Recently, birth control has become a highly discussed topic among my girlfriends who have been on it for years and are now talking babies. The birth control pill (BCP) is among one of the most commonly used drugs in developed nations. They are easy to prescribe, easy to take, reliable, and convenient. BCPs most commonly contain a combination of both synthetic estrogen and progestin (synthetic form of progesterone) in higher than naturally occurring amounts.
Let’s get started.
What exactly does the Birth Control Pill do?
Naturally, your ovaries produce estrogen and progesterone, your sex hormones, through signals via the brain. These hormones work together intricately, balancing each other out during our menstrual cycle every month. Each month, our ovaries will release a single egg, called ovulation. The hypothalamus signals the pituitary gland; the pituitary gland sends out gonadotrophic substances – follicle stimulating hormone (FSH) and luteinizing hormone (LH). FSH stimulates the ovaries to produce a follicle, while LH is released in a surge mid cycle, triggering ovulation.
Phew. That’s a handful.
Now let’s consider what happens when the BCP is added to this equation. The primary method of the BCP is to prevent ovulation. The estrogen component of the pill will directly inhibit the development of a follicle or egg by inhibiting FSH secretion. While, the progestin component will suppress your LH secretion surge. In addition to preventing ovulation, some back-up mechanisms are at play. The progestin component will also thin the lining of the endometrium making this an unfavourable environment for an embryo to implant and will cause a thick cervical mucus preventing sperm from travelling.
Thus, the BCP is very effective in preventing pregnancy through a number of mechanisms and back up mechanisms.
What else is happening behind the scenes from the influx of synthetic hormones to your system?
Here are 3 effects that the BCP causes that you may have not heard about:
- Hormonal Imbalance. Of course, if we are introducing synthetic hormones in higher than naturally normal amounts (sometimes 4x the amount!), we are disturbing the important balance between estrogen and progesterone. This increase will also disturb other hormones as they all work intricately together. An increase in thyroglobulin and sex hormone binding globulins (SHBG) will occur. These are proteins that bind to free thyroid hormone and testosterone, causing a decrease in their amounts in circulation. We will see symptoms of low libido, depression, weight gain, and constipation.
- Depletes Vitamins & Minerals. BCP’s deplete our B vitamins, especially B1, B2, B6, and B12. B6 is a big one for me as it is a co-factor in the production of some important neurotransmitters that help regulate mood such as serotonin and gamma-aminobutyric acid (GABA). In terms of minerals, the results of a study showed significant lower levels of zinc, selenium, phosphorus, and magnesium levels in users versus non-users.
- Promotes Oxidative Stress. Oxidative stress occurs when there is an imbalance between antioxidants and reactive oxygen species (ROS), which includes free radicals. When these free radicals outnumber our antioxidant levels, damage will occur. In a large study that measured lipid peroxides, a measure of oxidative stress, they found lipid peroxides to be on average 1.77 fold higher in users than non-users. This is important in understanding the potential risk of developing venous thromboembolism and cardiovascular disorders in woman taking BCPs. In another study, they went further and supplemented with vitamins E and C, well-known antioxidants, and saw significant improvements in their lipid peroxide levels.
As I’m all about being informed, it’s important to note there are some advantages to taking the BCP. Including effective contraception of 99%, reduction in acne due to lower androgens, and cancer reduction. This one is important. If taken longer than 1 year you will reduce your risk of ovarian cancer and thyroid cancer.
What is the take home message?
My only goal with this post is to empower you ladies out there. I’m absolutely all about being informed; showing you both sides to the story that you may not get in your doctor’s office, and allowing you to make the best decision that works solely for you.
If you are currently taking the BCP, talk to your health care provider about other non-hormonal options, such as the copper IUD, condoms, or get in tune with your body with fertility awareness. These options, when used correctly are just as effective as hormonal contraceptives.
On the other hand, if the BCP works for you and your lifestyle and coming off is not an option, discuss with your healthcare provider some other options. Add foods to your diet that are rich in the vitamins and minerals listed above and consider adding some supplements to your routine. A B complex is a great place to start.
Akinoye, O. et al. (2011). Effects of contraceptives on serum trace elements, calcium, and phosphorus levels. West Indian Med J. 60(3):308-315
Brogen, K. (2016). A mind of your own. New York: HarperCollins.
Brzyski, RG & Knudston, J. (2013). Female reproductive endocrinology. Retrieved from, http://www.merckmanuals.com/professional/gynecology-and-obstetrics/female-reproductive-endocrinology/female-reproductive-endocrinology
Gottfried, S. (2013). The hormone cure. New York: Scribner.
Pincemail, J. et al. (2007). Effects of different contraceptive methods on the oxidative stress status in women aged 40-48 years from the ELAN study in the province of Liege, Belgium. Human Reproduction, p. 1-9.