"The Pill" & Other Hormonal Birth Control

Talking on a new topic today...hormonal birth control. It's important to be in the know about what's going on in our bodies and likelihood is you've been on hormonal birth control before or at least know someone who was on hormonal birth control. But do you know what goes on in your body when you're on it? It's time to be empowered by knowledge and understand all things hormonal birth control.

Hormonal birth control is a bit of a controversial subject currently. Actually, it's always had some controversy since it first hit the market. When hormonal first was approved by the Food and Drug Administration in 1960, it was only approved for women who were married. Today, the topic of hormonal birth control either yields one extreme or another...it's either NEVER ok to use, or ALL WOMEN should use it for contraception.

Side note...I want to encourage you to first have an understanding of hormonal birth control while hearing both sides and find where you stand for yourself, personally, without feeling the need to be extreme with your thoughts. I know I can have a tendency to swing hard from one opinion to another. So I'll ask you to keep an open mind, hear the educational and evidence-based research, and then form your own opinion while still knowing other people may and will likely disagree with you regardless of where you stand.

Hormonal methods of birth control are, by definition, synthetic hormones that work to interrupt your body's normal release of hormones and often prevent ovulation. In some women, progestin-only birth controls will still yield the release of the egg and therefore cause ovulation but can interfere with cervical mucus and uterine conditions that prohibit implantation. We'll get into this further below, don't worry :) 

HOW HORMONAL BIRTH CONTROL WORKS

To get a little more into the nitty-gritty of hormonal birth control, let's talk about how it works exactly. As I mentioned above, hormonal birth control is configured to include either synthetic estrogen and progesterone or just synthetic progesterone. You may see ingredients such as norethindrone, which is the synthetic progesterone, as well as ethinyl estradiol, which is synthetic estrogen.

Hormonal birth control, no matter if it's composed of both synthetic estrogen and progesterone or just synthetic progesterone, is going to work to suppress your body's normal hormones that would bring about ovulation and/or a suitable environment for you to conceive. The beautiful process that is your body preparing to get pregnant each and every month is quite amazing when you think about it...you can read more about your body's cycle HERE. And as such a delicate process, interfering with one or a couple of these hormones will send a cascade-like reaction that will lead to a high chance (99% when used correctively) of not getting pregnant.

For the hormonal birth control that involves both synthetic progesterone & estrogen, pregnancy is inhibited by the reaction that constant levels of these hormones have on your body. With taking these hormones, your body's natural hormones will be suppressed and your chance of getting pregnant greatly decreases. Lutenizing Hormone (known as LH) and Follicle Stimulating Hormone (FSH) are key hormones in ovulation. Typically these hormones work to both promote maturation of the follicle surrounding eggs in your ovaries, leading to egg release or ovulation, as well as promoting thickening of your uterine lining or preparing for implantation of a fertilized egg. What hormonal birth control does is it suppresses the release of these two hormones, (LH & FSH), thus preventing both the start of a new cycle as well as preventing ovulation.That's a whole lotta stuff going on! If you don't fully understand, don't worry. Just know that the hormones you take with birth control that include both synthetic estrogen & progesterone are going to suppress the hormones needed for ovulation.

Progesterone-only birth control works similarly, but instead of working by preventing ovulation, it prevents sperm from reaching the egg by thickening cervical mucus as well as thins the lining of the uterus making it less suitable for pregnancy. Know that it does not always suppress ovulation; it more works through making the environment for pregnancy and fertilization less optimal. 

QUESTION: WHAT ABOUT THE DIFFERENCE BETWEEN MONOPHASIC & TRIPHASIC BIRTH CONTROLS?

I got this question sent by one of you when I put out on Instagram to share any questions you have about hormonal birth control. First off, thank you so much for your question! I love being able to speak directly to what you are wanting to know and serve you in this way!

More typically today women on hormonal pill birth control will be on a mono-phasic series. That means, there's only one dose of hormone used throughout the pack. This is your pack that includes the same hormone dosage throughout the entire pack. This excludes the placebo pills that are at the end with no hormones. Triphasic birth control, as you may guess, has different dosages of hormones throughout the pack.

It is not necessarily better or worse to be on mono-phasic vs triphasic. Both are interfering with and suppressing your body's own hormones. Some say that the triphasic more closely mimics your body's own ups and downs of hormones...but they're still not your hormones. 

