen dominance) and borderline high testosterone brought on by insulin resistance and high cortisol. By pumping my body full of man-made estrogen and progesterone (progestins), the pill did absolutely nothing to address either issue. 

Progestins are not the same thing as progesterone. In fact, they are actually closer in similarity to testosterone, which is why the progestin-only pill can cause hair loss and other negative side effects. Bringing me to my next point...

Synthetic โ€œhormonesโ€ are not health-promoting, and can even be dangerous.

In a recent interview, Functional Medicine Doctor and Womenโ€™s Health Guru Aviva Romm explains how these so-called โ€œhormonesโ€ are inflammatory to the body, affecting both your microbiome and gut health (which could explain why my digestion went to shit so fast), depleting necessary B vitamins, and making you more insulin resistant over time. Umm, not helpful for someone with signs of PCOS!

Despite all of this, my OB/GYN at the time failed to discuss these potential side effects with me, and so I blindly agreed to go on the pill without any knowledge whatsoever of the negative impact it could have on my body. (This is why I will always encourage my clients to be their own health advocate and do their own research.)

Something else your doctor might forget to mention? Estrogen and progestin-containing birth control pills have been linked to low libido (oh the irony!), depression, weight gain and/or metabolic syndrome, blood clots, and headaches. Ask yourself one question, ladies: Would your man take the equivalent if it meant agreeing to these risks?!

And if those side effects arenโ€™t bad enough, evidence suggests that the pill increases your risk of heart attack and stroke (especially in women who suffer from migraines), gallbladder disease, liver tumors, and certain cancers. As a borderline hypochondriac who hopes to live a relatively illness-free life, reading this after I started taking the pill scared the bejeezus out of me. I donโ€™t know about you, but I think women deserve better.

Okay, letโ€™s back up: Does this mean that everyone who takes the birth control pill ends up suffering from one or more of these conditions? No, thank goodness. But for me, choosing to stay on the pill came down to a benefit vs. risk analysis, and in my situation, the risks far outweighed the benefits.

The pill wasnโ€™t supporting my bodyโ€™s natural rhythm.

Even as young as 21, I knew that I wanted to have kids someday, and the thought of impairing my ovulation for any length of time sort of freaked me out. What if, after getting off of the pill, my hormones never switched back on, I worried? While this scenario seemed unlikelyโ€”I knew of many women that had gone on to have successful pregnancies after previously using the pillโ€”sadly, my fear of post-pill infertility turned out to be a rational one.

โ€œMost women that come to me who have been on birth control for a long time find that it can take up to a year after theyโ€™ve gone off the pill for their cycles to return to normalโ€”even if theyโ€™ve been on birth control for just six months or so,โ€ explains Romm.

Post-pill amenorrhea is defined by the absence of menses for at least six months after discontinuing the birth control pill, and startling enough, itโ€™s been reported that 3-6% of women who stop the pill may never see their periods return. Uhh, say what now? Also not encouraging for women like me: If you experienced irregular periods prior to the pill (*raises hand*), your odds for post-pill amenorrhea go up.

But even if/when period does return, thereโ€™s a chance that your cycles may continue to be anovulatory (or without ovulation) for months or yearsโ€”a condition that has been referred to as โ€œpill-induced PCOS,โ€ which can also be accompanied by acne, ovarian cysts, or a high LH to FSH ratio. Not fun!

THE IMPORTANCE OF MONTHLY OVULATION

Whether or not you want children in your future, whatโ€™s been made abundantly clear in my research of womenโ€™s health is that ovulation is absolutely critical to our wellbeing as women. I repeat: Ovulation is not just for procreation.

Just ask Endocrinology Professor Jerilynn Prior, who writes that โ€œovulatory cycles are both an indicator and a creator of healthโ€ (emphasis mine). 

Without regular ovulation, our bodies donโ€™t produce enough estrogen or progesterone to keep our health in tip-top shape for years to come. Progesterone in particular is crucial for  cardiovascular health, hair growth, quality sleep, and preventing breast cancer. (Letโ€™s just say, the more progesterone you have stored up in your body when menopause comes knockinโ€™, the better off youโ€™ll be!) Without sufficient amounts of this important natural hormone circulating through our bodies, we are more likely to come face-to-face with life-altering conditions such as PCOS, infertility, bone loss, and even some cancers.

