Using the Pill to Address Hormone Imbalances?
I've recently been thinking more and more about the hormonal birth control, because I see it prescribed in the clinic where I work on a regular basis. In teen girls and women in their 20's or older, it is often prescribed for acne concerns, heavy periods, or painful periods.
These conditions are noted to be caused by hormonal imbalances, so the thought is, in taking pre-determined amounts of hormones via the Pill, the hormone levels in the body become regulated, minimizing the symptoms of the hormonal imbalance. Some teens do see some relief with these complaints, so it sounds reasonable, right?
However, later down the road, I hear story after story of a women, who, after long term use of the Pill since the teen years, finally gets off of it because she is ready for pregnancy, only to find that she has a really hard time actually getting pregnant.
And, there are side effects such as headache, nausea, and weight gain, that make the Pill intolerable for some.
Not to mention, I frequently hear about decreased sex drive as a side effect of the Pill. For a woman who is on the Pill for actual birth control, the last thing you want is decreased sex drive. It defeats the purpose of being on the Pill in the first place for this group of women. Which is, to enjoy having sex with her partner without having to worry about getting pregnant.
But, Some of Those Symptoms DO Get Better!
Yes, we do see acne improve, and heavy and/or painful periods become more manageable. Irregular periods become regular, too, of course. So, it certainly seems like hormonal birth control can work, at first!
However, I recently saw this quote, and love the analogy: "Taking the Pill for hormonal imbalances is like fixing the engine light on your car dashboard by covering it over with a piece of black tape... it does nothing to fix the underlying health ailment."
In fact, upon further digging, I'm finding that hormone based birth control actually WORSENS these underlying ailments over time. Why?
Does the Pill Regulate, or Does it Replace?
So, what gives? Isn't the Pill (and other hormone based birth controls) supposed to REGULATE our hormones?
As it turns out, hormonal birth control like the Pill does not regulate our hormones, it cuts them off and replaces them. You get synthetic hormones in the birth control, in essence shutting down your own hormones.
Consequences of Replacing Sex Hormones
Gut Health. The Pill tends to alter our gut microbiome, leading to gut inflammation, and you guessed it, intestinal permeability/leaky gut. So, if you didn't have gut health issues to begin with, you're likely to have some after being on the Pill. Now, many of the very complaints that drive some people to the Pill in the first place are likely, to some extent at least, caused by poor gut health. So now, not only are we ignoring the cause of the problems, but we're actually likely making it worse.
Depletion of Nutrients. The Pill, and other hormone based birth controls, deplete Vitamins B2, B6, B12, Vitamin C, and the minerals Zinc, Selenium, and Magnesium. I was shocked when I read about this! No doctor ever told me this could happen because of the Pill.
These nutrients are key factors in maintaining good gut health, keeping inflammation levels low, maintaining a heathy immune response, and making your body less susceptible to environmental toxins. The B vitamins, in particular, are important in brain health and keeping anxiety levels in check (among many, many other vital functions that B vitamins support).
Emotional Side Effects. Hormonal birth control has been associated with depression, anxiety, mood swings, crying easily, irritability, and even increased risk of suicide. These side effects make it more likely that a woman may be prescribed an antidepressant. These symptoms are likely due to the synthetic replacement of our own hormones at levels that are not necessarily matching what our bodies normally produce, causing mood concerns.
Weight Gain. Unfortunately, lab made estrogen causes estrogen dominance, which in turn causes weight gain. It's pretty much as simple as that. Some Pills contain higher levels of estrogen than others, therefore making some more prone to cause weight gain than others.
Decreased Sex Drive. There's that conundrum I mentioned before. The woman takes the Pill so that she and her partner can enjoy sex without worrying about getting pregnant, but in the end, her sex drive gets destroyed, and it defeats the whole purposed to begin with. What's actually happening here?
On further digging of this issue, I found that Hormonal birth control increases sex hormone binding globulin (SHBG), which binds to testosterone, making it unavailable to the body! So, deceased testosterone levels will of course cause sex drive to diminish.
More on Diminished Testosterone Levels. Well, we just talked about decreased sex drive. However, optimal levels of testosterone also help maintain heart health, brain health, bone and muscle health, urinary and vaginal health. As it turns out, testosterone also has a protective effect against breast cancer! So, while we think of testosterone as being the male hormone, optimal levels are very important for females, as well.
Fertility Concerns. Difficulty getting pregnant after stopping the Pill is a concern especially for women who have been on it for an extended period of time. Well, this makes perfect sense. Since we've been synthetically replacing our bodies' own hormones for likely a significant amount of time, our body then has trouble kicking those hormones back in when we remove the Pill.
These hormones are necessary for getting pregnant in the first place, so for many people, pregnancy can be very delayed as the body recovers and starts to make it's own hormones again. For some, pregnancy doesn't happen without fertility intervention.
A Note on Bioidentical Hormones
What about Bioidentical Hormones? Bioidentical hormones are different than the hormones in the Pill, and other hormone based birth controls. The birth control versions are synthetic, and the bioidentical forms are natural, and recognized as such in the body. They are molecularly identical, making them a valid replacement option for hormones.
However, you don't want to take bioidentical hormones unless you truly are lacking in your own natural hormones, because, similar to the hormones in the Pill, bioidentical hormones you don't truly need can shut down production of your own hormones.
What's the Solution?
OK. Now that I've totally rained on the hormonal birth control parade, what am I suggesting you do? Well, that is just not up to me. What you do with your own body in this way is SUCH a personal decision. We all know the other methods of birth control you can consider, if you need them.
I just believe that whatever you decide for your body, you should get the full story before making a decision. It's the concept of Informed Consent; you need to FULLY know the benefits and risks before you decide. Unfortunately with Hormonal Birth Control, there are many side effects that are just not often discussed.
As far as the hormonal imbalances many go on the Pill for, like acne, heavy/irregular/painful periods, and other such concerns, it's no secret that I recommend finding the root cause of any health problem.
Start with gut health (you can read my Gut Health Series here), and keep digging until you find out WHY these things are happening. Hormonal imbalances are symptoms of a bigger problem, and I recommend working with a Functional Medicine Practitioner or Naturopathic Doctor to help you identify those problems.
If you've been on Hormonal Birth Control for a long time and are trying to get pregnant, focus on a gut healthy diet, optimizing micronutrient levels, and identifying any other underlying concerns. Again, working with a Functional Medicine Practitioner or Naturopathic Doctor could greatly help you.
What's your experience with Hormonal Birth Control? Was it no problem to be on it, or did you experience some of the concerns mentioned in this article? I'd love to hear your experience!