OTHER NON-PILL FORMS OF HORMONAL BIRTH CONTROL

"The pill" is just one form of hormonal birth control. Here are a few of the others that are out there.

Intrauterine devices (IUDs)-These work like the pill does by releasing a steady amount of hormones that suppress ovulation or make the environment in your uterus unsuitable for pregnancy. The exception is the copper IUD which does not release hormones but instead creates an unsuitable environment for sperm with the copper in the device. These devices are small and t-shaped and are placed in your uterus by a doctor or advanced practitioners such as a nurse practitioner or physician's assistant. Brands include ParaGard (this is the copper one without hormones), Mirena, Kyleena, Liletta, and Skyla.

Implants- Implants are small devices that look like a rod just an inch or two in length that is placed typically in the upper arm. They work by releasing synthetic progesterone, Etonogestrel, into your bloodstream and, like the progesterone-only pills, works by creating an unsuitable environment for pregnancy. Again, this is put in by a licensed advanced practitioner. Brands include Nexplanon and Implanon.

Shot- The depo-shot (Depo Provera is the brand) is another form of hormonal birth control that is administered every 12 weeks in a healthcare practice. This form also gives an administration of progesterone. This form is not used as often due to its side effects.

Patch- The patch is just that, a patch that you stick to your skin which releases synthetic estrogen and progesterone through your skin. It is worn for a week before changing it out, and repeating for three weeks before taking a week off which elicits a bleed. Side effects can be greater with this form due to the method of release of estrogen. The brand name is Xulane. 

THE POSITIVES OF HORMONAL BIRTH CONTROL

Birth control has positives to it's use. Though I tend to lean more towards living as natural as possible (*without getting stressed out...this is KEY!), there are definitely positives to birth control. I was on birth control for many years and for many years I did fine! I was on it for amenorrhea (recently learned these recommendations have changed) for around 5 years, then went off of it and got my period back pretty regularly right off the bat. Then I went back on birth control for another 6 months or so when I got married before deciding to try a more natural approach. Birth control is predictable, it can decrease symptoms of your period or take away your period altogether. It works great as it's intended use...for birth control. It can take the "guess-work" out of more natural approaches such as FAM (fertility awareness method), though there are ways to not have to guess with this method which I'll get into on a different blog post :) . Hormonal birth control, though not natural per say, can have it's benefits. And if this is something you choose, this is what you choose. My desire is that you are well informed about all things hormonal birth control...hence this post :) 

THE NEGATIVES OF HORMONAL BIRTH CONTROL

That said, things we put in our body and things we take that alter our body's natural system is hardly ever truly benign. With hormonal birth control, suppressing your body's natural hormones can interfere with your gut microbiome just like antibiotics can. This can lead to digestive issues from an imbalance of your healthy gut bacteria. If taking hormonal birth control, it's important to be on a probiotic and eat probiotic-rich foods to help off-set this alteration.

Secondly, it can lead to depletion of important micronutrients in your body such as B-vitamins, magnesium, and vitamin C. Knowing this, you can supplement with a multivitamin which can help support your body. Lastly, most hormonal birth controls as I mentioned above suppress ovulation which can have negative effects in the long run.

One last thought...if you're on hormonal birth control because of symptoms of difficult periods or mood, or acne, etc, it can suppress symptoms but doesn't cure or get to the bottom of the real cause of your symptoms. Just something to think about and discuss with your doctor if you feel so inclined. So, whoo! This has been a long one! I hope you've stuck with me through the end here now. Thank you for reading and I really hope you learned something that will empower you in your body! You see, you have the right to be informed about the research and the information that is out there and I hope to bring you information that is as clear-cut yet thought-provoking as I can. I'm not here to tell you whether you should or shouldn't be on hormonal birth control. I'm simply here to share what I know and what is out there that is true so you can decide what works best for you! Be empowered in what you do and what you choose for your body! 

What questions do you have for me on this topic of hormonal birth control?

References: https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/shot/index.htmlhttps://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619https://www.mayoclinic.org/tests-procedures/minipill/about/pac-20388306https://www.cdc.gov/reproductivehealth/contraception/index.htmhttp://sitn.hms.harvard.edu/flash/2008/issue40/https://www.mayoclinic.org/tests-procedures/birth-control-patch/about/pac-20384553https://www.ncbi.nlm.nih.gov/pubmed/26658991https://www.ncbi.nlm.nih.gov/pubmed/21967158