The pill has been around for several decades, since about the 1960s. Today, four out of five women have been on some kind of birth control and many women are on it for 10 years of more. In the US alone, about 10.6 million women are on some kind of oral contraceptive.
Many of these women, about 50%, are prescribed the pill for non-contraceptive reasons, including to suppress symptoms like painful periods and irregular cycles. Birth control is frequently prescribed to “balance hormones.” And while the pill may help some women with some symptoms, it doesn’t actually “balance” hormones and doesn’t address the underlying cause.
Using hormonal birth control to treat symptoms is a bandaid approach. We need to get to the root cause of hormonal imbalances and support women along the way.
If it doesn’t balance hormones, what does the pill really do?
The pill works by suppressing our natural cycle and shutting off communication between the brain and ovaries. While this can suppress symptoms such as irregular cycles and period pain, it can also come with a whole host of other issues and side effects.
It also depletes key nutrients needed for healthy hormone balance. Some of the nutrients depleted by hormonal birth control include:
- Vitamin A
- Vitamin E
- B-Vitamins: B1, B2, B6, B12
- Vitamin C
- Vitamin K
These are nutrients we need for hormone balance and fertility.
The pill suppresses ovulation. No ovulation = No progesterone.
Many forms of birth control work by shutting down ovulation, or suppressing it. Because we only make progesterone if we ovulate, women miss out on this beneficial pro-thyroid, anti-inflammatory hormone. Progesterone is important for so many reasons, including mood, sleep, brain health, bones, and metabolism.
Hormonal contraceptives completely override your natural hormonal rhythm and the period you get while on the pill is not an actual period, it’s just a bleed.
Other side effects of the pill:
The pill comes with a wide range of side effects, from mild to severe. Many of these we rarely hear about or the side effects are dismissed. Some of these side effects include:
- Increased risk of breast, cervical, liver cancer (PMIDs: 11943255, 2554724)
- Disrupts thyroid hormones (due to increased SHBG & TBGH)
- Can lead to weight gain, metabolic syndrome, and insulin resistance
- Increased risk of depression, even if you have no history of depression. A large Danish study published in JAMA found that, after starting the pill, about 23% of women (ages 15 to 34) needed to go on an antidepressant. For teens, it was worse. Teens were 80% more likely to experience depression while on the combination pill, while those on the progestin-only pill were twice as likely.
- Increased inflammation (increased C-reactive protein)
- Increased risk of developing blood clots
- Disrupts the gut microbiome, making more susceptible to yeast and bacterial overgrowths
- Contributes to iron overload
- Taxes the liver as your body has to detox synthetic hormones
From the insert package from Phizer’s LO/OVRAL:
RISKS OF TAKING ORAL CONTRACEPTIVES
- Risk of developing blood clots: Blood clots and blockage of blood vessels are the most serious side effects of taking oral
contraceptives and can cause death or serious disability. In particular, a clot in the legs can cause
thrombophlebitis and a clot that travels to the lungs can cause a sudden blocking of the vessel
carrying blood to the lungs. Rarely, clots occur in the blood vessels of the eye and may cause
blindness, double vision, or impaired vision.
Users of COCs have a higher risk of developing blood clots compared to nonusers. This risk is
highest during the first year of COC use.
If you take oral contraceptives and need elective surgery, need to stay in bed for a prolonged
illness or injury, or have recently delivered a baby, you may be at risk of developing blood clots.
You should consult your health-care professional about stopping oral contraceptives three to four
weeks before surgery and not taking oral contraceptives for two weeks after surgery or during
bed rest. You should also not take oral contraceptives soon after delivery of a baby or a
midtrimester pregnancy termination. It is advisable to wait for at least four weeks after delivery
if you are not breast-feeding. If you are breast-feeding, you should wait until you have weaned
your child before using the pill. (See also the section on breast-feeding in GENERAL
- Heart attacks and strokes: Oral contraceptives may increase the tendency to develop strokes (stoppage or rupture of blood vessels in the brain) and angina pectoris and heart attacks (blockage of blood vessels in the
heart). Any of these conditions can cause death or serious disability. Women with migraine (especially migraine/headache with neurological symptoms) who take oral contraceptives also may be at higher risk of stroke.
- Gallbladder disease: Oral-contraceptive users probably have a greater risk than nonusers of having gallbladder
disease. This risk may be related to pills containing high doses of estrogens. Oral contraceptives
may worsen existing gallbladder disease or accelerate the development of gallbladder disease in
women previously without symptoms.
- Liver tumors: In rare cases, oral contraceptives can cause benign but dangerous liver tumors. These benign liver tumors can rupture and cause fatal internal bleeding. In addition, a possible but not definite association has been found with the pill and liver cancers in two studies in which a few women who developed these very rare cancers were found to have used oral contraceptives for long periods. However, liver cancers are extremely rare. The chance of developing liver cancer from using the pill is thus even rarer.
- Cancer of the reproductive organs and breasts: Various studies give conflicting reports on the relationship between breast cancer and oral-contraceptive use. Oral-contraceptive use may slightly increase your chance of having breast cancer diagnosed, particularly if you started using hormonal contraceptives at a younger age. After you stop using hormonal contraceptives, the chances of having breast cancer diagnosed begin to go down and disappear 10 years after stopping use of the pill. It is not known whether this slightly increased risk of having breast cancer diagnosed is caused by the pill. It may be that women taking the pill were examined more often, so that breast cancer was more likely to be detected. Some studies have found an increase in the incidence of cancer of the cervix in women who use oral contraceptives.
