The Birth Control Pill: Side Effects on Health, Fertility and Menopause [Updated]
Written by Dr. Kelsi Ervin, originally posted on NCNM.
Part 1 of the Birth Control Series on hormonal health.
The birth control pill, often called the pill, offers a fascinating snapshot of how a teeny tiny dose of a lab-made chemical hormone can have a complex impact on the body. It’s a useful model for beginning to understand the power of hormones. None of us respond the same to this form of contraception, but I am here to respond to your burning questions. From a naturopathic perspective!
What is the birth control pill?
The birth control pill, the pill, is a tiny and powerful dose of hormones that help control the body’s production of hormones. The pill was developed in 1960 to help give women more choice in their ability to become pregnant. Currently, the pill is considered to be 91% effective in allowing women to avoid pregnancy.
The pill is available in many different recipes. The birth control pills formulated with more estrogen act differently in the body than the pills that have forms of progesterone. Usually, the pill is taken by a woman for 3 weeks out of the month, then for one week it is a dud- meaning there are no hormones present. This drop in hormone availability usually causes the body to have a menstrual bleed.
Why take the birth control pill?
Women are prescribed the pill to control their hormone cycles for the sake of fertility, to influence hormone cycle regularity, to suppress hormone dysfunctions that contribute to menstrual pain, and to clear acne. Is the pill effective for these needs?
Let’s find out.
What does the pill do to your body?
The pill is designed to work in the brain to suppress a woman’s natural production of hormones so that she cannot ovulate. Avoiding ovulation means avoiding a potential for pregnancy, as well as avoiding a surge of hormone production. In a normally cycling woman, mid-cycle, around 13-17 days after the first day of her menstrual bleed, ovulation occurs (an egg is released!). Then, the body builds up progesterone (the hormone that provides sleep and anti-anxiety support) to welcome a potential offspring to grow if the egg is fertilized.
Studies suggest that the hormones in the pill influence the brain primarily- causing altered neurohormones, neurotransmitters, neuropeptides, and emotional, cognitive, social and sexual behaviors (Porcu, 2019)
What are the common side effects of the pill?
In the last 40 years, scientists have realized the need for less hormones in birth control pills, leading to improved side effects. The dramatic cardiovascular risks associated with oral dosing of estrogens have greatly decreased with the lower-estrogen formulas used today. Still, the known side effects are extensive. Due to the wide range of birth control pill types and the huge variation in individual response to hormonal dosing, the side effects vary widely. If you are experiencing side effects, schedule with me for comprehensive hormone support.
Can the birth control pill cause headaches & migraines?
Headaches and migraines are increased in women using estrogen-containing pills.
Can the birth control pill make me nauseous?
Nausea is a very common side effect and the one that was most annoying to me when I was on the pill.
Can the birth control pill cause fatigue?
B12, B6, and folate deficiencies are well-established as a side effect of the pill. These deficiencies lead to fatigue, impaired reaction to stress, anxiety and sleeping concerns.
Can the birth control pill cause depression?
There is conflicting research on mental health and the pill. I have many women come see me in the clinic suspecting that the pill has impacted their mood. This absolutely makes sense due to the impact the hormones have on the brain, nutrients, and rhythms.
Does the birth control pill wreck digestion?
Some folks with leaky gut, food sensitivities, and irritable bowel experience worsening symptoms on the pill. The estrogen dosing (found in “combination” pills) increases intestinal permeability (Kahlili, 2016), which leads to disorders of the gut- inflammation and food sensitivities.
Does the birth control pill aggravate autoimmune disease?
Majority of autoimmune diseases are aggravated by the pill, though less-so by the progestin only pills.
Does the birth control pill cause blood clots, cholesterol problems, diabetes aggravation, and high blood pressure?
All of these symptoms have been shown to be caused or aggravated by the pill. Due to this combination of impacts, the pill increases risk of cardiovascular disease. These side effects may be less pronounced with progestin-only pill formulas. Women with these risk factors are recommended to request these pill formulations without estrogens. (Coussa, 2020).
Women at risk of blood clots and women with obesity should seek alternatives to the pill.
Does the birth control pill make me “hangry”?
The pill impairs glucose metabolism and promotes insulin resistance and inflammation (Both, 2019). So, getting “hangry,” “shakey”, irritable, and “edgey” is more likely. Women with known diabetes should avoid the pill when possible.
Can the birth control pill kill sex drive and orgasm?
A portion of women using the pill experience a change in sexual functioning with regard to general sexual response, desire, lubrication, orgasm, and relationship satisfaction. There is not enough research on this subject to troubleshoot which type of hormonal combination of the pill is going to have less of an impact on this issue.
Can the birth control pill make me fat?
Research confirms certain birth control pills are associated with weight gain, but not all.
Can the birth control pill cause PCOS, worsen PMDD, or cause PMS?
In the last decade or two the pill has been designed with lower doses of hormone in hopes of becoming “safer.” This is tricky, because women on these formulas can have some rebound recovery of their hormones during the dud pill week. Women with PCOS need a complex naturopathic approach- sometimes involving the pill as well as herbals. Certain types of the pill will help some of these women but can worsen the symptoms of some women with PCOS.
