We’re going to talk about birth control pills and birth control in general. I want you to have full informed consent when you sign up to take birth control pills, get an IUD, have surgery, or whatever your gynecologist is talking you into. I want you to be fully informed before you make that decision. If you’ve already made that decision and now you’re realizing that you weren’t fully informed, that’s okay. It’s never too late to change and do something different. Sometimes we have to deal with the consequences of those decisions, but all we can do is move forward.
One of the biggest lessons I’ve learned in my life is you cannot dwell on the past. I’ve had a lot of bad stuff happen to me in my life. I’ve had a lot of struggles and made a lot of bad decisions. You cannot dwell on them or beat yourself up. All you can do is start making better choices going forward and learn from those mistakes. I always say, “Fail forward, if you’re not learning, you’re repeating.”
I have a unique perspective because I used to be a conventional gynecologist. I handed you the birth control pills as a bandaid to all your symptoms. I did surgeries that probably shouldn’t have been done because other things were the root cause issue and that wasn’t really going to fix the problem. But once you know better, you do better. So, I’m here with my tail between my legs. I did the best that I could at the time with the information that I had.
I think most gynecologists care about you and want you to do well. Obviously, there are doctors who are a little bit ego-driven and more self-concerned, but I’m not saying your doctor doesn’t care about you. What I’m saying is, they might not be informed because they might be trained in antiquated medicine. I was practicing the same way doctors were practicing 50 years ago. Not a lot has changed in that sick care broken system. So, all we can do is realize the truth and move forward.
It’s important for you to be fully informed when you’re putting birth control in your body. There are long-lasting consequences for a lot of women. Infertility rates and hormone imbalances are through the roof. Definitely listen to my other episodes for reasons behind all that, but birth control is one of them.
Types of Birth Control
There are barrier methods, pills, IUDs, injections, implants, and permanent sterilization. So let’s talk about all of it.
Barrier methods are what is preventing the sperm from getting to the egg. Typically, that’s condoms, cervical caps, sponges, spermicide, IUDs, and diaphragms. One of my favorite barrier methods is the diaphragm. Believe it or not, I was actually given a diaphragm when I was 18 years old after I had my baby in 11th grade. My doctor gave me a diaphragm and said good luck and somehow by the grace of God, I didn’t get pregnant again. Honestly, I think the diaphragm works really well. You do need to use it with a spermicide for maximum effectiveness. It kind of takes the spontaneity out of things because you have to know you’re going to be intimate. You have to have time to go put it in and then you have to leave it in for four to six hours afterward. Say you’re having sex at night, you can just leave it in, go to sleep and take it out in the morning and that gives the sperm ample time to be killed off. It’s a little bit cumbersome, but I would say it’s a really good option if you’re trying to avoid hormones.
Watch the video version of this blog post here.
Back in the day, you used to have to get a pelvic exam and they would decide what size diaphragm you would get. Then you would get a prescription for that. Now, there’s something called the Caya diaphragm and it’s nice because it fits almost all women. You don’t need a pelvic exam or need to be fitted for it. So even if your gynecologist doesn’t normally prescribe diaphragms, they can prescribe you the Caya. It’s a great option if you are trying to avoid hormones.
Over-the-Counter Sponges, Spermicide, and Condoms
You could use over-the-counter methods such as sponges, spermicides, and condoms. Their effectiveness is very much dependent on the user and if you are using it as instructed. Typically, you’re protected 85-95% of the time. It’s not the most effective, but it’s pretty darn good.
You can add in cycling, like the rhythm method with the use of sponges, spermicide, or condoms. If you know when your period is and it’s regular every month, every 20 to 30 days and you know when you ovulate, then you can avoid intercourse during that time.
Typically, you want to start avoiding two days before you ovulate because sperm can live in the vagina and uterus for up to two days. Then you want to wait at least two to three days after you ovulate because the egg lasts for a few days after you release it. So, if you know when you’re going to have your period and you’re super consistent, the rhythm method can be very helpful. Put that on top of a barrier method and you’re good to go.
Birth Control Pills
Birth control pills are great for birth control, they do prevent pregnancy. But I want you to understand what you’re signing up for. So many of us aren’t on them for a short period of time. A lot of women are on them their entire reproductive life.
Birth control pills are synthetic hormones. They shut down the communication between your brain and your ovaries. Normally, your brain and ovaries talk to each other by the hormones they produce. This is called HPOA, hypothalamic-pituitary-ovarian access and that communication is very important to keep your cycle balanced. The birth control pill does not regulate your hormones, that is a myth. It shuts down their production completely and overrides the system.
What we’ve come to realize is that you’re on this for anywhere between 5 and 15 years and when you try to come off of it sometimes the brain and the ovaries, don’t talk to each other. That system has been down for so long they don’t even know how to communicate.
