This week's post is a guest post from hormonal health coach, Kara DeDonato of Libera Wellness. She's an NYC local and, like Katinka and I, is super passionate about giving women tools to use the Fertility Awareness Method. This piece is a two part-er. Part 1 will cover effects from your hormonal birth control you might not have covered with your gyno (like a decrease in clitoris sensation!) Part 2 will delve into supporting your system coming off hormonal contraception to make a smooth transition to using FAM.
My entire journey to becoming a women’s fertility coach started with one simple desire: to go off of my hormonal birth control without a recurrence of acne or the loss of my period.
I had been on the pill for nearly a decade, and while I had no major symptoms prior to taking it, each time I tried to go off of it my period slowly deregulated and disappeared completely, and my skin broke out in tons of angry little bumps along my jaw line, and on my chest and back. Not fun.
Ultimately, I decided that, as a healthy twenty-something year old, I should not need to be on a prescription medication to manage my cycle or skin. I began to research how to go off of the pill without these unwanted side effects and what I started to learn about the hormonal contraception I had been taking for years shocked me.
The birth control pill and other hormonal contraceptives were simply not created to cure any period-related ailment. They were also not created with long-term use in mind, and the effects of long-term hormonal contraceptive use are still being studied.
While the pill and hormonal methods of contraception do an excellent job at preventing pregnancy, they do not come without risks. I remain grateful for the years of safety from unwanted pregnancy that it provided. However, I do wish I learned more about the downside to the pill earlier in my life and believe it would have affected my choices if I had.
CANCER RISK
The World Health Organization lists it as a Class One Carcinogen. This is the highest classification for a cancer-causing agent. It's been on their list, despite the periodic review of new lower-dose pills, since 1999.
While it's true that the pill does lower your risk of ovarian cancer, the high levels of estrogen it contains could put you at a higher risk of breast cancer. Recent studies on women in their teens and twenties taking the pill continuously have indicated that it increases breast cancer risk by as much as 40%.
DEPLETION OF NUTRIENTS
Hormonal contraceptives rob your body of essential nutrients. Metabolism of birth control hormones by the liver requires extra B-complex vitamins, vitamin C, magnesium, zinc and selenium. B-complex vitamins play a major role in happiness, stable mood and warding off depression and anxiety. Magnesium is essential to over 300 biological processes and also plays an important role in stress and anxiety management. These same nutrients are also critically important to pregnancy and the developing fetus.
COMPROMISED GUT AND LIVER FUNCTION
The birth control pill compromises gut health. The pill can have a similar affect on gut flora as antibiotics - that is, it can kill the good bacteria and make way for bad bacteria and organisms like candida to colonize the intestinal tract. This compromises digestion (further exacerbating nutrient deficiencies), increases inflammation in the body, and could even weaken the immune system. This can also lead to increased frequency of yeast infections. It is also bad news for acne-sufferers as recent studies have found connections between plentiful gut bacteria and clear skin.
The extra work the liver has to do to break down excess synthetic hormones often results in a dark spot on the liver, visible on the liver by X-rays. Some women even develop benign liver tumors. Adverse affects have not been connected to either condition, but a dark spot on the liver still sounds pretty scary to me.
ANATOMY AND SEX DRIVE
The birth control pill can alter a woman's actual anatomy. A 2013 study in The Journal of Sexual Medicine found that "after only three months of use, pill users had thinner labia, smaller clitorises and a decreased entrance of the vagina." A study on Yaz showed that after only 3 months, some women's clitorises had decreased in size by 15%.
The hormones in the pill dry up the crypts that make cervical fluid, (think natural lube) and even age the cervix twice as fast. This can also weaken orgasms. That same study showed decreased orgasm, measured by both intensity, frequency and ease of achievement, in the women on the pill. Other studies have indicated that the pill can even decrease the frequency of sexual thoughts.
It may alter sex drive - even after you stop taking it. The pill causes the liver to make a protein, sex-hormone-binding-globulin (SHBG), in excess. Normal levels are 20-30 nmol/L and pill users often have levels of 200-300 and up to 500 nmol/L. SHBG binds to free testosterone, which is primarily responsible for sexual response, and makes it unavailable. Even after six months off the pill, former pill users still had elevated levels of SHBG.
