Birth Control Pill: The Good, The Bad, and The Ugly

As a Naturopathic Doctor who focuses on women’s health, one of the most common questions I’m asked is “so, is birth control really that bad for me?” The answer, like most medical questions, is ‘it depends’.

Birth control is a very controversial topic, especially amongst health care professionals. I have seen the birth control pill be demonized by some doctors, essentially scaring women into believing they must forgo any form of hormonal birth control. I however, find this very disheartening. A woman should never feel ashamed about her reproductive rights, or feel guilty for using the birth control pill.

The choice to use or not to use birth control pill is a personal one. There is no one right answer or clear pathway for everyone. There is though, the evidence for and against birth control, which can help women feel empowered to make an informed decision.

Most important, it gives women a choice to decide when they are ready to have children. When used effectively, it can be 99.9% effective at preventing pregnancies. This is a game changer for women who are not yet ready to be become pregnant, be a mom and raise a child. This is a something we are fortunate to have in Canada.

The Good

Decreased risk of endometrial and ovarian cancer- The use of the birth control is linked to a decreased risk of endometrial and ovarian cancer. The birth control pill causes your uterine lining to shed every month, reducing the risk of endometrial hyperplasia. It also reduces your risk of ovarian cancer, although the exact mechanism is not known. These protective effects seems to last for 15 years after stopping the pill, before diminishing back to baseline risk.1

Symptom management- Birth control can be a miracle worker for many common ailments. It can help manage flow, reduce pain and cramping, produce a steady cycle length, and lead to clear skin. Birth control may potentially help stabilize mood and fix hormone related headaches (more on this below). For some women, this can be life-changing. If someone is completely debilitated by their symptoms, the birth control pill can offer an a highly effective method for management. Although the birth control pill does not address the actual root cause of your symptoms, it is an option to consider.

The Bad

Unwanted new symptoms-While the birth control pill can help manage migraines and mood swings in some women, it was exacerbate or induce these problems in others.2 Estrogen has a direct impact on serotonin levels in our body, the ‘happy hormone’. This can lead to symptoms of depression after starting the birth control pill. The birth control pill can also worsen migraines, as the sharp decline in estrogen after finishing a pack can trigger an attack.3

Nutrient Depletion- I find it absolutely shocking how little medical doctors talk about this, if at all. It is well documented that the birth control pill depletes several important nutrients, most notably B6. The birth control pill also depletes Vitamin C, B2, B12 and folate, which are all extremely important for health.4 I always recommend working with a Naturopathic Doctor who recognizes these nutrient depletions and has the expertise to supplement appropriately.

The Ugly

Increased risk of Breast and Cervical Cancer- The most concerning issue with birth control use is the risk of increased breast cancer, especially estrogen-positive. Use for 5 or more years is associated with a modest increase in the risk for breast cancer for women between the ages of 22-49.  However, the risk does decline back to baseline after ten years after stopping birth control.5 There is also an increased risk of cervical cancer with use beyond 5 years, but this risk also declines to the same level as non-users ten years after stopping.6

As you can see, the decision to start, stop or continue birth control is complex and personal. I strongly believe in educating my patients on their different birth control options, and coming up with a solution for works for them. It is important to get the facts, understand the risks and benefits, and ultimately make the best decision for you. If you are unsure which method of birth control is right for you, let’s talk and find a solution that fits your lifestyle, family history and personal health.

 

References

  1. Vessey, M. P., & Painter, R. (1995). Endometrial and ovarian cancer and oral contraceptives-findings in a large cohort study. British journal of cancer, 71(6), 1340.
  2. De Leo, V., Scolaro, V., Musacchio, M. C., Di Sabatino, A., Morgante, G., & Cianci, A. (2011). Combined oral contraceptives in women with menstrual migraine without aura. Fertility and sterility, 96(4), 917-920.
  3. Brandes, J. L. (2006). The influence of estrogen on migraine: a systematic review. Jama, 295(15), 1824-1830.
  4. Wynn, V. (1975). Vitamins and oral contraceptive use. The Lancet, 305(7906), 561-564.
  5. Beaber, E. F., Buist, D. S., Barlow, W. E., Malone, K. E., Reed, S. D., & Li, C. I. (2014). Recent oral contraceptive use by formulation and breast cancer risk among women 20 to 49 years of age. Cancer research, 74(15), 4078-4089.
  6. International Collaboration of Epidemiological Studies of Cervical Cancer. (2007). Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16 573 women with cervical cancer and 35 509 women without cervical cancer from 24 epidemiological studies. The Lancet, 370(9599), 1609-1621.
2019-01-24T16:54:51-05:00