What every woman should know about hormonal birth control

Allow me to preface this article by saying that in absolutely no way am I trying to suggest what a woman should or should not do with her body. My goal is to share information that I don’t believe is being discussed fully with women by their healthcare providers based on both my own experiences and that of my clients. The choice is ultimately yours to make, and knowledge is power.

Know that you are not getting the full or accurate story if you’ve been told that hormonal birth control will “reset your cycles”. After reading this article, you’ll see that isn’t how hormonal birth control works, and yet it is frequently described by health practitioners as doing exactly that. Also know that you are not getting a complete or accurate story if you are told that hormonal birth control will cure painful, heavy periods without any long term consequences. That was the story I was told back when I was a teen, before my cycles even had a chance to regulate themselves. The truth is it can take years for hormones to regulate and while that’s completely normal, there are also healthy, effective alternatives so that there isn’t needless suffering along the way. With more than 15 years taking “the pill” behind me, I now know that I was one of many women who were not given accurate information hormonal birth control by many of my providers along the way.

This article is a labor of love, written to empower women to make educated decisions about their reproductive health.

Hormonal birth control is widely used by women around the world as an effective method of preventing unwanted pregnancy. They have allowed women to take control of their fertility in a way that had never been possible before. But, although the traditional medical community thinks they are completely safe, new research is revealing some pretty significant side effects of using hormonal birth control. These long-term consequences should be disclosed to women seeking to prevent pregnancy so they are able to make an informed decision.

How does hormonal birth control work?

One of the most common forms of hormonal birth control are oral contraceptives, also known as birth control pills. Birth control pills supply a woman with man-made versions of two main reproductive hormones, estrogen and progesterone. These synthetic hormones found in the pill work to prevent pregnancy by suppressing a woman’s natural production and regulation of estrogen and progesterone.

Most birth control pills are taken for 28 days, which includes three weeks of hormone containing pills and one week of placebo pills. The timeline is designed to replicate a woman’s natural menstrual cycle and women still experience a monthly bleed during the week of placebo pills. However, women on birth control pills are not truly menstruating.

During a woman’s natural menstrual cycle, estrogen levels rise and fall during the four phases of her cycle: menstruation, follicular, ovulation, and luteal phases. Ovulation occurs when a mature egg is released from the ovaries ready to be fertilized. This phase occurs about halfway through the menstrual cycle following a rapid spike in estrogen levels. If a male sperm does not fertilize an egg during the fertile ovulation phase, menstruation will occur approximately two weeks later. Menstruation is how a woman’s body sheds unfertilized eggs and accumulated uterine lining.

Women taking birth control pills receive a steady amount of estrogen through the month, which overrides their natural estrogen production and suppresses ovulation. Without a monthly spike in estrogen, ovulation will not occur and no eggs are released while taking birth control pills. Therefore, a woman will not be able to get pregnant if ovulation is suppressed.

The synthetic hormones in the pill also help prevent pregnancy by causing physical changes in a woman’s reproductive organs. A woman’s cervical mucus thickens and the lining of the uterus is altered on the pill, resulting in an environment where fertilization of an egg by a sperm would be difficult and unlikely to occur.

The monthly bleeding experienced during the week of placebo birth control pills is known as withdrawal bleeding. The week 4 bleeding experienced on birth control pills is the body’s response to a sudden change in synthetic hormone levels. The hormones suddenly drop off, which causes bleeding from the uterus. The monthly bleeding is often lighter and less symptomatic than a normal menstrual period due to the fact there is no unfertilized egg or uterine lining for the body to shed. Many women still refer to this week as their “period,” but as you can see it is not the same.

In addition to preventing unwanted pregnancy, birth control pills are also commonly prescribed to women suffering from acne, migraine headaches, and heavy or painful menstrual periods.

An excess of estrogen is often the root cause behind many women’s health issues. It’s common for women to have abnormally high levels of natural estrogen. Lifestyle factors, like poor nutrition, lack of physical activity, unmanaged stress, and poor sleep habits, all contribute to the production of too much natural estrogen.

Birth control pills can be an effective solution for women suffering from hormone related health issues. Providing a woman with steady amounts of synthetic hormones can override erratic estrogen levels and provide relief from unpleasant symptoms, especially during menstruation.

However, relying on the pill to treat headaches, difficult periods, and skin issues tend to mask root cause of the problem. Taking synthetic hormones to suppress natural hormones does not correct the underlying cause of the hormonal imbalance.

