PILL OR NO PILL? UNDERSTANDING HOW BIRTH CONTROL ACTUALLY WORKS

Over the past several decades, the availability of birth control has allowed women to stay in control of their reproductive health. Know how it impacts your health, and choose what’s right for your body.


BY: VICTORIA YATES, RN

As a woman, it’s important to stay in tune with what’s going on in your body during your monthly cycle. And if you’ve been on hormonal birth control, there are more things to pay closer attention to. 

Historically, there has always been controversy when it comes to hormonal birth control. When it was first approved by the Food and Drug Administration in 1960, it was only approved for women who were married.

Today, the use of hormonal birth control is being debated on its benefits and risks as more women are questioning whether it’s truly needed. However, it’s important to have an understanding of what hormonal birth control is before making that judgment call. 

So how exactly does birth control work?

Hormonal methods of birth control are, by definition, synthetic hormones that work to interrupt your body’s normal release of hormones and often prevent ovulation. It is configured to include either synthetic estrogen and progesterone, or just synthetic progesterone. 

You may see ingredients such as norethindrone, which is the synthetic progesterone, as well as ethinyl estradiol, which is synthetic estrogen. No matter what it’s composed of, it works to suppress your body’s normal hormones that would bring about ovulation and a suitable environment for you to conceive. 

By interfering with one or a couple of these hormones, it sends a cascade-like reaction that leads to a high chance (99% when used correctively) of not getting pregnant. For the hormonal birth control that involves both synthetic progesterone & estrogen, your body’s natural hormones will be suppressed and your chance of getting pregnant greatly decreases. 

Specifically, it suppresses the release of the key ovulation hormones Luteinizing Hormone (known as LH) and Follicle Stimulating Hormone (FSH), which promote maturation of the follicle surrounding the eggs in your ovaries that leads to egg release or ovulation, as well as the thickening of your uterine lining to prepare for implantation of a fertilized egg. By suppressing the release of these two hormones, it prevents both the start of a new cycle as well as preventing ovulation.

Progesterone-only birth control works similarly, but instead of disrupting ovulation, it prevents sperm from reaching the egg by thickening the cervical mucus and thinning the lining of the uterus to make it less suitable for pregnancy. It essentially works by making the environment for pregnancy and fertilization less optimal.

While most women are familiar with “the pill” as their chosen form of hormonal birth control, there are other options out there that function similarly.

INTRAUTERINE DEVICES (IUDs)

These work similarly to the pill by releasing a steady amount of hormones, which suppresses ovulation or makes the environment in your uterus unsuitable for pregnancy. The exception is the copper IUD, which does not release hormones but instead creates an unsuitable environment for sperm with the copper in the device. These devices are small and t-shaped and are placed in your uterus by a doctor or advanced practitioner such as a nurse practitioner or physician’s assistant.

IMPLANTS

Implants are small rod-like devices that are placed typically in the upper arm. They work by releasing synthetic progesterone, Etonogestrel, into your bloodstream and, like the progesterone-only pills, works by creating an unsuitable environment for pregnancy. Again, this is put in by a licensed advanced practitioner. 

SHOT

The depo-shot is another form of hormonal birth control that is administered every 12 weeks by a health provider. This form is not used as often due to its side effects, including decreased bone mineral density and a delayed return of fertility.

PATCH

The patch is an adhesive on your skin which releases synthetic estrogen and progesterone. It is worn for a week before changing it out, and repeating for three weeks before taking a week off which elicits bleeding. Side effects can be greater with this form, such as the increased risk of blood clot formation

So what are the benefits of using birth control?

When it is used as intended, birth control provides predictability in your cycle by taking the “guesswork” out of more natural approaches such as FAM (fertility awareness method). It can also decrease symptoms of your period or take away your period altogether.

However, with that said, what is put into your body to alter its natural system is hardly ever truly benign. With hormonal birth control, suppressing your body’s natural hormones can interfere with your gut microbiome and immune health.

Secondly, it can lead to the depletion of important micronutrients in your body such as folic acid, B-vitamins, magnesium, and vitamin C. By knowing this, it’s important to supplement with a multivitamin to help support your body. 

Lastly, it’s important to remember that hormonal birth controls disrupt ovulation and menstruation, which can have negative effects on bone health in the long run.  

In knowing all this, just remember that you are in control of whether you should or shouldn’t be on hormonal birth control. Be empowered in what you do, 

And the opportunity to choose what’s best for your body.

Adapted from the original post.
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Victoria Yates, RN is a Registered Nurse & Certified Intuitive Eating Counselor based in Westchester, NY who focuses on helping women reach a healthier relationship with food and their bodies. She is passionate about guiding others reprogram negative thoughts around food and body image so they may experience a truly joyful life. 

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