Does the birth control pill worsen pain?
Inflammation caused by the pill is still under investigation and hasn't been well studied. A small 2018 Australian study showed increased inflammation (CRP lab) in women on the pill.
Is the birth control pill bad?
Nothing is all bad, Not even the pill.
But if we’re going to use this stuff, we should be aware of side effects. Women deserve the reproductive freedom that an appropriate birth control can provide. Sometimes the pill is the best option.
Will the pill help with acne?
The pill has the potential for aggravating or improving acne. There is very limited research on the use of the pill for acne, but it is often prescribed this way. I have seen many women experience acne reduction when using it, but by the time they come to me, they are reporting concerns with the side effects of the pill- including mood disorders and evidence of vitamin deficiencies (energy issues).
URGENT: If you’re on antibiotics for acne, please schedule with me or another naturopathic doctor today. Antibiotic use for acne needs to be discontinued as soon as possible in favor of a safer approach for acne control. Acne is best approached holistically because the treatments that improve acne, nutritional changes and natural hormone balancing, typically provide huge upgrades for a woman’s well-being.
Is it safe to take the birth control pill nonstop to stop periods?
Gynecologists still prescribe continuous birth control pills to women who have endometriosis pelvic pain associated with their cycles. This method involves the low hormone dose every day without the 1 week break. So, menstruation is stopped entirely.
These women need a better answer. Research published in Feb 2020 reports that this method, studied in 373 women with endometriosis, resulted in worsening quality of life due to the side effects from continual dosing of birth control (Yong, 2020).
Some women with heavy periods are prescribed birth control to decrease bleeding, but research is still unclear as to whether the pill reliably decreases flow. This leads us to the option of IUDs, which are more safe and effective for controlling heavy or painful periods. I will address IUDs and other forms of birth control in Part 2 of the Birth Control Series.
Does the birth control pill affect fertility later in life?
A comprehensive research report involving more than 14,000 women, did not correlate use of the pill with change in fertility (Giram, 2018). But because of the side effects discussed, it seems feasible that fertility may be decreased for some women. For women planning for future pregnancy, it is recommended that you consult with your naturopathic doctor to address prenatal preparations.
Does the birth control pill affect menopause?
Going back to the side effects associated with use of the pill, we can presume that grown-ass women may still be impacted by conditions developed due to usage during their reproductive years. We don’t have much research on long term outcomes associated with use of the pill. Except, we know some women who took the pill during adolescence have greater risk of bone loss.
There is also evidence that the pill might increase the risk of breast cancer (Bardaweel, 2019). More research is needed.
How can I work to balance my hormones after the birth control pill?
I often recommend women start a hormone balancing journey with seed cycling. This is a simple way to use food and connection with the natural laws to start curing healthy hormone cycles internally. Hormone balancing is complex and women often need professional medical support.
Is the pill right for me?
Each woman is unique and will respond differently to the birth control pill. Thus, it is unclear who will have a positive or negative response. When it comes to pregnancy avoidance, modern medicine has some alternative options to the pill or low dose pills. We will discuss the other forms of contraception (pregnancy avoidance techniques) that have fewer side effects, in Part 2 of the Birth Control Series.
Still, the pill might be the right choice for you. If you want to go on the pill, you should choose a medical provider who educates you on the potential risks. Your questions require an individualized approach. If you’re looking for more direct coaching to balance hormones, prepare for fertility, or transition through menopause with support, schedule with me today.
My Personal Experience
Ever since I educated myself on my options, I have chosen not to take the pill, but I’ve used it.
After a late start with my period, I suffered from dramatic PMS before and throughout my period cycle- gut distress, fainting, vomiting and 10 of 10 pain for 2-3 days of my cycle. I suffered from disembodiment and despair. I missed school and work due to the pain. Eventually, I learned to control pain with high doses of ibuprofen/anti-inflammatories starting the day before my first bleed. This method of pain control dramatically worsened my gut health and led to food sensitivities.
In my twenties...
My medical doctor suggested birth control pills. Within a year of taking the pills, I was depressed for the first time. I didn’t realize the connection for a couple years. My dramatic hormones were suppressed which improved many of my cycles, but my spirit was also suppressed and I couldn’t stand it. I tried different pills, but the depression didn’t lift until a few months after I discontinued the pill.
After discontinuing the pill...
I wasn’t nauseous all the time anymore.. Gosh, didn’t even know that was associated! I didn’t have a period for a year, then life-altering menstrual pain re-accompanied most cycles. I returned to over-use of anti-inflammatories without realizing the long term gut issue I was creating. Finally, when I was 26, I found a naturopathic doctor for the first time. She helped restore my vitamin deficiencies and prescribed naturopathic medicine to balance my hormones. I continue to use herbal medicines daily to help keep my hormonal cycles balanced. I also must practice Radical Self Care techniques for ongoing hormone balancing and pain management. Before and after my cycle, I use contrast hydrotherapy, qigong meditation. I also drink 60 ounces of water a day, because hydration is key for maintaining a healthy mind and body.
Learn about the IUD and other alternatives to the pill in part 2 of the Birth Control Series.
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Research findings not explored in this article:
Article: OCP significantly influence VOC exhalations throughout the cycle.