“When the pill was released, women had to stand up to their doctors to get it. Today they must fight to get off it”
- Holly Grigg-Spall, «Sweetening the pill.»
Whether you use the pill as birth control, you plan to, or your doctor just prescribe it to you in case you have menstrual cycle irregularities, or you're just curious about it, I say: Welcome to you! Today we talk about HCs and birth-control pill in particular. Stay with me until the end. I have no doubt that this will change your vision on the subject.
About birth-control:
They are 5 types of birth control:
Short-acting hormonal contraception (pills) ;
Long-term contraception (intrauterine devices IUD) ;
Emergency contraception ;
Onetime barrier contraception (condoms) ;
Permanent contraception (vasectomy, hysterectomy).
In this post, we're gonna focus on the pill (1,3). But first let's have a quick idea about what is HC's. Hormonal Contraceptive (HC's) or hormonal birth-control refers to birth control methods that act on the endocrine system. It included the pills, the patch, the UID etc. HC's is often prescribed as a contraceptive or in response to certain menstrual cycle irregularities such as painful period, PCOS, HA so and so on.
History of the pill:
In 1951, Carl Djerassi (1923-2015) discovered the synthetic progestogen, norethindrone, a discovery which paved the way for several other synthetic progestogens and estrogens. The first oral contraceptive to get approval was Enovid in 1957, a mixture of the compounds norethynodrel and mestranol. It was put on the market to treat gynecological disorders but was used off-label for birth control. Enovid was approved by the FDA in 1960 and was finally marketed explicitly for contraceptive purpose in the same year. The pill and was created in response to the problems of family planning and population control. When first release it was hard to convince women to take it, since they wondered why would they take drugs, if they are not sick? Why would they take a pill that stopped their natural menstrual cycle?, In response to these questions, scientists choose to present birth control in a way that mimicked women's natural period (28 days + bleeding). Without this, women in the 60s wouldn't have agreed to take the pill in the first place.
But in reality, the bleeding you may observe when you take the pill isn't called menstrual bleeding, but withdrawal bleeding. It results from the withdrawal of hormones in your pill and in your body where the drop in hormone levels causes the lining of your uterus (the endometrium) to shed. The menstrual bleeding or period on the opposite result from ovulation and if an egg is not fertilized, the uterine lining breaks down and bleeds. The egg and the uterine lining are then shed during your period.
Chemistry of Oral Contraceptives:
They are two types of hormonal pills:
Combination pills: Also called COCs or combined oral contraceptives. These are the most common type of birth control pill. Ex of COCs brands: Azurette; Beyaz; Enpresse; Estrostep Fe; Adepal; Kariva; Levora; Loestrin; Ortho-TriCyclen®.
Progestin-only pills: Also called POPs or mini pills.contraceptives, Ex of POPs brands : Camila; Errin; Heather; Jencycla; Lutenyl; Utrogestan 200. Minipills are mostly used in response to cycle irregularities such as PCOS, but note that some POPs can also be used as contraceptives but that’s not the primary function of these pills.
Both types of oral contraceptive prevent pregnancy by affecting hormone levels. Ovulation is usually triggered by a peak in estrogen in the body during the menstrual cycle, usually around 14 days in. This peak causes the release of hormones from the pituitary gland, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which prompt the ovaries to produce an egg. Taking oral contraceptives containing synthetic estrogens that keep estrogen levels in the body stable. And without this peak in estrogen levels, ovulation does not take place.
The pill & your health:
If used correctly, the pill has an effectiveness rate of 99.9% (birth-control). But have you ever wondered why almost all HC's including the pill, are so effective? Well, in case you didn't know, HC's effectiveness lie on 3 aspects :
They interfere with ovulation by preventing your ovaries from releasing an egg. Without the egg, the sperm have nothing to fertilize.
They interfere with implantation by thinning the lining of your uterus. Without a thick lining, a fertilized egg has a difficult time attaching and developing.
They prevent your cervix from producing fertile-quality mucus by causing a buildup of thick, sticky mucus (G-type) at the opening of your cervix. This makes it harder for sperm to pass through your cervical opening.
We must wonder: Effectiveness yes! But at what cost? It has been shown that all HCs disrupt normal endocrine function to some degree, but not all HCs affect the body in the same way. Here are some side effects we need to watch for:
By decreasing your testosterone level, pill and HCs in general have negative impact on your libido.
Using HCs can shrink the clitoris and surrounding vulvar tissues, especially the vaginal opening, which increases the risk of painful sex;
And shrink your ovaries by 50%;
They impair your body's ability to metabolize tryptophan normally by rapidly depleting Vitamin B6. This decreases of serotonin production and consequently increases your risk of depression. While not all women on HCs suffer from depression, it's clear that HC use is associated with an increased risk;
They can cause you choose a wrong intimate partner by affecting the way you perceive their "scent";
They are associated with the depletion of a bunch key of nutrients. They disrupt your nutrients stores, but also disrupt the balance of minerals in your body;
Although long-term HCs use have been shown to reduce rates of ovarian endometrial and colorectal cancer, it is also associated with higher rate of cervical, breast and liver cancer.
Dr Lara Briden, author of «Period Repair Manual» and «Hormone Repair Manual» said :
“The pill is a form of castration. It's a chemical castration... It shuts down hormones, it shuts down libido, it affects mood, it affects hormonal vitality and health in the same way that castration would affect men...”
The picture below is called a black box warning. And it's present on about all of the birth-control pills prescribing information. In case you didn't know, a black box warning is the strongest warning the FDA requires. Any drug with a black box warning carries a significant risk of serious or even life-threatening adverse effects. This is a sample of the Ortho-Cyclen® warning label :
Does all of this mean that you should never use the pill? Not necessarily! But I think you have the right to make an informed choice about the medications you use.
Reminder :
Pills do not protect you against STD's and AIDS*
So whenever you plan to have sex, make sure your partner and you are healthy. If you're not sure, use the condom! Simple as that. It is not just about avoiding pregnancy, first it's about your health and your life. You can't turn a blind eye to this.
Sources:
Talking about the pill is a bit complicated since they are two schools : the pro and the cons. For some people, pill are 'credited for giving women control over their bodies by empowering them to choose if and when they wish to have children'. But what we don't always know, is the risks behind it. For me, freedom is also about embracing your body and be able to cycle naturally. The menstrual cycle is a biological function of the female body, and it's also a vital sign as we will talk in a next article. Thank you for reading. May God bless you, take care!
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