How well do you know your birth control?
Since the 1960’s, hormonal birth control has been widely perceived as a revolutionary option for people looking to plan their future and put off any potential pregnancies until they are ready. Birth control pills, at the time, were in their own right a feminist icon. There is no denying that, for that time period, this was more control and liberation than women may ever have known in relation to family planning.
But what is hormonal birth control actually doing to prevent pregnancy?
How It Works
Hormonal birth control uses synthetic estrogen and/or progestin to prevent ovulation. By increasing the level of estrogen/progestin, your body never receives a signal to begin ovulation from other hormones FSH and LH. In a natural system, FSH and LH trigger your body to mature and release an egg or ovulate. If sperm comes in contact with this egg during ovulation, fertilization is possible.
I find this is a surprise for some - you can only get pregnant during ovulation which happens about halfway through your monthly cycle and lasts only a couple of days. When the egg is not fertilized, your body moves through the cycle to thicken the uterine lining and then shed the lining which is what we know as a period.
With all that in mind, you may be wondering why you have a period on some hormonal birth control options if you are not ovulating in the first place…
A History Lesson
In the 1960’s, studies and drug trials began on The Pill. This would revolutionize modern medicine as the first drug study done on an all female cohort. The subjects of this study entered the trial mostly believing it was impossible to control their cycles. This left them all in a stage of wild disbelief when their periods did not come at all for the length of the study. Many of the women had begun planning for a birth and even creating nurseries in their homes because they believed the drugs must not have worked and they simply must be pregnant.
This scenario left the scientists overseeing the study to ponder what they could do to make sure people on birth control knew they were not pregnant. Thus, enters the “fake” period that people taking the pill experience. Bleeding while on hormonal birth control is related to a sudden withdrawal of the estrogen/progestin levels that create a sudden shedding of the uterine lining. This “fake” period was built into the birth control cycle by scientists on purpose to ensure you know your medication is working, but it is in no way a natural or healthy version of what your period does for your body. You experience this type of bleeding during the week of “sugar pills” at the end of the pill cycle because that week of medication has a very low level of hormone, if any.
Depo Enters The Chat
A common hormonal birth control option that is usually spoken highly of by its users is the Depo-Provera shot because it is hands-off birth control. This method is only injected 4 times per year to prevent pregnancy. The Depo shot is also used in the prison systems as a form of chemical castration…which then makes you wonder what is it actually doing to your body?
The answer to that question is - the Depo shot carries a label that warns against use for longer than 2 years. It is unlikely that your provider has ever mentioned this because most people end up using Depo for around 5-10 years.
The Black Box
One of many things that providers are not telling you about birth control options is that many hormonal birth controls carry a black box warning. Black Box Warning is the strongest level of warning that the FDA puts on products meaning that it has found the product to pose a significant risk or life threatening side effects. Depo, Essure, Yaz and many others carry this warning label and have for many years.
Hormonal birth control is also considered a Group 1 Carcinogen. This is the same class of carcinogens as tobacco products and asbestos, just in case you wondered. These two labeling systems should not be taken lightly. The reason that a product would be listed in either of the aforementioned ways is because they are known to cause cancer and increase the risk of cancer for people who are exposed.
Other Side Effects That We Do Not Talk About Enough
We are all probably familiar with side effects like weight gain, depression, nausea, loss of libido- but what else are we not talking about? If you have ever unfolded the thesis length pamphlet that comes in your birth control, then you know the list is much longer than that.
The side effects that are life threatening include increased risk of stroke and cancer, risk of cardiovascular disease and significant weight gain, liver damage and uncontrollable mood changes just to name a few.
But what about the others that may not be “life threatening” but they will come up later in life? Those side effects include increased risk of endometriosis and PCOS after long term use and even changes to the type of person you are attracted to. The simple fact is that we know long term use of birth control makes changes to your brain's structure and function by altering its chemistry. You cannot deny that this is actually posing a danger to the lives and futures of long term users.
So what can you do?
There are non-hormonal options available for everyone! Some of these options even boast a similar prevention rating as the pill when used correctly. This includes condoms, spermicidal products applied before penetration, non-hormonal IUD’s, reversible vasectomies and (my favorite option) - fertility tracking!
Fertility Tracking is not only a great way to prevent pregnancy without hormones, it is also a great way to get to know your own body and how it works. This is where I assert that this method takes trial and there will be errors in the beginning so it may be best to avoid sperm for a few months while you get the process down. This is especially true if you are coming off of long term birth control because your cycles will be a little chaotic for a few months.
This method involves tracking your temperature and/or cervical mucus daily and building a chart to know exactly when you are ovulating. When done correctly, it leaves you with 100% certainty that you are ovulating in a 3-5 day window for which you can avoid sperm and prevent pregnancy.
There are some great resources about this method from books to coaches that can guide you through each step of the process. The best part about this method is that you will gain a sense of empowerment around your cycle and know exactly what is going into your most delicate parts.
Hormonal birth control may be a great option for short term prevention and certain parts of life, but it most definitely is not designed to be a long term or permanent solution. Please discuss your options with trained providers and know what the potential risks associated with your birth control are!
