by Mari Troitiño //
Disclaimer: Please note that the following article uses the word “women” to largely refer to cisgendered women; this is not meant to be dismissive of transgender and gender nonbinary experiences. We acknowledge that the discourse surrounding sexual and reproductive health greatly omits a diverse community of transgender and gender nonbinary people whose needs may have similarities and differences to the needs of cisgendered women.
If I asked you whether you use birth control, you would most likely respond in one of two ways: “Yes, I use the pill” or “No, I don’t use the pill.” Nowadays, it is not at all uncommon to equate the concept of birth control solely with the contraceptive pill. This assumption is risky because it negates not only the possibility of the wide array of other birth control methods that exist, but also the seeking of help by women and individuals with uteruses who are unhappy with the side-effects of their hormonal contraception.
Let me share with you something that you have not heard before: if you have been taking hormonal birth control for say, four years, you have not had a real period in four years. That’s right—the monthly bleed that you experience is not real menstruation. It does not result from ovulation, nor does it involve real estrogen or progesterone. Instead, the pill is derived from steroid drugs that function as a hormone replacement not greatly differing from the one supplied to menopausal women.
As Dr. Lara Briden claims in her best-selling book The Period Repair Manual, “Pill bleeds are pharmaceutically induced bleeds which are arbitrarily coordinated into a 28-day pattern to reassure you that your body is doing something natural. Having the occasional pill bleed is necessary to prevent breakthrough bleeding, but it doesn’t have to be monthly. A pill bleed could just as easily be every 56 days or every 83 days, or any number of days you’d like.” In fewer words, hormonal birth control causes you to bleed monthly, but relies on shutting down your ovaries and hormones. This made sense decades ago, in the 1950s, when contraception was illegal and hormonal birth control was starting to be developed. The pill was proclaimed a cure for irregular periods and other “womanly” disorders (rather than for pregnancy prevention) with the sole purpose of attaining legality. Without a doubt, the emergence and legalization of contraception was once a highly significant step towards the feminist movement and women’s jurisdiction over their bodies. But seventy years later, it should no longer be acceptable to sacrifice women’s overall health, nor to disregard less harmful anti-contraception in order to prevent pregnancy.
But why exactly should you want to quit the pill? After all, the pill keeps you free of worry, gives you clear skin, regulates your periods, subdues your monthly pains, and even makes PCOs manageable. And your doctor seems to agree! Or is not hormonal contraception the first solution offered by a medical professional when you complain of any of the former maladies? What if I told you that the contraceptive pill is not a permanent treatment for any of those, but rather a band-aid that conceals your underlying health issues while unquestionably worsening your overall wellness? What if I told you that you can have regular, painless periods, reverse PCOs, and effectively (and conveniently) avoid pregnancy?
If you are not yet convinced that you should quit hormonal contraception, let me introduce to you the lengthy list of its short and long-term health effects. We are all familiar with the more commonly reported symptoms of long-term pill usage: depression, loss of libido, weight gain, blood clots, and hair loss. Lesser known is the increase in breast cancer risk by three times while on a high estrogen drug, as well as high blood pressure, thyroid dysfunction, digestive problems, yeast infections, and many other illnesses. The higher depression risk had been more of an anecdotal than scientific fact up until 2016 when the medical journal JAMA Psychiatry established a significant correlation between girls and women relying on hormonal birth control and clinical diagnoses of depression. And may I emphasize that this study only took into account those women diagnosed, and not the many more who experience mood changes but do not (or cannot) seek help.
Post-pill side effects are not any better. After stopping taking the pill, polycystic ovaries for the first months (or longer depending on how long a person took the drug) are not uncommon. Neither is acne, post-pill PMS, or missing periods. After so many years without ovulating, women who are trying to conceive without success are sold fertility treatments as the only option. Still, you may be reluctant to go off the pill because you were prescribed it for reasons (which you thought to be) beyond your control. The truth is that if you were prescribed hormonal birth control at a young age to regulate your period, you likely only had to wait a few more years for the newly emergent hormones of estrogen and progesterone to self-adjust. And if you suffer from painful heavy periods, PCOs, or even endometriosis, I highly encourage you to read Dr. Briden’s book. In it, she describes natural and highly effective methods to completely heal (rather than placing a band-aid on them) these maladies. From an absolutely anti-inflammatory diet to supplementation of Zinc and Magnesium, The Period Repair Manual will teach you exactly how to take back the reins of your health.
By now, you may still have three questions: one, does a healthy period really matter so much anyway? Two, what other effective yet convenient birth control methods are out there then? And three, what about all the beneficial aspects of the pill that my doctor has talked about? To answer the first question, your period is, in the words of Dr. Briden, your monthly report card. It is a representation of your general wellness. A healthy woman will have regular, smooth and painless menstruations. If you are unhealthy in any way—whether under eating, under significant stress, or consuming a highly inflammatory diet—your monthly report card will not fail to show so. Plus, progesterone, one of the hormones involved in your menstrual cycle, improves brain health, hair growth, and combats inflammation, among other benefits. If at any point you do decide that the pill is no longer for you, I urge you to not postpone your natural period repair since the longer you wait, the more troublesome and difficult to reverse your issues will become.
Regarding the other birth control options in existence, know that outside of other hormonal alternatives (including but not limited to injections, the “mini” pill, and implants), there exist at least five other ways, ranging in efficacy and convenience of course, to prevent pregnancy. The least unreliable ones include the “pull-out” method and spermicide, but methods with a failure rate even lower than that of the contraceptive pill include male and female condoms, the copper IUD, diaphragms and cervical caps, and the Fertility Awareness Method. Lastly, the benefits that you associate with the pill (namely preserved fertility and postponed menopause) are based on the outdated and now disproved concept that women’s ovaries eventually exhaust their eggs.
This article would not be complete without a brief discussion of the gender disparity between women’s and men’s birth control choices. Though it is unquestionable that a woman who solely relies on a man’s cooperation for birth control is at a huge disadvantage to say the least, it is similarly interesting to note that there exists technology for male hormonal birth control which continues to stay off the market. Why? It is highly dubious that men would agree to shut down their hormones, experience low libido, and suffer depression among other ailments in the name of contraception. And to be completely fair: why should they have to? By the same token, why should women have to?
All this having been said, I want to stress the socioeconomic privilege that those women who can even ponder whether hormonal contraception is for them have. Birth control in any shape continues to be representative of women’s autonomy over their own bodies, and that must continue to be celebrated. My only argument is that it is now 2020—not 1950, a time when contraception was illegal and when the pill was the most convenient option to prevent pregnancy. Let us keep in mind that for reproductive health to be attained, eliminating the very things that make us female (at least biologically) is not the answer. For this reason, the privilege of choice—a consequence of resources and education—is more crucial than ever before.
(For more information on quitting hormonal birth control, what a healthy period is like, and treatments for all the maladies discussed above, make sure to read Dr. Briden’s The Period Repair Manual)