• Alex Bovell

Hormonal Birth Control… The Pill

Updated: Apr 3, 2019

Settle yourselves in and grab a cup of tea because this could be a long one! It’s something I believe we really should be taught in schools without a doubt. I remember learning this information at uni when I was 19 years old and questioning why am I only just finding this out now?


We all know when it’s our time of the month cupcakes and chocolate and all of the sugar is what we crave, but that’s about all I used to know about ‘my time of the month’. It seems ridiculous that we’re not aware of our own bodies, we’re not aware what a period really is and we definitely aren’t aware of the harm hormonal birth control can have on us. Like anything, contraception does have a place in this world I’m not going to deny that. However, the problem I have is that it’s being prescribed to girls FAR TOO YOUNG without other options being explained or explored first, causing immediate and future problems. Hormonal birth control is relatively new, only being invented in the 50’s which means if you’re my age (23) your mother would’ve been using it and perhaps her mother. Therefore, we’re still finding out soooo much research about this little pill and in particular the negative consequences. The Oral Contraceptive Pill (OCP) is one of the world’s most prescribed medications with over 100 million women across the globe using it.


This is an incredibly BIG topic, so for today, I’m only going to speak about the basics and my experiences with the Combined OCP & The Implant. I’m not writing this to tell you what to do with your body, I have no right to do that! I’m only trying to provide some basic explanation about a very complex and taboo topic. Knowledge is power, so once you’re aware of the facts it’s then your choice.


Fun Fact

Did you know that it takes 12 years for your menstrual cycle to mature from your first period! Think about it, if you’re placed on contraception before you’ve had a cycle for 12 years, the natural maturation process is halted.  In my case, this is probably why it took years for my period to naturally return after years of contraception.


How Does Hormonal Birth Control Work?

An OCP Bleed IS NOT a real bleedA real period is the natural cycling of hormones

Lara Briden states, pill bleeds “are pharmaceutically induced bleeds that are arbitrarily coordinated into a 29-day pattern to reassure you that your body is doing something natural”.


We often hear from others the pill regulates our hormones which isn’t true because the pill’s steroids DO NOT equal natural hormones. In our bodies, we have ovarian hormones called estradiol & progesterone. Whereas, in contraception the steroid drugs used are ethinylestradiol, drospirenone, levonorgestrel & others. Levonorgestrel is a progestin (similar to progesterone – a natural ovarian hormone) because it suppresses ovulation and thins the uterine lining (endometrium) to prevent pregnancy [1]. However, if you look at the molecules Levonorgestrel is actually MORE similar to TESTOSTERONE than it is PROGESTERONE. The OCP works by preventing the ovary from releasing an egg and changing the lining of the uterus making implantation difficult. Basically, hormonal birth control such as the OCP shuts down natural hormones and functions as a synthetic hormone replacement.


Combined OCP

This was the first method of contraception I ever used starting in year 8 to ‘regulate’ my period whilst I was playing a lot of sport. I was on this form on contraception from 2008-2012. This is probably one of the most classic methods, a pill that contains a combination of synthetic estrogen & synthetic progestin in the form of ethinylestradiol levonorgestrel. The main way the OCP works is by inhibiting ovulation like I explained above.

It was only last year when I saw a naturopath and was explaining my timeline of crazy events that I realised straight after going on the OCP my depression definitely became worse. After recently researching, I learnt depression is the most common reason women come off their OCP and the use of hormonal birth control is associated with subsequent use of anti-depressants [2, 3]. These studies highlight depression and the OCP could potentially be linked and that really worries me!


The Implant

This was the second method I turned too, due to the fact it was ridiculously cheap and didn’t require me doing anything once it was inserted into my arm for 3 YEARS. I thought I was winning and this seemed like a dream come true to me! I stayed on this form of contraception from 2013-2016. The implant is a progestin-only rod that’s inserted into your arm suppressing ovulation. Personally, the big side-effect I noticed going on the implant was how anxious I became! I was such a nervous wreck all the time and I don’t know if that’s linked or not but it seems like a coincidence to me.


Coming OFF contraception

In 2016, I came off the implant and didn’t go on any contraception. I wanted to see what my body was doing naturally as I was studying nutrition and becoming extremely interested in natural health. I was naive to think my period would start up again knowing what I know now as I never gave my period the time to mature (12 years) and I suppressed my natural cycle for 3 years completely on the implant never bleeding once from 2013-2016. From the day I had the implant taken out to this year I hadn’t had 1 period, that’s 5.5 years WITHOUT a natural bleed. I really don’t believe this is good for our bodies, we’re preventing a natural cycle… messing with our bodies!


Acne

When I stopped the contraception I had severe acne all over my chin for months. I’d never experienced acne this bad before and I was bloody confused!

Why does this happen in many women who stop their birth control?

The steroid drugs in hormonal contraception suppress sebum production which is the oil in our skin. The progestin – cyproterone, actually suppresses sebum to ‘childhood levels’ which is disturbing considering we’re adults and this shouldn’t be happening. Our body responds to this situation by upregulating sebum which means it increases sebum production and this increased production continues even when you come off hormonal birth control.

On top of this, your ovaries are triggered when coming off the OCP to make more androgens such as testosterone which also increases acne. It’s like this horrible double whammy of pimples as some sort of withdrawal effect of the OCP. It lasted for about 3-6 months until everything started to clear up and my breakouts calmed down.


Post-Pill Amenorrhoea

I also suffered terribly with post-pill amenorrhoea and what I now guess was hypothalamic amenorrhoea. This is such a complex topic that I’ll go into further one day but basically, my hypothalamus-pituitary-ovarian (HPO) axis was disrupted and this is where our natural cycles come from, this delicate balance of hormonal reactions.


Like I said before, there’s SOOOO much to talk about for contraception and hormonal birth control. In fact, there is heaps that we aren’t aware of growing up in regards to our periods and cycles. I hope this brief little snippet of information can help you a little and provide you with the knowledge to know what questions to ask. I’d never tell anyone what to do with their bodies, I just think it’s important to know what contraception is and if you want more information get your hands on ‘The Period Repair Manual’ by Lara Briden! Best $30 I ever spent as she explains all about periods in such a simple way!


References

[1] Gilson, G. (2007). Clarifying hormone terminology. Canadian Family Physician, 53(1), 29-30

[2] Kulkarni, J. (2007). Depression as a side effect of the contraceptive pill. Expert opinion on drug safety6(4), 371-374.

[3] Skovlund, C. W., Mørch, L. S., Kessing, L. V., & Lidegaard, O. (2016). Association of hormonal contraception with depression. JAMA psychiatry73(11), 1154-1162.