BRAIN-OVARY COMMUNICATION
Hormonal contraceptives disrupt communication between the ovaries and brain. Because the pill pumps a woman's body full of all the sex hormones she needs, your brain no longer needs to tell the ovaries to produce the appropriate amount of sex hormones (estrogen, testosterone, progesterone). With long term pill use, this pathway erodes and it can take months (or years) to re-establish after pill use stops.
Until healthy function is restored, women are likely to experience fatigue, hair loss, dry skin and brittle nails, irregular periods, or potentially no periods at all. Women are also more likely to develop ovarian cysts when coming off the pill, and may experience oral contraceptive withdrawal symptoms like headaches, pelvic pain, and nausea. After long-term use of greater than one year, all women will experience some variety of symptoms.
PARTNER CHOICE
The pill could affect your choice of long-term partner. The birth control pill changes preferences when it comes to selecting a mate. Studies show that women on the pill rate slightly more feminine male faces as more attractive than their counterparts, who opt for more traditionally masculine features.
Women on the pill are also more attracted to men with a similar chemical makeup, as detected subconsciously via smell. Women not on the pill generally select mates with a dissimilar chemical makeup - biologists believe this was an evolutionary mechanism to diversify the genetic material of the child, decreasing the chances of recessive and potentially disordered or weak traits. It's possible that if a woman selected her partner while on the pill that she may find him less attractive when she goes off of it.
FUTURE FERTILITY
Past-users of hormonal contraceptives may experience difficulty conceiving. Recent studies have shown that women are twice as likely to have difficulty conceiving after long-term contraception use. This is sometimes attributed to the weakened connection between the ovaries and brain, and subsequent low levels of progesterone, the pregnancy hormone. Nutritional deficiencies may also be a contributing factor. Additionally, many women are prescribed the birth control pill for irregular periods or conditions like endometriosis and PCOS - these women who may have had difficulty ovulating (and therefore conceiving) before pill use, will find that the underlying issues still exist and may have worsened when they go off their hormonal contraceptive.
Doctors will often point out that many women are able to conceive within six months after terminating pill use. However, some studies indicate that women who conceive soon after going off the pill have an increased risk of miscarriage; babies with neural tube defects (which often result in a miscarriage or children born with conditions like spina bifida); or children with allergies and/or compromised gut flora (because the baby inherits the state of the mother's gut health at birth).
If you've decided hormonal contraception isn't right for you, stay tuned next week for Part 2! Kara will go in depth on ways to support your system coming off of the pill! (Or ring, or IUD, or patch, or shot...did I cover them all?)
I had been on the pill for nearly a decade, and while I had no major symptoms prior to taking it, each time I tried to go off of it my period slowly deregulated and disappeared completely, and my skin broke out in tons of angry little bumps along my jaw line, and on my chest and back. Not fun.
Ultimately, I decided that, as a healthy twenty-something year old, I should not need to be on a prescription medication to manage my cycle or skin. I began to research how to go off of the pill without these unwanted side effects and what I started to learn about the hormonal contraception I had been taking for years shocked me.
The birth control pill and other hormonal contraceptives were simply not created to cure any period-related ailment. They were also not created with long-term use in mind, and the effects of long-term hormonal contraceptive use are still being studied.
While the pill and hormonal methods of contraception do an excellent job at preventing pregnancy, they do not come without risks. I remain grateful for the years of safety from unwanted pregnancy that it provided. However, I do wish I learned more about the downside to the pill earlier in my life and believe it would have affected my choices if I had.
CANCER RISK
The World Health Organization lists it as a Class One Carcinogen. This is the highest classification for a cancer-causing agent. It's been on their list, despite the periodic review of new lower-dose pills, since 1999.
While it's true that the pill does lower your risk of ovarian cancer, the high levels of estrogen it contains could put you at a higher risk of breast cancer. Recent studies on women in their teens and twenties taking the pill continuously have indicated that it increases breast cancer risk by as much as 40%.
DEPLETION OF NUTRIENTS
Hormonal contraceptives rob your body of essential nutrients. Metabolism of birth control hormones by the liver requires extra B-complex vitamins, vitamin C, magnesium, zinc and selenium. B-complex vitamins play a major role in happiness, stable mood and warding off depression and anxiety. Magnesium is essential to over 300 biological processes and also plays an important role in stress and anxiety management. These same nutrients are also critically important to pregnancy and the developing fetus.
