A patient consults me because she wants to get pregnant. She recently got off the birth control pills she had been taking for more than a decade, only to find that her period is not coming back like she thought it would. She is worried that she might have an underlying hormonal imbalance.
She may be right.
The pill can regulate menstrual cycles and improve period-related symptoms, but contrary to popular belief, it does not balance hormones. In fact, it can mask underlying problems—and actually cause hormonal imbalances.
Menstrual Cycle Regulation
When a young woman goes through menarche and has her first period, it often takes some time for her menstrual cycle to normalize and her periods to become regular. She may also have distressing symptoms such as painful or heavy periods, acne, and bloating.
Several factors can affect the severity of cycle irregularities and symptoms, including excessive exercise, weight (overweight or underweight), and some medications. There may also be an underlying hormonal imbalance from the get-go that is contributing to irregularity and symptoms.
Instead of taking a closer look at her hormone levels and investigating the underlying factors contributing to hormonal imbalances and how best to address them, the “solution” in the overwhelming number of cases is to simply start her on oral birth control pills.
Birth Control Pills Do Not Help with Hormonal Imbalance
Oral contraceptives contain synthetic estrogen and progestin, an artificial form of progesterone. (The mini pill is progestin only.) These synthetic hormones, which vary in doses in each daily pill over the course of four weeks, prevent ovulation (the release of an egg from an ovary), thicken the cervical mucus, thin the endometrium (uterine lining), and, during the last week, trigger a menstrual period.
In addition to preventing pregnancy, this makes menstrual cycles regular and may help with undesired symptoms. Unfortunately, many women have the misguided belief that because their periods are now regulated, their hormones are balanced. In actuality, this is not true.
Rather than balancing endogenous hormones—the estrogen and progesterone that are naturally produced in the body—the synthetic hormones in birth control pills artificially suppress them. So, the hormonal imbalance has not been “fixed.” It has been suppressed altogether!
After Years on Birth Control Pills
Fast forward 15–20 years—the length of time most women stay on birth control pills. Like my patient, they are often surprised when their periods don't bounce back after discontinuing the pill.
That’s because those initial symptoms, which sparked the decision to start on oral birth control in the first place, were never investigated and are still there. Underlying conditions, including polycystic ovary syndrome (PCOS), endometriosis, and autoimmune diseases, may have gone undiagnosed for years.
In the meantime, the adjacent adverse effects of synthetic hormones plus other factors such as lifestyle choices, excessive stress, and our often toxic environment (EMFs, plastics, xenoestrogens, artificial light, etc.) have compounded the issue.
What is Post-Birth Control Syndrome?
There is now research showing that oral birth control pills have a negative impact on the female body that doesn’t always go away when they are discontinued. Symptoms of this condition, called post-birth control syndrome, include:
- Acne, cystic acne, rosacea, and other skin problems
- Amenorrhea (lack of menstrual periods), which can last on average three to six months
- Mood symptoms, including anxiety and depression among others
- Low libido
- Hair loss
- Headaches or migraines
- Heavy, painful periods
- Gas or bloating
- Gut dysbiosis
- Inflammation and immune imbalances
Benefits and Side Effects of Hormonal Birth Control
Don’t get me wrong, I believe the oral birth control pill is an AMAZING, life-changing, and life-saving discovery that has given women autonomy over their bodies and their ability to procreate—or not to procreate. It is very important for women, especially teens, to have a relatively simple and reliable method of birth control.
But the pill does have a downside. Up to 60% of women report experiencing side effects of hormonal birth control. The most common include breast tenderness, mood changes, spotting, and headaches. However, birth control pills can also have a negative impact in these areas:
- Microbiome, contributing to leaky gut and SIBO
- Thyroid and adrenal health, causing other hormonal dysregulation
- Metabolic health, increasing the risk of stroke, cancer, insulin resistance, and elevated blood pressure
- Mood and anxiety
- Fertility and libido
- Nutrient levels, as these drugs may deplete certain key nutrients
- Inflammation and susceptibility to autoimmune disease
You Do Have Options
When I question my patients, most of them were not initially put on oral birth control pills to prevent pregnancy but to regulate their periods and improve menstrual symptoms. Their hormones were not tested, nor were potential causes in addition to hormonal imbalances discussed.
They were also unaware of the full range of adverse side effects. For example, did you know that there is a 300% increased risk of Crohn’s disease in women who take birth control pills!? I bet that was never given to you as a disclaimer—and likely still isn’t when women are offered this as a treatment for symptom relief.
I firmly believe a woman has the right to thoroughly understand the reasons for her symptoms and the potential hormonal imbalances at play before her practitioner starts her on synthetic hormones for symptom management.
I also believe that every young woman needs to be educated and empowered to understand her hormonal cycles and what is going on in her body at each stage of her cycle. Learning the Fertility Awareness Method (FAM) empowers women to track what is going on at different times during the cycle, to understand the signs of ovulation, and to recognize her fertile days.
When used correctly, FAM is 95-99% effective in preventing unintentional pregnancies. In comparison, even when used correctly, the oral birth control pill is only 90% effective, which means that every year, nine of 100 people using the pill will get pregnant.
Birth Control Pills Recap
The pill can be an amazing tool for birth control for some women. It may also help reduce disruptive menstrual symptoms related to hormone imbalances—but you must understand that hormonal birth control does not correct the hormone imbalance.
It is up to you and your healthcare provider to discuss your options and then decide on the correct path for you. Never feel that the oral birth control pill is the only option, especially if, like many women, you experience negative side effects. There are natural therapies for balancing hormones and preventing pregnancy. As with everything surrounding your health and well-being, you need to take the driver’s seat.
This knowledge is also an opportunity to be an active co-pilot riding shotgun for a younger woman in your life who is experiencing symptoms of hormonal imbalance. Support her by encouraging her to get the testing and full diagnostic workup she deserves to understand the “why” behind her symptoms. Then, with thorough informed consent on the pros and cons of the oral birth control pill, she can decide if that is a valuable option for her.
Also know that this is where naturopathic medicine shines. Do not hesitate to search out and consult an alternative healthcare practitioner such as a naturopathic doctor to listen to your concerns and support you if your symptoms are dismissed by your current provider.