Is Anti-Birth Control Pill Just Another Trend?

In this post, I discuss my most recent conversation surrounding oral contraceptives with my friend, role model, OBGYN, and Reproductive Endocrinologist who changed my viewpoint on the birth control pill.

First and foremost, oral contraceptives are not the fix. Birth control is often seen as a viable solution for managing certain health issues, such as irregular periods, acne, or hormonal imbalances. However, it's important to recognize that birth control primarily addresses the symptoms of these conditions rather than addressing the underlying causes. While birth control can provide relief by regulating hormones and controlling menstrual cycles, it doesn't address the root problems. This can lead to a situation where individuals believe their issues are resolved while the underlying health concerns remain unattended.

Oral Contraceptives and Fertility 

Many people have been taught to believe that oral contraceptives can harm fertility. However, this isn’t true. What happens is that many women are on the oral contraceptive for 10+ years and over that course of time they have developed some form of ovarian insufficiency. Ovarian insufficiency is the loss of normal ovarian function before age 40, but it’s not caused by the pill. Women taking the oral contraceptive would never know that they had ovarian insufficiency because the oral contraceptive safely stops ovulation. 

Where we run into problems with fertility from oral contraceptives is in patients who have been diagnosed with cancer, such as breast cancer. Once these patients are aware of their diagnosis, they have approximately 6 months to freeze their eggs before starting chemotherapy. Cancer treatments are one of the most common causes of ovarian insufficiency. Once you stop taking the pill, it can take 3-6 months for your ovulation to return, person dependent. This means for some patients this can end in devastating news if their ovulation doesn’t return before those 6 months are up. 

Oral Contraceptives and Osteoporosis

Oral contraceptives cause “withdrawal bleeding” during your period meaning you don’t experience a “true period” or ovulation while on the pill. This information has led many to believe that since you don’t ovulate, which is when estrogen spikes, it can put you at a higher risk for developing osteoporosis. Again, not true. The synthetic estrogen that is in the oral contraceptive is just as capable as your endogenous (natural) estrogen in maintaining bone health. Many postmenopausal women are prescribed synthetic estrogen to prevent osteoporosis.

What about the hormonal IUD?

The hormonal IUD doesn’t act on your body the same way the oral contraceptive does. The oral contraceptive is systemic, meaning it is absorbed into your body affecting your production of endogenous hormones. The hormonal IUD is localized meaning it affects only the uterus creating cervical mucus so thick it prevents sperm from reaching the egg. It does not impact your body’s production of endogenous hormones. An IUD should not affect your ability to conceive if you are on a timeline, such as a patient with a recent diagnosis of cancer. 

In summary, birth control is not the fix and often has side effects such as weight gain, mood swings, and low libido to name a few. However, oral contraceptives have been given a very bad reputation and led many to believe they are not beneficial. Again, this is simply not true.