- Lipid metabolism and inflammation of the pancreas: In patients with abnormal lipid levels, there have been reports of significant increases in plasma triglycerides during estrogen therapy. This has led to inflammation of the pancreas in some cases.
Just because it’s not life-threatening, doesn’t mean we should ignore the other side effects.
The side effects listed in the above excerpt are the more serious side effects of birth control. And are not all that common.
But what about the more common ones like mood disorders, anxiety, and depression? Studies show that while taking the pill, you have an increased risk of depression, even if you have no history of depression. A large Danish study published in JAMA found that, after starting the pill, about 23% of women (ages 15 to 34) needed to go on an antidepressant. For teens, it was worse. Teens were 80% more likely to experience depression while on the combination pill, while those on the progestin-only pill were twice as likely.
The question is, did your doctor review all of these potential side effects with you? Mine didn’t.
My personal experience with birth control
I was prescribed birth control at the age of 16, the same time I was diagnosed with PCOS. This was long before my body and brain were fully developed. I question now what that did to my overall development. To shut down communication between my ovaries and brain and shut down my body’s natural hormonal production? Of course, we don’t have studies yet. But I wish I would have been informed.
I wish one of the many doctors I saw across multiple cities over a period of nine years would have told me that birth control wasn’t “balancing my hormones” and it wasn’t “fixing my PCOS.” It was, however, making me incredibly depressed and anxious and have hormonal break-outs and other issues. When I complained about the side effects, that it was making me anxious or depressed, I was just told to just give it more time or try a different brand (I tried about seven types). In other cases, I was completely gaslighted and made to feel like I was being “dramatic” for complaining about my symptoms.
My last effort was the Skyla IUD. After gaining 10 lbs in 9 months with it in, I had it removed and ditched hormonal birth control for good. I was finally listening to my body and committed to learning alternative methods, like the Fertility Awareness Method.
The pros of birth control
We can’t deny that birth control has provided women with more autonomy around preventing unwanted pregnancies. It has allowed us more freedom and independence in planning our careers, families, relationships, and lives. We also often forget that it wasn’t too long ago the idea of maternity leave did not exist. If you got pregnant, that often meant you had to quit your job.
The thing is, just because something offers up some good, doesn’t mean it can’t also come with detrimental side effects at the same time. The whole point is to let women decide for themselves. It’s not empowering to just be given a drug without full knowledge of all the possible outcomes. What is empowering is educating and informing women of all the possible choices, along with their pros and cons. Let women decide what is right for them based on all the available information.
It’s your choice. It should be well-informed.
This post is not meant to scare or shame anyone, but to bring awareness to the fact that while some women do benefit from symptom reduction while on the pill, that’s not solving any underlying issues. Key parts of this conversation are missing.
Deciding which contraceptive you want to use is a personal decision. Whatever you choose to do, make sure you are well-informed about the pros and cons of each type. For us to have true control over our health, it’s important to know what hormonal birth control can do to our health, bodies, and minds.
And no, I’m not anti-birth control. I am PRO empowering women to make informed decisions about their health
Want to come off the pill?
For some women, it takes time to restore your body’s functions after coming off the pill.
While many women come off the pill with few symptoms or interruptions to their daily life, some women can experience a rather bumpy ride. This can look like acne, hair loss, missing periods, heavy periods, and delayed return of fertility.
To help support your body in the process, it’s important to:
- Replenish lost nutrients (the pill depletes your body of many nutrients required for healthy hormones)
- Support the gut
- Support detox pathways
- Support the thyroid and metabolic health
- Balance blood sugar
I have a whole post on Supporting Your Body While Getting off the Pill that explains all of this in more detail.
There are very effective natural forms of contraception, like the Fertility Awareness Method (FAM). Many women don’t know that you are only fertile about 6 days of your cycle! There are easy ways to track fertility so that you can avoid an unplanned pregnancy (or to help you conceive, if that’s your goal).
More on that to come. Some great additional resources on FAM are:
✨ Taking Charge of Your Fertility by Toni Weschler
✨ Beyond the Pill by Dr. Jolene Brighten
✨ The Fifth Vital Sign by Lisa Hendrickson-Jack @ fertilityfriday
I am not a doctor, and I don’t claim to be one. I can’t prevent, treat, cure or diagnose illness or disease. The information presented on this website is not meant to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice, treatment or diagnosis. The purpose of this website is to share knowledge from my research and experience. I encourage you to make your own decisions regarding your health care based on your own research and relationship with your health care professional.
Some of the links on this page are affiliate links, which means I earn a small commission if you purchase through that link, at no additional cost to you. Thank you for supporting my work!
Oral contraceptives and changes in nutritional requirements
Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study
The impact of oral contraception on vulvovaginal candidiasis
The metabolic impact of oral contraceptives
Effect of contraceptive pill on the selenium and zinc status of healthy subjects
Effects of contraceptives on serum trace elements, calcium and phosphorus levels
Oral contraceptive use: impact on folate, vitamin B6, and vitamin B12 status
Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: clinical implications
Gut bugs’ relationship with estrogen-related cancer
The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study
Association of Hormonal Contraception With Depression
Effect of Oral and Vaginal Hormonal Contraceptives on Inflammatory Blood Biomarkers
The impact of oral contraception on vulvovaginal candidiasis
Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function
Tight Junctions, Intestinal Permeability, and Autoimmunity Celiac Disease and Type 1 Diabetes Paradigms
Association Between Long-term Oral Contraceptive Use and Risk of Crohn’s Disease Complications in a Nationwide Study
The risk of oral contraceptives in the etiology of inflammatory bowel disease: a meta-analysis
New insights into the molecular mechanisms underlying effects of estrogen on cholesterol gallstone formation