Let's get a few things straight: Birth control is extremely important, and every woman has the right to choose what's best for her body and health. There's no single solution that's going to be right for every person, but could one of the most commonly used forms of contraception, the pill, actually be negatively messing with your hormones?
The CDC's last comprehensive study found that 28% of women take oral contraception—yes, 10.6 million people take a tiny pill every day containing hormones to stop ovulation. If you're one of them, when was the last time you paused to ask yourself, Is this the right birth control for me?
"As a gynecologist practicing functional medicine, I have a skewed perspective when it comes to BCPs," admits Sara Gottfried, MD, author of The Hormone Cure and Younger. A Harvard-trained doctor, Gottfried draws on holistic methods to help other women. "I've seen many women over the years suffering from side effects from these pills. From vaginal dryness to lost libido in about 20%, from micronutrient deficiency to premature menopause, and from infertility and early menopause to worsening mood problems—I've seen it all."
Don't toss out your pill packet just yet, though—here's everything you need to know to make a smart, informed decision about contraception so you can find the best option for you.
If you've been taking the pill since your first period, how can you tell if it's actually messing with your hormones? According to Gottfried, there are a number of subtle clues that your system might be out of whack. "When your hormones are imbalanced, you may have a range of symptoms including fatigue, sugar cravings, weight-loss resistance, bloating, belly fat, trouble sleeping, anxiety or irritability, and constant stress," she says.
We hear you—these signs are frustratingly vague and all too common, so how do you know if you're just a regular, sugar-craving, stressed-out person or someone with a hormonal imbalance? "You won't truly know if your hormones are to blame for your symptoms until you get some basic blood work done," she says. Record your symptoms and check in with your physician about your concerns.
Request the following blood panels from your doctor, she recommends:
- TSH, free T3, reverse T3, free T4
- testosterone: free, bioavailable, and total
- day 3 estradiol
- day 3 FSH
- day 21-23 progesterone
For millions of women, taking oral contraception is a daily routine that doesn't merit a second thought. It's just a regular part of our routine. But given that the birth control pill is a medical drug, it's important to know exactly how it works.
According to Planned Parenthood, the hormones in the pill work to stop our body from ovulating. "No ovulation means there's no egg hanging around for sperm to fertilize, so pregnancy can't happen," the organization explains. "The pill's hormones also thicken the mucus on the cervix. Thicker cervical mucus makes it hard for the sperm to swim to an egg—kind of like a sticky security guard."
When you ingest a pill that contains hormones, it alters your body's natural balance. "BCPs contain synthetic versions of estrogen and progesterone, the two main female hormones," says Gottfried. "Studies show that testosterone levels drop on average by 61% in women on BCPs."
Over the years, the number of hormones in the pill has changed too. "Over time, the dose of synthetic estrogen in BCPs has declined, [and] more synthetic progestins have been included," Gottfried continues. "BCPs are now prescribed, mostly off-label, for acne, painful periods, irregular menstruation, reduction in risk of ovarian and endometrial cancers, and improvement in premenstrual syndrome and premenstrual dysphoric disorder."
This doesn't mean that the pill should be demonized though, argues Wendy Wilcox, MD, vice chairperson of the North Bronx Healthcare Network Department of Obstetrics and Gynecology. She tells Parents that there are a number of benefits to taking oral contraception, and it should be assessed on a case-by-case basis. "Oral contraceptives have been around for 50 years. They've undergone many improvements, including decreasing the amounts of hormones put into the pills," she says. "All that makes them safer."
Gottfried's opinion isn't a popular one, but she wants to speak openly about it: "It makes me cringe, but I would even consider oral contraceptives the biggest hormone problem for women," she says. That doesn't mean you should go off birth control, though—there are non-hormonal alternatives to consider. "That said, I support a woman's right to choose and fully understand that for some women, the BCP is the most convenient choice," she says.
Thinking about switching contraception? These are the nonhormonal forms she recommends:
- copper intrauterine device, a T-shaped device that's inserted into the uterus
- cervical caps, a silicone cup inserted into the vagina
- diaphragms, a shallow, cone-shaped silicone cup that blocks the entrance of the uterus
If you are on the contraceptive pill, be sure to supplement. "If you are taking BCPs, I do recommend adding a vitamin B complex to your daily regimen," she says, as the pill depletes your body of this vitamin. "Focus on eating a balanced, varied diet that includes selections from all food groups in order to ensure that you replenish or prevent micronutrient gaps."
Add these foods to your diet to balance nutrient depletion, if you choose to stay on the pill:
- B vitamins: poultry, dark leafy greens, milk, eggs, and seafood
- vitamin C: dark leafy greens, citrus fruits, and berries
- vitamin E: nuts, seeds, and extracted oils
- zinc: oysters, seafood, meat, and beans
- selenium: brazil nuts, tuna, and eggs
- magnesium: seeds, yogurt, black beans, and dark chocolate
The bottom line? "For some women, the BCP is the easiest or most convenient choice, and above all else, I support a woman's right to choose," says Gottfried. Pay attention to your body and chat with your physician to find the best birth control method for you.
Have you switched to a nonhormonal form of birth control? Tell us if you've noticed a difference.