COMPROMISED GUT AND LIVER FUNCTION
The birth control pill compromises gut health. The pill can have a similar affect on gut flora as antibiotics - that is, it can kill the good bacteria and make way for bad bacteria and organisms like candida to colonize the intestinal tract. This compromises digestion (further exacerbating nutrient deficiencies), increases inflammation in the body, and could even weaken the immune system. This can also lead to increased frequency of yeast infections. It is also bad news for acne-sufferers as recent studies have found connections between plentiful gut bacteria and clear skin.
The extra work the liver has to do to break down excess synthetic hormones often results in a dark spot on the liver, visible on the liver by X-rays. Some women even develop benign liver tumors. Adverse affects have not been connected to either condition, but a dark spot on the liver still sounds pretty scary to me.
ANATOMY AND SEX DRIVE
The birth control pill can alter a woman's actual anatomy. A 2013 study in The Journal of Sexual Medicine found that "after only three months of use, pill users had thinner labia, smaller clitorises and a decreased entrance of the vagina." A study on Yaz showed that after only 3 months, some women's clitorises had decreased in size by 15%.
The hormones in the pill dry up the crypts that make cervical fluid, (think natural lube) and even age the cervix twice as fast. This can also weaken orgasms. That same study showed decreased orgasm, measured by both intensity, frequency and ease of achievement, in the women on the pill. Other studies have indicated that the pill can even decrease the frequency of sexual thoughts.
It may alter sex drive - even after you stop taking it. The pill causes the liver to make a protein, sex-hormone-binding-globulin (SHBG), in excess. Normal levels are 20-30 nmol/L and pill users often have levels of 200-300 and up to 500 nmol/L. SHBG binds to free testosterone, which is primarily responsible for sexual response, and makes it unavailable. Even after six months off the pill, former pill users still had elevated levels of SHBG.
BRAIN-OVARY COMMUNICATION
Hormonal contraceptives disrupt communication between the ovaries and brain. Because the pill pumps a woman's body full of all the sex hormones she needs, your brain no longer needs to tell the ovaries to produce the appropriate amount of sex hormones (estrogen, testosterone, progesterone). With long term pill use, this pathway erodes and it can take months (or years) to re-establish after pill use stops.
Until healthy function is restored, women are likely to experience fatigue, hair loss, dry skin and brittle nails, irregular periods, or potentially no periods at all. Women are also more likely to develop ovarian cysts when coming off the pill, and may experience oral contraceptive withdrawal symptoms like headaches, pelvic pain, and nausea. After long-term use of greater than one year, all women will experience some variety of symptoms.
PARTNER CHOICE
The pill could affect your choice of long-term partner. The birth control pill changes preferences when it comes to selecting a mate. Studies show that women on the pill rate slightly more feminine male faces as more attractive than their counterparts, who opt for more traditionally masculine features.
Women on the pill are also more attracted to men with a similar chemical makeup, as detected subconsciously via smell. Women not on the pill generally select mates with a dissimilar chemical makeup - biologists believe this was an evolutionary mechanism to diversify the genetic material of the child, decreasing the chances of recessive and potentially disordered or weak traits. It's possible that if a woman selected her partner while on the pill that she may find him less attractive when she goes off of it.
FUTURE FERTILITY
Past-users of hormonal contraceptives may experience difficulty conceiving. Recent studies have shown that women are twice as likely to have difficulty conceiving after long-term contraception use. This is sometimes attributed to the weakened connection between the ovaries and brain, and subsequent low levels of progesterone, the pregnancy hormone. Nutritional deficiencies may also be a contributing factor. Additionally, many women are prescribed the birth control pill for irregular periods or conditions like endometriosis and PCOS - these women who may have had difficulty ovulating (and therefore conceiving) before pill use, will find that the underlying issues still exist and may have worsened when they go off their hormonal contraceptive.
Doctors will often point out that many women are able to conceive within six months after terminating pill use. However, some studies indicate that women who conceive soon after going off the pill have an increased risk of miscarriage; babies with neural tube defects (which often result in a miscarriage or children born with conditions like spina bifida); or children with allergies and/or compromised gut flora (because the baby inherits the state of the mother's gut health at birth).
If you've decided hormonal contraception isn't right for you, stay tuned next week for Part 2! Kara will go in depth on ways to support your system coming off of the pill! (Or ring, or IUD, or patch, or shot...did I cover them all?)
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