The Pill

The birth control pill (“the pill”): miraculous reliever of debilitating periods for some, an effective and convenient birth control option for others, and for a few the cause of major side effects and complications.

Introduced in 1960, the pill revolutionized women’s lives by giving them a choice about their family size. Its discovery also stifled the growth of alternatives to hormonal birth control in North America; the pill was and still is promoted as the primary choice for women.

As a doctor, with a primary focus in obstetrics and gynecology, I have seen the benefits and the woes of hormonal contraceptive methods. I have treated those rare women who had strokes or premature ovarian failure after using the pill.

On the flip side, I have worked in maternity wards in developing countries with women begging me for birth control options not available to them, because they cannot support or feed the children they have, never mind the baby I have just delivered for them.

Birth control options should be available to women, but women should be informed of the pros, cons, side effects, risks, and alternatives.

Pill Pros

The pill is a combination of synthetic estrogen and progesterone formulated to suppress ovulation. Manufacturers have been able to lower the doses of hormones without losing effectiveness, thus improving their safety and minimizing side effects.

Oral contraceptives are among the most extensively studied pharmaceutical preparations. It is important to understand, though, that the existing research is mainly from data prior to 1980, when higher doses of estrogen were used. The effects of long-term use of lower doses of hormones remain to be determined.

Effective Contraception
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Effective Symptom Relief

The pill reduces heavy bleeding (and anemia), painful periods, irregular periods, and acne. Although effective for symptom relief, the pill does not treat what caused these problems in the first place.

I use diet, detoxification, herbs, and nutritional supplements to correct the underlying imbalances and I reserve the pill for occasions when the severity of the symptoms necessitates it.

Protection Against Ovarian and Uterine Cancer

A recent review looking at 45 studies found a reduction of ovarian cancer before the age of 75 if oral contraceptives were used for 10 years.

The Nurses’ Health Study (tracking 120,000 nurses over the past 25 years) found that women taking the pill for five years were protected for at least another decade against ovarian cancer.

This study also corroborated evidence from previous research that women who took the pill for two years reduced their risk of uterine cancer for another 15 years.

Rapid Reversibility

The majority of women will return to ovulating only two weeks after discontinuing the pill; however, for some women periods do not return for many months.

Pill Cons

Within one year of starting, 33 to 50 percent of women have discontinued the pill, often without consulting their health care provider.

Nutritional Deficiencies

Long-term use causes a deficiency of folate and other B vitamins along with vitamin C, magnesium, and zinc. I recommend women on the pill take a multivitamin high in B vitamins and folate and increase their fruits, veggies, and whole grains.

Women are often told they can conceive shortly after discontinuing the pill, but folate deficiency, linked with spina bifida, can take six months to correct after pill use.

Suppression of Menstrual Cycles

Women are cycling in a linear world. Is it any surprise then that the message in our culture is that our period is inconvenient–and unnecessary? An interesting study in the 1930s–well before the pill was introduced–found that during the first half of the menstrual cycle, women’s energy was directed toward the outer world. During ovulation, women were receptive to being cared for and loved by others. During the premenstrual or postovulatory phase, women were more focused inwardly.

As a clinician, I encounter a startling lack of knowledge among today’s women about how their bodies work. I empower them to embrace their cycle, something the pill completely suppresses.

Does Not Prevent HIV and Sexually Transmitted Diseases

Increases Risk of Serious Illness

Women who take the pill face increased risk of breast cancer, blood clots, deep vein thrombosis, heart attack, stroke, and malignant melanoma.

Breast cancer risk increases with long-term pill use; for each year she uses the pill a woman’s risk increases 3.3 percent. The excess risk gradually disappears within 10 years of stopping the pill.

Because the breast cancer rate is only 15 percent before age 45, many researchers feel it is safe for younger women. However, evidence shows a higher risk for those who start taking the pill before age 20.

Heart attack risk greatly increases when women who take the pill smoke, while blood clots and strokes are more prevalent with the use of high-dose pills and the contraceptive patch.

Estrogen In the Water Supply

Women on the pill excrete hormones into waste water. These compounds have also been found in our drinking water; the effects of excreted hormones in our lakes and streams as well as in our drinking water are currently being investigated by the US Environmental Protection Agency.

Side Effects

Women can experience mild side effects such as abdominal bloating, cramping, spotting, acne, breast tenderness, mood swings, fatigue, nausea, and vomiting. Less common side effects include headaches, depression, changes in weight, high blood pressure, vaginal yeast infections, and lower libido.

Contraindications

Currently hormone contraception is not recommended for women who smoke and are over age 35, who have a personal history of diabetes, blood clots, high blood pressure, heart disease, or breast or uterine cancer.

Alternatives

Frequently I see patients who are seeking alternatives for birth control; these women have often been offered hormones or condoms as the only choices by their medical doctors. Women are surprised to learn there are many alternatives, including various methods of fertility awareness, cervical caps, diaphragms, and IUDs (intrauterine devices).

I believe in empowering women to learn more about their bodies’ cycles. I also believe in providing women with choices about how to practise birth control using methods that meet their needs and agree with their personal beliefs.

Hormonal Contraception Options