There’s no doubt women can experience tremendous benefits and freedom using birth control pills. But, like all prescription medications, using birth control pills does not come without some adverse health risks. Let’s explore some of the less desirable effects birth control pills can have on your body and health.

Birth Control Pills Can Increase Your Risk of Developing Nutrient Deficiencies

Research has found that women who use birth control pill have lower blood levels of the following important vitamins and minerals compared to women who don’t take the pill:

B Vitamins: Riboflavin, Vitamin B6, Vitamin B12, and Folic Acid
B vitamins play crucial roles in many biological processes, including metabolism of carbohydrates, protein, and fats, energy production, mood regulation, synthesis of DNA and red blood cells, and normal brain and nervous system function.
Getting enough B vitamins, especially folic acid, is critical for women of reproductive age due to their critical role in metabolism and DNA synthesis. Folic acid plays an important role in human development and is essential for healthy pregnancies and preventing birth defects.
Signs of B vitamin deficiencies include fatigue, decreased energy, headaches, confusion/brain fog, and changes in mood.
Vitamins C & E
Powerful antioxidants that help boost immune system function, protect your body from inflammation and cellular damage, and promote healthy skin.
Getting enough Vitamin C is important to prevent iron deficiency and anemia. Vitamin C increase the absorption of iron from food.
Deficiency is rare, but decreased immunity (i.e you may suffer from more colds and viruses than normal) may be a sign of low nutrient levels.
Magnesium, selenium, and zinc
Minerals that play a role in several hundred chemical reactions in the body, including metabolism, hormone regulation, immune system function, and disease prevention.

The biological mechanism of how birth control pills alter these nutrient levels isn’t clearly understood. Researchers and healthcare professionals believe that most prescription and over-the-counter medications, including birth control pills, cause changes in the health of the small intestine (more on that later), which disrupt the digestion and absorption of food and nutrients. This link may play a role in decreasing the bioavailability of certain key vitamins and minerals, making it difficult to absorb these important nutrients. Metabolism of medications also requires nutrients, which creates an increased need for certain nutrients.

It’s unlikely you’ll become entirely deficient in any of the above-mentioned vitamins or minerals simply due to using birth control pills. But, the longer a woman takes the pill, the more time she is at risk for developing altered nutrient levels. Also, combined with other factors that can impact nutritional status, like medication use, poor diet, chronic inflammation, and illness, slightly altered nutrient levels from the pill can increase your risk of developing a full-blown nutrient deficiency. Almost across the board, the clients I see in practice that have been on hormonal birth control for awhile, are deficient in folic acid, vitamin B12, magnesium and more. These nutrients are key to a healthy pregnancy so it can make it more difficult to conceive, or complicate a pregnancy if they are depleted prior to conceiving.

If you take birth control pills and are concerned your nutrient levels may be out of balance, consider getting your nutrient levels tested (I do this in my practice with clients), using quality nutrient supplements targeted at your needs, and make sure you eat a varied diet that includes plenty of foods rich in vitamins and minerals. Some nutrient-rich food sources that contain commonly depleted nutrients include:

Leafy green vegetables, like spinach – B vitamins, Vitamin C, Vitamin E, and magnesium
Nuts and seeds
Almonds – good source of vitamin E
Pumpkin seeds – good source of magnesium and zinc
Brazil nuts – good source of selenium
Seafood and shellfish – Zinc
Beans and lentils – B vitamins, folic acid, zinc
Citrus fruits, strawberries, tomatoes, and bell peppers – Vitamin C
Dark chocolate – Magnesium
Meat, eggs, and dairy – B vitamins and zinc

Birth Control Pills Can Disrupt the Health of Your Gut

If you regularly experience bloating, gas, constipation, diarrhea, or other digestive system upset, it could be a sign of an imbalanced gut. Most of us are quick to dismiss stomach trouble as an isolated incident of irritable bowel in response to something we ate. However, stomach and digestive distress can be symptoms you’re suffering from an imbalance in your intestinal microbiome.

Our intestines are where everything you orally take in from the outside world – food, medication, and supplements – are processed and absorbed into the bloodstream for transport to the rest of the body. The intestines are also the primary hub for your microbiome – the good-for-you bacteria, also known as gut flora, which helps maintain the lining and function of the intestines. The bacteria also help digest the food you eat, enhance nutrient absorption, and keep your bowels running smoothly.