If you read my full story, you know that this is essentially what happened to me: The combination of stress and under-eating in my late teens caused my period to disappear for more than a year, which led to a host of health issues in my 20s (including PCOS and hypothyroidism). To throw fuel on the fire, I was on and off the pill during those critical reproductive years as well.

It was only once I quit the pill and learned to support my bodyโ€™s natural rhythm through cycle syncing that I was able to reach a level of health I felt good about.

CONTRACEPTION: WHATโ€™S A GIRL TO DO?

Okay, okay. I think Iโ€™ve run my point into the ground: The pill, in my opinion, is not the best option for anyone, with the possible exception of women who use it to treat severe endometriosis or heavy, painful periods. (Even then, I recommend working with a naturopath to get to the root cause of the issueโ€”whether it be inflammation, immune dysfunction, hormonal issues, etc.โ€”and heal your body naturally.) 

But what if youโ€™re not on the pill for health reasons at all, and would simply prefer not to have kids at the moment? Contraception is the #1 reason most women go on the pill, after all, so it must be addressed.  

For the purpose of avoiding pregnancy, I recommend two methods. The first might get me some eye rolls, as I believe itโ€™s widely misunderstood, but hear me out! Natural family planningโ€”or the Fertility Awareness Methodโ€”is the method that my husband and I used during the first several years of our marriage, and it was also the catalyst for my becoming educated on the topic of womenโ€™s health. Before NFP, I had no idea that my cycle was made up of โ€œphases,โ€ or what my hormones were supposed to be doing during those phases. In addition to opening up a whole new world of knowledge of my bodyโ€™s functions, using the Creighton Model also led me to seek the NaProTechnology OB/GYN that diagnosed me with PCOS and ultimately put me on the path to healing. #worthit

Hereโ€™s the catch: Although this method has been found to have a success rate of 99% when executed correctly to avoid pregnancy, charting your cycle takes effort and commitment, and has a bit of a learning curveโ€”but definitely pays off in the end. While youโ€™re just starting out, a fertility tracker might also be helpful to make the transition easier. I swear by the Ava bracelet, which uses 5 physiological signs to determine your fertile window while you sleep! (Keep in mind, Ava is not to be used alone to avoid pregnancy, as fertility trackers are not always spot-onโ€”but in conjunction with charting, I think itโ€™s a great tool for family planning.)

Secondly, if tracking your cycles is just not going to provide you with the same peace of mind that birth control does/did, Iโ€™d rely on the good olโ€™ fashioned barrier method to give you that extra assurance. Condoms might not make for the most romantic sex in the world, but they get bonus points in my book because of their dual protection from most STDs. (If we know anything about female fertility, itโ€™s that keeping our reproductive areas free from bacterial and virus exposure is vital!) One caveat, though: Always choose unlubricated, non-spermicidal condoms for optimal health down yonder for both you and your partner.

What about an IUD?

Whether weโ€™re talking about the hormonal IUD like Mirenaโ€”which still suppresses ovulation some of the timeโ€”or the copper IUD, a slightly better alternative, both create local inflammation while chemically changing the lining of the uterus, and are associated with heavy/irregular bleeding, bacterial vaginosis, and pelvic inflammatory disease. 

Not getting pregnant may seem like the most important thing right now, but are these more โ€œconvenientโ€ methods really worth the expense of your long-term health?


References & Resources:

The Period Repair Manual | Dr. Lara Briden, ND

How Do Birth Control Pills Work | Dr. Jolene Brighten, ND

The Problem with Hormonal Birth Control | Experience Life Magazine

Period Missing After the Pill? | Dr. Jolene Brighten, ND

The Pill: Are the Risks too Bitter to Swallow? | Dr. Aviva Romm, MD

How Birth Control Switches Off Hormones and Why That Matters | Dr. Lara Briden, ND

Contraceptive Choices | Dr. Jerilynn C. Prior, Endocrinology Professor

The Crucial Difference Between Progesterone and Progestins | Dr. Lara Briden, ND

Effectiveness of the System | Creighton Model FertilityCare System

How Harmful Is the Pill? | Alisa Vitti, HHC, AADP

Temporary PCOS? Explaining Pill-Induced PCOS | Dr. Shawna Darou, ND

5 Side Effects of the Pill That No One Tells You About | Nicole Jardim, Certified Womenโ€™s Hormonal Health Coach

The Pros and Cons of the Hormonal IUD | Dr. Lara Briden, ND

The Pros and Cons of the Copper IUD | Dr. Lara Briden, ND

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