Often women will come off the birth control pill and not have a period, have scamp bleeding here and there, or it’s super irregular. What’s happening is your brain and your ovaries don’t know how to communicate properly and they don’t know how to respond to each other. This results in not having a consistent regular cycle. Sometimes your androgens can be elevated, your testosterone, particularly. And that can cause PCOS-induced birth control.
A lot of issues are associated with long-term birth control use. I’m seeing infertility rise because of this. I recommend only using it for birth control for the shortest duration that you need it.
The other main issues with birth control pills and all synthetic hormones that you’re putting in your body are it causes gut dysbiosis and leaky gut. It destroys the lining in your intestines called your epithelial lining. And if you have leaky gut, that makes you susceptible to autoimmune diseases, if you have the genes for it, like Hashimoto’s, Celiac, Lupus, and Rheumatoid. I can also create food sensitivities and systemic inflammation in your body. Systemic inflammation is the root cause of cardiovascular disease, cancer, and diabetes. Synthetic hormones long-term are really not safe and I don’t recommend them. I definitely want you to be aware of what you’re signing up for.
NuvaRing is essentially a birth control pill in ring form. They have the same synthetic hormones, risks, and side effects. They have the same potential for vitamin and mineral deficiencies, leaky gut, and hormone imbalance trying to come off of them.
Birth Control Shots
There are shots like the Depo-Provera shot. Depo-Provera is a progestin. There’s no estrogen in it. Norplant implant is also a progestin. It goes in your arm and looks like a little matchstick. It is a synthetic progestin that slowly gets released day after day over time.
Estrogens grow in the lining of your uterus and are a growth hormone. It grows your boobs, hips, and uterus lining. It’s preparing to get you pregnant. Progesterone is your balancing hormone to estrogen and it keeps that growth in check. Progesterone prevents the lining from growing too thick.
So, when you use birth control which is only progestin and progestins are synthetic progesterone, there’s a huge difference. They don’t talk about that and conventional gynecology. Your gynecologist might not even realize the difference but there’s a huge difference. These synthetic progestins prevent the lining of your uterus from growing. Without any estrogen to balance that progestin, sometimes the lining gets too thin and you bleed through it. There are 1000s of little arteries in your uterus. Those get exposed and they start bleeding because there’s nothing to stop that bleeding because there’s no estrogen. It’s really common with a Depo-Provera shot or Norplant rod to have breakthrough bleeding or to have bleeding constantly that just never stops. The goal is for you to have no bleeding.
If you are on a synthetic progestin not progesterone, a synthetic progestin for more than three years, you are going to thin out your bones. You are at risk for osteopenia and osteoporosis. If you’re young, it’s potentially reversible. If you get off that synthetic progestin and really support good bone health, you can sometimes bring back some of that bone thickening. It often doesn’t get discussed by conventional gynecologists. So, if you are listening to this and you’ve been on a Depo shot for more than a couple of years, you should get a bone density scan. It’s called a DEXA scan and it will tell you the status of your bone health. Osteoporosis has a major increase in the chances of hip fractures for older women. That’s the number one cause of death for elderly women is hip fracture. If you fall and break your hip, you almost never recover from surgery and leave the hospital. Oftentimes you end up going to a nursing home or dying. So sorry to be the bearer of bad news, but so much of this is preventable.
Image from: Reproductive Health Supplies Coalition
Popular hormonal IUDs include Mirena, Kyleena, and Skyla. They have a synthetic progestin in them, just like the Depo shot, and the Nexplanon rod. It gets slowly released day after day. The difference is that with the IUD your synthetic progestin is getting released inside the uterus where that lining is. The companies will tell you that it only works locally on the uterus to prevent that lining from growing. So, hopefully, you either have super light periods or no periods because you’re not growing any lining to shed. The problem with that is your ovaries are literally one to two inches away with a big fat artery connecting them and so that synthetic progestin goes into the bloodstream directly to the ovary. It tells the ovary “Wow, we have a lot of progestin in here. You don’t need to make any more hormones.” It’s really common for those IUDs to actually shut down that HPO Axis I was telling you about and you stop making your hormones.
Most women notice that they make less testosterone, no libido, and they’re not interested in sex. It’s the same thing when you’re on a birth control pill, testosterone production goes in the tank and you don’t have any libido. So, I just want you to keep that in mind because a lot of gynecologists tell patients that IUDs are not absorbed systemically and they don’t have any effects on your mood or your weight and that’s simply not the case.
The Mirena IUD has 52 milligrams of progestin, Ky Lena has 19.5 milligrams, and Skyla has 13.5 milligrams. Some women love the idea of the IUD because it is 99% effective. It’s the most effective reversible birth control out there. So, if you want to make sure you don’t get pregnant, it’s a great option. However, if you’re not handling the hormone aspect of it very well, you are feeling super depressed, gaining weight, or getting acne, then sometimes switching that out for a lower dose IUD like Skyla can make a difference for you.
Personally, I could not handle a Mirena IUD. It actually made me suicidal. That’s how strong it was for me personally and I have seen that with my patients time and time again.
