women's health

Your Guide to Hormonal Birth Control

There’s so much information out there about the different forms of birth control. You can Google your heart out all day, but now you don’t have to! Because I’ve taken information from multiple sources and condensed it all into a need-to-know format.

Let’s be clear – I don’t like Hormonal Birth Control (HBC). I think that in almost all cases it does more harm than good, but I am also not naive to the fact that an estimated over 70% of sexually active women around the ages of 15-44 are on some sort of hormonal birth control.

I believe that every woman deserves education about her body and especially a better understanding of what she’s putting into it.

Let’s start with 2 basic points:

A pill bleed is not a period.
The bleed you get on the pill is not a real period. It is a response to the withdrawal from the hormones. A real period comes from ovulation, which is how we get the amazing hormone – progesterone. When you’re on HBC, you don’t get to ovulate (with the exception of the hormonal IUD).

The hormones in HBC may be similar to your body’s natural hormones, but they are not the same.
Our bodies make specific hormones because we NEED them. Our bodies are designed to make a baby, whether we want one or not. There is a systematic balance between your hormones and all of your other bodily functions that requires hormonal balance.

The Mini Pill (Progestin)
The concept of the mini pill came about in 1956 and was tested in a study called, “The Puerto Rico Pill Trials.” The women who took the pill complained of many extreme side-effects, including three women who died. Their reactions were dismissed and deemed psychosomatic. (1)

The high-dose progestin pill was approved by the FDA in 1957 but taken off the market in 1988 because of the continual side effects. (2)

The mini pill is now a low dose form of progestin. It works by suppressing ovulation in most cycles while thinning the cervical lining, making it difficult for an egg to implant, and also changes the cervical fluid. (3)

Some common symptoms of progestin include:

Dizziness

Headache

Abdominal bloating

Vaginal discharge

Spotting or irregular vaginal bleeding

Amenorrhea (no period)

Prolonged periods

Loss of libido

Increase or decrease in acne

Anxiety and nervousness

Skin rash or darkened patches of skin

Bone density loss

Decrease or increase in facial and/or body hair

Breast tenderness

https://www.verywellhealth.com/progestinonly-birth-control-methods-906627

It is important that we touched on progestin first so that you could have a better understanding of the other methods moving forward.

The Combined Pill (Estrogen + Progestin)
The combined pill comes in 2 forms of: a synthetic estrogen and progestin and estradiol (naturally occurring hormone in our bodies) and progestin. The concept for the combined pill came after the mini pill as an alternative without as many supposed health risks.

The option with estradiol has typically less side effects in regards to the estrogen portion, but it does still have progestin which comes with the side effects previously stated.

Many women have a sensitivity to estrogen which is why they choose the mini-pill. Side-effects and increased conditions as a result of the combination pill include, but are not limited to: (4)

  • Depression
  • Blood Clots
  • Rash
  • Seizures
  • Fainting
  • Bloating
  • Headaches
  • Breast Tenderness
  • Breakthrough Bleeding

All in all, the pill is about 99% effective when used perfectly.

NuvaRing (Estrogen + Progestin)
The NuvaRing is a combination of synthetic estrogen and progesterone, similar to one version of the combination pill.

The NuvaRing is inserted into the vagina for 3 weeks at a time and then removed for 1 week. This happens each month, but can be done at home. It is 99% effective when used perfectly. The ring prevents ovulation, thickens the cervical mucus, and thin the lining of the uterus.

The risk of clotting is much higher with the NuvaRing than with the pill because of the hormone delivery into the bloodstream. (5)

There are other side affects as well like those previously stated that are associated with progestin.

Implant (Progestin)
The Implant is a rod that is placed within the arm. It is 99% effective with perfect use for up to 5 years. It prevents pregnancy by thinning the uterine lining, suppressing some ovulation, and thickens the cervical mucus.

See: the progestin side effects. You know the drill at this point.

Hormonal IUD (Progestin)
The Hormonal IUD is inserted by your doc and can stay in for 3-5 years depending on which brand you use. It does not completely suppress ovulation, making it the “better” form of hormonal birth control. You’re still able to make some of your own progesterone, which is better than not making some. Really poetic wording there.

The IUD may also exacerbate vaginal infections for women who are prone to them.

The IUD has been linked to depression and has been shown to alter brain chemicals. (6) Thanks progestin!

The Injection (Progestin)
So this is an injection that essentially tanks your sex hormones. It takes about 8-12 weeks for your body to cycle it out, and then you have to get another shot. It is highly effective if used on an appropriate schedule, but it has pretty severe side effects. Proge- nevermind you’ve probably caught onto the trend by now.

Changes in menstrual periods
Weight Gain
Nausea
Stomach Cramping or Pain
Bloating
Dizziness
Headache
Tiredness
Drowsiness
Irritability
Breast Tenderness
Decrease in Breast Size
Acne
Hair Loss
Decreased Sex Drive
Hot Flashes
Join Pain
Mental/ Mood Changes
Swelling
Bone Pain
Seizures

https://www.rxlist.com/depo-provera-side-effects-drug-center.htm

So those are the lovely HBC choices! What a lovely selection we have to choose from right ladies?!

Note: Understand effectiveness of Contraceptive Methods.

How This Plays A Role in Gut Health
Something that goes unmentioned too often is how HBC affects gut health. It can be just as damaging as antibiotics. Hormonal contraceptives increase estrogen which has shown to increase intestinal permeability, connecting inflammatory bowel diseases to hormonal birth control. (7)

“In two large prospective cohorts of US women, oral contraceptive use was associated with risk of [Crohn’s disease].”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465475/

HBC can increase the chance of Candida Overgrowth, which can cause symptoms like headaches, yeast infections, psoriasis, PMS, autoimmune disorders, and more. (8)

Nutritional Deficiencies
Lastly, HBC can deplete your nutrients. Studies have found that women who are on hormonal contraceptives have more nutritional deficiencies than women who are not. (9)

If you’re interested in coming off HBC to get pregnant, do some research into detoxing properly first.

“[A mother’s] [n]utritional deficiencies right at the time of conception can alter a baby’s genes permanently, scientists at the London School of Hygiene and Tropical Medicine report -“

https://www.npr.org/sections/health-shots/2014/04/29/307787984/moms-diet-right-before-pregnancy-can-alter-babys-genes

Conclusion
Hormonal birth control can potentially be necessary for those with debilitating illnesses, but it is overused as a bandaid for the general population. If a woman has something like irregular periods, PMS, acne, painful periods, or clotting, she is typically prescribed HBC instead of being encouraged to get to the root cause of why those symptoms are showing up.

Watch this for non-hormonal birth control options!

If you are on HBC and interested in coming off, I encourage you to work with a qualified healthcare professional so that the transition can be as symptomless as possible.

Sources:
(1) http://www.pbs.org/wgbh/americanexperience/features/pill-puerto-rico-pill-trials/
(2) http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/
(3) https://www.mayoclinic.org/tests-procedures/minipill/about/pac-20388306
(4) https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/about/pac-20385282
(5) https://www.npr.org/sections/health-shots/2014/02/09/273145327/nuvaring-contraceptive-settlement-leaves-women-weighing-risks
(6) https://www.bloodandmilk.com/the-link-between-iuds-and-depression-that-we-need-to-talk-about/
(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752384/
(8) https://www.medicalnewstoday.com/articles/319568.php
(9) https://universityhealthnews.com/daily/nutrition/side-effects-of-birth-control-pills-include-nutrient-depletion/

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