08/18/2021
Millions of women take birth control pills (BCP) for contraception and/or to treat an underlying hormone imbalance. BCPs block ovulation and thicken your cervical mucus so that s***m have a reduced chance of meeting up with a fertilized egg. But are they a good idea? That depends.
As a gynecologist practicing precision medicine, I have a skewed perspective when it comes to the Pill. I’ve seen many women over the years suffering with side effects from BCPs. From vaginal dryness to lost libido, from micronutrient deficiency to breast cancer, and from infertility and early menopause to worsening mood problems, I’ve seen it all.
There’s even a term for the former Pill-taking refugee, called “post birth control syndrome,” a constellation of signs and symptoms that together define a syndrome, not a disease. I wish more women were forewarned, and received full informed consent before picking up their monthly packets at the pharmacy. I would even call oral contraceptives the biggest hormone problem for women, and yet it’s iatrogenic – prescribed by clinicians and considered by most to be relatively risk-free, at least that’s what the pharmaceutical companies would like you to believe. They say BCPs are safer than being pregnant, but that’s not the right comparison when it comes to a woman’s quality of life, mood, confidence, agency, libido, and lubrication.
BCPs contain synthetic versions of estrogen and progesterone, the two main female hormones. Over time, the dose of synthetic estrogen in BCPs has declined, more synthetic progestins have been included, and regimens beyond the 21 day active/7 day placebo have been developed and marketed. Along with these changes, BCPs have gone far beyond pregnancy prevention. As you probably know, BCPs are prescribed, mostly off label, for acne, hirsutism, painful periods (dysmenorrhea, including endometriosis), irregular menstruation, heavy periods (menorrhagia), reduction in risk of ovarian and endometrial cancers, and improvement in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).
In upcoming posts, I will address the disadvantages, as well as the advantages of BCPs + recommendations and advice for those who are taking the pill to reduce the side effects.