The Oral Contraceptive Pill
The history of the pill
The oral contraceptive pill, often simply referred to as "the pill," is one of the most popular methods of birth control. It was developed in the 1960s and at the time provided women with a safe and convenient option for managing their own reproductive health, which was a huge step forward in female empowerment! However since the pill’s development, the medical community has been able to increase the pill’s usage far beyond what it is actually useful for. It is prescribed for all manner of hormonal conditions and is now used to treat acne, PCOS (polycystic ovary syndrome), endometriosis, dysmenorrhea (painful periods), and metrorrhagia (heavy blood flow).
There is a very distorted and persuasive message around the OCP which usually leaves women uninformed, confused, lacking options and in worse health than when they started.
Understanding the Oral Contraceptive Pill
The oral contraceptive pill is a hormonal birth control method that comes in two primary forms: the combination pill and the progestin-only pill.
Combination Pill: This type of pill contains both oestrogen and progestin hormones. They work together to prevent pregnancy by inhibiting ovulation (the release of an egg from the ovaries), thickening cervical mucus to make it difficult for sperm to reach the egg, and altering the uterine lining to make it less receptive to implantation.
Progestin-Only Pill: Also known as the mini-pill, this pill only contains progestin. It primarily works by thickening cervical mucus and, to a lesser extent, suppressing ovulation. Unlike the combination pill, it doesn't contain oestrogen.
The positive sides to the pill
- Symptom relief, many women do experience relief from certain symptoms like hormonal acne, period pain, irregular periods and heavy bleeding. Let me make myself very clear here, they are not being ‘treated’ with the pill, the symptoms are being suppressed, until you come off it.
- Preventing unwanted pregnancy (in 99% of cases, with 100% compliance of taking the drug). At certain times of women’s lives, this can be at the top of the priority list, and that’s ok! If you are in a circumstance where this provides you a huge amount of peace of mind and freedom, it is an option! However, put a time limit on yourself - two years is the maximum I would consider taking the pill for without it causing too much havoc to your hormonal system!
Myths of the pill
- It doesn’t balance hormones, it simply switches your natural endocrine system off (making hormones) and your body starts relying on the dosage of your synthetic hormones (which don’t act like your natural hormones.) Your pill is basically using hormone replacement therapy to put you into a state of temporary menopause that is chemically driven.
- You can’t take it for your whole menstrual life. Women over 35 cannot be prescribed the pill because the risk of blood clots, heart attack and stroke increase, which are all possible side effects of the pill. So even if you are not planning to have children, you will have to face the realities of your menstrual cycle anyway.
- That you continue getting your period while on the pill. When you take the ‘sugar-pill’ which is just a placebo pill to keep the compliance of taking it everyday, and you start bleeding, this is not a period, this is a drug-withdrawal bleed.
- The synthetic hormones do not work the same as your natural hormones. The pill contains molecules like ethinylestradiol, levonorgestrel, and drospirenone. These don’t act the same in our body as oestrogen and progesterone (our natural hormones.) There are so many other benefits of hormones that go way beyond our menstrual cycle that when you're taking the pill and all your hormones are switched off, you don’t get those benefits (which are not actually benefits, but rather essential to baseline functioning health.)
Here are some examples:
- Estradiol supports how you regulate blood sugar. The pill equivalent is ethinylestradiol which potentially causes insulin resistance. This is why, if you have a diagnosis of PCOS, the pill will make your symptoms worse.
- Progesterone promotes healthy strong hair growth. Levonorgestrel (synthetic progesterone) causes hair weakening and loss.
- Levonorgestrel has been shown to cause acne, depression and headaches.
Downsides to the pill
- It depletes you of numerous nutrients which are vital for baseline functioning (not even optimal functioning.) The vitamins and minerals we currently know are depleted by taking the pill: Vitamins B1/B2/B6, Folate, Biotin, Choline, PABA, Vitamins C & E, Zinc and Cobalt
- It can have side effects that usually are not explained to you at all when you are getting prescribed the pill including bone loss, breast and cervical cancer (it’s listed as a class 1 carcinogen by the World Cancer Authority), deep vein thrombosis, depression, diabetes/insulin resistance, gallstones, loss of libido, hair loss, migraines, PCOS, obesity, stroke & heart attack, thrush.
- It can affect your hormonal balance and therefore menstrual health when you come off the pill. Every woman has to come off the pill at some point! Either they want to start a family, or they turn 35 and are told that the pill they are taking is no longer able to be prescribed to them (because the risks of blood clots are too high.)
- The pill stops the production of copulin, a female pheromone that is a part of “attracting a mate” to use early evolution terms. This can influence women finding the right partner. Which is a bit ironic considering its purpose.
- It means you can’t get to know your body. Your menstrual cycle is like a guide to your health, all the symptoms associated with a period can tell you so much about your health overall, if you're not getting a menstrual cycle, you won’t get this precious data.
- Perimenopause can be a tricky time hormonally. If you're in your twenties or thirties I can understand if it feels too early to think about this. But, the transition into menopause becomes a lot easier if you have had as many natural (no intervention) cycles under your belt as possible. If you have taken the pill your whole life, only come off to have a baby or a short break to transition to another pill, perimenopause might be a lot harder of a time for you.
Words of caution
There are several contraindications to taking the pill. This is supposed to be identified by your GP and told if it isn’t a good option for you. But it is best you know these for yourself as I have had so many clients over the years on the pill when they shouldn’t be, and have no idea!
- Crohn's disease
- High Cholesterol
Rethinking the pill
I would like everyone (women and men) to understand the pill a lot better, so that women can make informed decisions on whether they wish to take it or not.
Imagine if this situation was reversed and we asked young men to suppress their testosterone, replacing it with a synthetic version in the name of contraception. Side effects they may experience include: weight gain, acne, depression and a loss of libido. It’s safe to say the drug would never have been made and if it had, no one would take it.
Legalising contraception through the invention of the pill allowed women reproductive rights, and this is something to celebrate. It still serves this purpose today for the women who are in a position where this is needed - but we also have more knowledge about the importance of natural hormones, and other contraceptive options that our once “all women should be on the pill” attitude is outdated!
To all my current clients and future clients
I see many women who are on the pill! It is not something I ever tell a woman to come off of, as this is a very personal decision.
I will always support my client’s choices and create a treatment plan to support them.
I also ask if I can educate them about what the pill is doing to their body and how this might affect their health. Usually, what I share with them is new information and they are grateful to have it.
The pill is a tool that should be used wisely and sparingly.