On the flip side, I’ve seen a lot of women feel amazing on their Mirena IUD. It all depends on where you were when you started, and how much it’s affecting your HPO access, thyroid, and adrenal function. Everybody is different, but what I want to get across to you is that as long as you know the truth, risks, benefits, and alternatives, you should be able to sign up for whatever you want to. If you want a Mirena IUD every five years for 15 years, that’s your prerogative. Just know that it might be causing you issues that your doctor isn’t necessarily putting two and two together and relaying to you. So, if you’re struggling with things that seem hormonal, but you’re being dismissed, then you need to question and consider other options. If you feel amazing on it, good for you and I’m super happy for you.
Paragard is non-hormonal and it’s made of copper. It simply blocks the sperm from ever reaching the egg. It makes a hostile environment in the uterus, so the sperm dies off and never makes it to the tube where the egg is hanging out.
You’re not going to have any potential hormonal side effects. However, the most common complaint from a copper IUD is that it causes heavy painful periods. Here’s the key ladies, those heavy painful periods are usually from a hormone imbalance. So usually you’re already dealing with estrogen dominance or lack of progesterone to keep that estrogen balanced. There are some women that get the IUD placed that had great periods before that they get the Paragard and it got worse because you are creating a hostile environment with this foreign object inside your uterus. Some of us have more reactive and stronger immune responses than others. Your immune system is like, “Hey, that’s a foreign object in here, let’s attack.” And some women’s bodies never stopped that attack and that can create a lot of cytokine production and prostaglandin production. Those don’t feel good. It causes cramping and they make the period heavier.
But there are so many women who absolutely love it because it’s the most effective birth control that’s reversible. 99% of the time it doesn’t affect your hormones. Once it’s in you can leave it in up to 10 years. So, it’s a really great option for some women.
There is some talk about copper toxicity, but I think that’s a very uncommon issue for women. You can measure your serum copper levels. Sometimes that can cause your estrogen to go up. Although, I have not seen it that often in the past 20 years that I’ve been doing this.
Another option is permanent sterilization. You can get your tubes tied, but really, we cut, burn and remove them. We don’t tie them. It’s just a nice term to make it not sound as big of a deal. I do not recommend the Essure coils. That was a guinea pig situation where we just experimented on women and some women did okay, but a lot of women had major complications from Essure coils. So luckily, that has been exposed and is no longer an issue. If you’ve had Essure coils, there are little coils that go in the fallopian tubes to scar them shut to prevent pregnancy. They are known to cause cyclical pain. They’re known to migrate and leave the fallopian tube and go out into the abdominal cavity or into your uterus. A lot of women end up having other surgeries or even hysterectomies because of these complications. So if you had Essure, and you’re having chronic pain or abnormal bleeding, you need to get that evaluated because those little Essure coils could be the problem.
Have your partner get a vasectomy. If you’re 100% done having children this is another choice. However, you want to make sure you guys are 100% done having children because it’s permanent.
Focus on Gut Health
Focus on good gut health and make sure you’re not eating processed garbage food. Make sure you’re doing everything you can to keep your gut lining healthy. Sometimes that looks like supplementation or managing your stress better.
The other main issue with birth control pills is that they deplete really important vitamins and minerals. Namely B vitamins, magnesium, zinc, and selenium. Those vitamins are super important for energy production and thyroid function. This is what I see go hand in hand, ladies. A woman is on a birth control pill for 10 or 15 years, she develops a thyroid issue, her doctor says, “Oh, your thyroid is just sluggish.” Then that woman gets exhausted and she can’t function. She’s barely making it through the day, gaining weight, and losing hair. So much of it can be attributed to that birth control pill that she was on for so long because that combination of vitamin and mineral deficiencies, leaky gut, and autoimmune disease, culminates into thyroid dysfunction and chronic fatigue.
The amazing thing is it’s all reversible so, please don’t lose hope. Please be aware if you don’t have enough vitamins and minerals, then your body can’t do the processes that it needs to do all day long every day. So, if you’re on a birth control pill and you’re going to continue, please take a high-quality, nutraceutical grade multivitamin with methylated B vitamins. That will make a huge difference for you whether or not you’re going to develop fatigue like so many women are struggling with right now.
I honestly think every woman needs a high-quality multivitamin, not one from your corner drugstore. Those kinds of supplements are filled with heavy metals and fillers such as gluten and other toxicants. You need something that’s high quality and that’s third-party tested on the regular. You need good quality supplementation that you’re just not going to get from your diet.
To Wrap It Up
There are so many non-permanent options to choose from. I hope that this really helped give you a better idea of which way to go. If there’s anything I missed, please let me know. I’m trying to answer all your guys’ questions so that you can make the best-informed decisions despite what your regular doctor may or may not be telling you. The answers are out there, there are alternatives and other options. You don’t have to do what they say. Use your voice, speak up and always ask why, and come to me if it doesn’t make sense.