Dysbiosis or a bacterial imbalance in the intestine results when there isn’t enough “good” bacteria in relation to “bad” bacteria in your gut. When this occurs, the digestion and absorption of nutrients can be impaired. Over time, dysbiosis can also cause the lining of the small intestine to weaken and become damaged.

The microbiome does more than just maintain a healthy digestive environment. It’s believed to also play a large role in immune system function. When out of whack, a compromised intestinal environment is thought to be the root cause of many health issues, including inflammatory bowel disease, diabetes, obesity, cardiovascular disease, autoimmune disorders, mood disorders, and food allergies and intolerances.

Anything that promotes inflammation in the body can contribute to dysbiosis in the gut. In fact, the same lifestyle factors that can throw your hormones out of whack, like diet, sleep, and stress, can cause inflammation in the intestines and end up disrupting your gut microbiome.

Another major cause of microbiome imbalance and compromised gut health is the use of oral medications. You might have heard antibiotic use can disrupt gut health, but the same is true for any medication that passes through the intestine, including prescription drugs, NSAIDS, like ibuprofen, and yes – even birth control pills.

A 2013 study that followed 230,000 American women concluded that oral contraceptive use is linked with an increased risk of developing inflammatory bowel disease. Compared to women who never used the pill, birth control pill users were found to have a higher risk of developing Crohn’s disease. The risk was greatest among birth control pill users whose genetic makeup made them more susceptible to gastrointestinal disease.

Research has also found the gut microbiome and estrogen levels have a synergistic relationship. Healthy levels of natural estrogen help create a diverse population of healthy bacteria in the gut and maintain the lining of the gut. A healthy gut microbiome regulates the metabolism of estrogen and impacts blood levels of estrogen.

Some studies have found that an imbalanced intestinal environment results in estrogen imbalances, which can impact fertility and increase a woman’s risk of developing hormone-related disease, like endometriosis, polycystic ovary syndrome, certain cancers, and obesity.

Overriding your body’s natural estrogen production of estrogen with long-term use of birth control pills may throw this gut-estrogen relationship out of balance and increase your risk of gut and hormone related health issues.

Long-Term Birth Control Pill Use May Increase Your Risk of Diabetes Later In Life

Yep, there’s more! An alarming recent study suggests birth control pills affect your blood sugar health and can increase your risk of insulin resistance and diabetes well past your reproductive years.

The researchers found a positive association between birth control pill use and the development of type 2 diabetes later in life. The study included over 6000 post-menopausal women and found a higher prevalence of diabetes among those who had taken the pill for more than six months earlier in life.

The study also found increased blood sugar and insulin levels among the non-diabetic former birth control pill users compared to women who had never taken the pill.

After adjusting for other factors, the researchers estimated the risk of developing diabetes post-menopause to be 35% higher for women who have used the pill greater than six months. Most birth control pill users remain on the pill much longer than six months. Additional research is needed to determine whether years of hormonal contraceptive use further increases the risk of diabetes.

Your reproductive hormones are not isolated to the role of your reproductive and sexual health. Hormones interact with each other and are responsible for regulating health throughout the body. When there is an imbalance in one hormone, others, like insulin, can be altered in a domino-like effect.

Using synthetic hormone drugs in the form of oral contraception change your body’s natural regulation of estrogen and progesterone, which can have long-lasting effects on your health.

If you found this article helpful, please share it with other women in your life! Perhaps especially mama’s of adolescent girls who may be faced with having to decide whether or not to put their daughter on the pill. Know that there are healthy effective alternatives to balancing hormones in teens and adults and also a number of effective, non-hormonal birth control options available.

If you believe your hormones are out of balance, you have nutrient deficiencies, difficulty conceiving, or want to come up with a solid plan to prepare for pregnancy post birth control pill, learn more about working with me here. When your hormones are balanced, other aspects of your body’s functioning fall into balance as well including digestive health, skin health, mood and emotions and more.

Here’s to empowered women making educated choices about their bodies!

References

https://www.ncbi.nlm.nih.gov/pubmed/23852908

https://www.ncbi.nlm.nih.gov/pubmed/28042926

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017946/

https://www.ncbi.nlm.nih.gov/pubmed/28778332

https://www.ncbi.nlm.nih.gov/pubmed/26901277

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

https://www.ncbi.nlm.nih.gov/pubmed/?term=Use+of+Oral+Contraceptives+at+Child-Bearing+Age+Are+Associated+with+the+Prevalence+of+Diabetes+in+Postmenopausal+Women