The hormonal birth control pill became available in 1960 and helped create a revolution in industrialized countries by enabling women to control if and when they will have babies. Certainly, doctors, researchers and patients initially came under tremendous pressure (and some spent time in jail) for something that gave women more say over their fertility, but in the long term the pill contributed to a rise in women’s pay and provided other health and social benefits by preventing unwanted pregnancies and many abortions.

But oral contraceptives also come at a considerable price to women’s health. They are not benign pharmaceuticals and can increase the risk of cardiovascular disease and breast and cervical cancers in some women. These prescription drugs are also the go-to intervention for many physicians to alleviate or control a wide range of menstrual irregularities that women experience, and thus are not just used to suppress fertility.

While I am very much in favor of giving women a range of tools to decide when to try for pregnancy, unfortunately most physicians will not provide women with objective and comprehensive information about the ways in which hormonal birth control methods work in the body and what range of negative effects they can experience. Many women are made to believe that the pill is like a light switch and, consequently, a safe and convenient way to prevent pregnancy until they are ready. Often, women begin taking oral contraceptive almost as soon as they start menstruating in their teens and will continue taking them for years, if not decades.

So, why am I so concerned about the effects of these drugs on your health and, ultimately, your fertility? Let’s start with getting a better understanding of what hormonal birth control is.

A woman’s health is reflected in her menstrual cycles. Most women begin to experience cycles around the age of 12-14 years. This is called menarche. During the first few years these cycles are often still somewhat irregular, and ovulation does not occur consistently. It’s like the ovaries are still training to learn the rhythm of menstrual cycles. The pituitary, a gland below the brain, is in charge of directing the ovaries to produce certain hormones and ripen eggs in preparation for ovulation. Ovulation and menstrual periods are the manifestations of an intricate symphony of hormones in a woman’s body. The prominent soloists are estrogens (primarily estradiol) and progesterone. These natural hormones have different effects on the reproductive organs to prepare for pregnancy and keep each other in balance. They also have many beneficial effects on other tissues in the body, including the brain.

The main purpose of hormonal birth control is to suppress this natural undulation of hormone production that keeps you healthy and prepares you for pregnancy. Biologically, procreation is the natural goal of a healthy woman’s body, though we may prefer not to conceive most of the time. The two main ingredients in most oral contraceptives mimic your natural hormones, to a degree. Unfortunately, though, they do not provide the health benefits of your own natural estrogens and progesterone, especially for brain health and thyroid functioning. The effect of these pharmaceuticals is to flat-line your natural hormone fluctuations and substitute an artificial withdrawal bleed for your natural period.

You may think that menstrual irregularities and associated discomforts, even regular periods, are nothing but a nuisance (or worse) but they are actually a report card about your health in general and allow you to develop an understanding of where your body needs support to function better. If you take the pill, you won’t know what’s going on. Many women have no idea how well or how poorly their bodies are functioning because they’ve been on the pill for as long as they can remember. In other words, the pill prevents them from addressing the imbalances in their hormonal and menstrual health because the artificial hormones suppress and cover up the manifestations of natural menstrual cycles.

But that’s not all. Especially women who are using oral contraceptives to “treat” conditions like endometriosis, polycystic ovary syndrome, or other dysfunctions of normal menstrual health may be in for a rude awakening when they decide to eventually go off the pill, either because they don’t want to take it any longer for health reasons or because they hope to conceive a baby. Many of these women (though definitely not all) experience rebound symptoms that can be worse than what they felt like before going on the pill. But even women without any of these hormonal and menstrual conditions, who are otherwise healthy, sometimes don’t resume regular menstrual cycles for months or even longer than a year. They may also experience periodic bleeds but not actually ovulate. If you don’t ovulate, you can’t get pregnant. The synthetic “hormones” in the pill have confused your own hormone production and regulation, and your body needs quite a bit of time to find its stride again.

The good news is that oral contraceptives or other hormonal birth control products are not your only choices to prevent pregnancy. Non-hormonal methods, such as a copper IUD, as well as various barrier methods are reasonable and often much safer options because they don’t interfere with your body’s natural production of healthy reproductive (and other) hormones. When used properly, they are also almost as effective as the pill in preventing pregnancy. Barrier methods such as male and female condoms also have the added benefit that they help prevent sexually transmitted infections.

Not suppressing ovulation and your natural menstrual periods will also give you and your health care provider an opportunity to figure out whether your body is out of balance and could benefit from natural interventions to help you get back on track. Appropriate nutrition strategies, certain supplements and botanical therapies, not to mention exercise and stress management, can have a profound effect on your menstrual health, usually within a few months but sometimes even after just a couple of weeks. Wouldn’t you much rather get an A on your monthly report card?

© 2020 Christiane Siebert