According to the Centers for Disease Control and Prevention (CDC), about 14 percent of women ages 15 to 49 are currently using oral pills (OCPs, commonly known as “the pill”) for contraception.
According to a 2011 study conducted by Rachel K. Jones and sponsored by the Guttmacher Institute titled “Beyond Birth Control: The Overlooked Benefits of Contraceptive Pills,” (note: link opens a PDF file) approximately 18 percent of women age 15 to 44 currently use OCPs, some of whom use them for reasons beyond birth control:
- 86 percent of OCP users use the pill for birth control
- 58 percent of OCP users rely on it, at least in part, for purposes other than birth control, including cramps, menstrual regulation or pain, acne, endometriosis, or other unspecified reasons
While the pill is generally promoted as “safe and effective,” it is often prescribed without fully informing patients of the potential negative side effects.
And when women begin experiencing these side effects, they’re usually unaware that the pill could be causing them. In many cases, even their doctors don’t suspect the pill is a possible cause.
Recognizing Potential Undesirable Side Effects of the Pill
If you take the pill, you should be aware of the following common side effects of oral contraceptives:
- Spotting between periods
- Nausea
- Breast tenderness
- Headaches or migraines
- Weight gain or difficulty losing weight
- Mood changes
- Missed periods
- Decreased libido
- Vaginal discharge
- Changes in vision or discomfort wearing contact lenses
The pill, which uses synthetic hormones, can also create imbalances that increase certain health risks. Some evidence even suggests that taking birth control pills may raise a person’s risk of blood clots and high blood pressure, which can lead to a heart attack or stroke.
Birth control pills may also increase the risk of some forms of cancer (and may decrease the risk of others).
Good Intentions with a Potential Downside
Many teenage women start taking birth control pills to help with irregular cycles, heavy menstrual bleeding, cramping, and pain often associated with the premenstrual dysphoric disorder (PMDD) or polycystic ovary syndrome (PCOS):
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Premenstrual dysphoric disorder (PMDD) is like premenstrual syndrome (PMS) but more severe. Symptoms include severe irritability, depression, or anxiety in a week or two before the period starts.
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Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age (it can occur regardless of whether a woman has ovarian cysts). Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels.
The ovaries may develop numerous small collections of fluid (follicles) and fail to release eggs regularly.
PCOS is also linked to hyper adrenal function (resulting in excess of the hormones cortisol and DHEA), along with excess insulin or insulin resistance, which can impact blood sugar balance in a way similar to diabetes.
While reducing the pain and discomfort associated with the premenstrual dysphoric disorder and polycystic ovary syndrome is important, birth control pills containing synthetic estrogen and progestin can have long-term harmful consequences.
Gynecologists often feel that birth control pills are minimally invasive and relatively safe, which may be the case for some women. Unfortunately, these same pills can mask the problems causing the hormonal imbalance or even amplify the imbalance.
Addressing Estrogen Dominance
Many women who struggle with premenstrual dysphoric disorder or polycystic ovary syndrome have what is termed estrogen dominance — that is, they have a higher ratio of estrogen to progesterone than is normal.
Estrogen dominance is often associated with symptoms of weight gain (especially around the hips, buttocks, and thighs), heavy menses, and skin eruptions/acne.
The estrogen in birth control pills can exacerbate the imbalance. While birth control pills also contain progestins, they’re not the same as natural progesterone.
Therefore, taking birth control pills does not “balance” hormones. “The pill” actually changes how the brain signals the ovaries to produce hormones.
As these hormones are produced, they create a feedback loop signaling the brain that the body has enough circulating hormones, which slows or stops the natural hormone cycle.
Hence, there is no ovulation or ripening of the endometrium that prepares the body for conception. This can help to reduce symptoms but does not fix the underlying reason why the hormones are “imbalanced.”
Because the pill doesn’t address the underlying cause(s) of the hormonal imbalances, symptoms never fully resolve while a patient is on the pill, and other symptoms may arise years after being on the pill.
Identifying the Underlying Causes of Hormonal Imbalances
In our experience here at BioDesign Wellness Center, a Tampa Functional Medicine clinic, the most common factors contributing to hormonal imbalances in the patients we see are these:
- Estrogen dominance stemming from polycystic ovary syndrome or premenstrual dysphoric disorder
- Stress — physical or emotional
- Blood sugar imbalance — high or low blood sugar
- Candida yeast overgrowth (see “Candida Yeast Infections — A Growing Problem”)
- Small intestinal bacterial overgrowth (see “Understanding Small Intestinal Bacterial Overgrowth”)
- Environmental toxins (see “Detoxing with Cholestyramine and Natural Binders”)
- Gut microbiome imbalances (see “How Gastroenterologist Helps Treat GI and Bowel Disorders”)
- Nutrition/diet (see “Addressing Hormone Issues with Proper Nutrition and Diet”)
- Exercise — too much or too little
- Genetic factors
Case Study
Nancy, a 35-year-old Realtor and mother of three had been either on or off birth control pills since she was 17 years old. She started on the pill to help with the premenstrual dysphoric disorder.
Her weight was normal until her twenties, when her weight and breast size started to increase. Over the course of her pregnancies, she continued to struggle with weight issues and, at the time of her consultation, was about 80 pounds overweight.
She was taking a progestin-only form of birth control after discovering that the estrogen forms of the pill aggravated her symptoms, including migraines, nausea, and bloating.
While she had no history of polycystic ovary syndrome, her sister did, which indicated a likely genetic vulnerability to polycystic ovary syndrome.
Over the years, she had built up excess levels of estrogen, which was apparent when we received the results of her blood work and examined her estrogen-to-progesterone ratio. We replaced her progestin with bioidentical progesterone, and Nancy started to remove foods from her diet that caused blood sugar spikes. As a result of these two changes, she was finally able to start losing weight.
We also had her do a 60-day detox program to clear her body of excess estrogen. Balancing hormones requires more than just addressing low levels of certain hormones (such as progesterone in Nancy’s case). It also requires enabling the body to metabolize and remove excess hormones.
Her 60-day detox protocol included limiting foods with animal protein (to rest the liver) and taking a variety of antioxidants and vitamins via liquid and injections to support the process of hormonal metabolism in the liver. Additionally, hormones are cleared through the bowels, so we needed to make sure that she had normal bowel movements.
A Great Plains Laboratory Organic Acid Test (OAT), a urine test, revealed a yeast overgrowth in her GI tract. We treated the overgrowth with antifungal herbs and grapefruit seed extract, which reduced the bloating and discomfort she typically experienced during her cycle.
Although every patient is different, Nancy’s case is like that of many other female patients we see here at BioDesign Wellness Center in that multiple contributing factors had to be identified and resolved to improve her symptoms — weight gain (and inability to lose weight), menstrual irregularities, bloating, and headaches.
Taking a Cautious Approach to Birth Control Pills
Birth control pills can certainly be helpful as a contraceptive and as a treatment for certain health conditions, but the pill shouldn’t be assumed to be completely “safe and effective.” Long-term use can cause harm and trigger unforeseen symptoms beyond anything expected by patients or prescribing physicians.
If you’re on the pill and experiencing any of the health issues described in this post, or if you’re taking the pill to treat certain conditions and aren’t getting total relief, we strongly encourage you to consult with a functional and integrative healthcare provider to have your hormone levels checked and explore natural ways to restore a healthy balance.
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Disclaimer: The information in this blog post about the unintended side effects of birth control pills, is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at BioDesign Wellness Center, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.