In this episode I’m going to be talking about birth control pills (also known as oral contraceptive pills) and the information that I feel is important for everyone to have, especially those of you who are considering taking birth control pills or are already taking a birth control pill. This topic is important because a lot of this information is often not shared by the providers who are prescribing these pills. It’s really necessary to understand everything before you make any decision about what to take for your health.

One of the things I want to talk about are the risks related to taking birth control pills, including risk of HPV related cancers (like cervical cancer) and nutrient deficiencies associated with the use of “the pill.” I also want to help you understand how it’s possible to feel good and balance your hormones and ovarian function naturally if you have reached a point in your life where you don’t want to take birth control pills anymore.

It is estimated that more than 10 million women in the United States alone are taking the birth control pill. These are prescription medications, and they are synthetic hormones. When these pills are made, they’re made with chemical versions of estrogen and progesterone. You can get birth control pills that are only a synthetic form of progesterone, but most people take what are called combined formulas that contain synthetic estrogen and synthetic progesterone. 

When we make a hormone synthetically it signals to our bodies, but it doesn’t signal exactly the same as natural hormones or bioidentical hormones. So, I want to emphasize that when I’m talking about birth control pills, I’m referencing synthetic hormones and the risks associated with those types of hormones versus bioidentical or natural hormones, like naturally produced estrogen and progesterone, or bioidentical estradiol, for example, or estriol, and progesterone formulas that are sometimes used for fertility and perimenopause.

Our bodies recognize bioidentical hormones. They know exactly what they are and they know how to respond to them in a healthy way. When we take a synthetic hormone, it can have a slightly different effect in our bodies and that’s why there are side effects and risks associated, especially with longer term use.

If you’re taking synthetic hormones on a short-term basis, the risk of health issues is lower and as the length of time increases, the risks increase. Sometimes you may need birth control pills for a short period of time and that may not be as concerning. It’s also known that the risks tend to decrease the longer you are off the birth control pill.

Why Are So Many Women Taking Birth Control Pills?

What I find in my practice is that for most women (I would say definitely greater than 50%), the pill is not just being used for birth control. They’re more often prescribed by gynecologists for regulating the menstrual cycle in some way.

Most women, when they go in to see a gynecologist, it’s usually to get help with irregular menstrual cycles or maybe perimenopausal symptoms, PCOS or endometriosis, or perhaps you have PMS symptoms or even PMDD, higher anxiety or depression and fatigue, bloating, severe cramps or heavy bleeding and acne during your period. All of these symptoms can happen because of hormone imbalances related to the menstrual cycle. And often times the first thing a gynecologist or other practitioner will prescribe is a birth control pill.

What the birth control pill does is it takes over for your ovaries. It literally turns off the ovaries, so your ovaries are not making estrogen and progesterone on their own. You are relying solely on the synthetic estrogen or progesterone that you’re swallowing in the birth control pill. This is why if you miss a dose, you could have breakthrough bleeding or other symptoms like headaches, nausea, etc. because these hormones are signaling to your body every day. 

Birth control pills can regulate the menstrual cycle, decrease bleeding, pain and acne for a lot of women, which can help them keep up with their daily life. At the same time, it’s absolutely false to think that the only option to help with menstrual related symptoms is to use a synthetic hormone pill. 

There are a lot of things we could do to help with those symptoms and support your body naturally to address them without necessarily having to use a synthetic hormone pill. Now, if your priority is to prevent pregnancy at this point in life, maybe birth control pills are a good option, but there are also other options for contraception that don’t require to take a synthetic hormone. I’ll discuss them more later in this episode.

What Are the Risks of Long-Term Use of Birth Control Pills?

Nutrient deficiencies: 

Birth control pills can end up depleting our nutrients. This is especially true of some of the B vitamins like B2 or riboflavin, B6, B12 and Folate or B9. All those B vitamins can become deficient with use of birth control pill. Also, vitamin C and vitamin E can become deficient. Minerals like magnesium, selenium, and zinc can also be affected. This is why it is important to take a good quality multivitamin if you are on the birth control pill. If you would like to learn more about high-quality multivitamins, you can watch Episode 167 of How Humans Heal here.

One of the ways to know if it’s a high-quality multivitamin is to look at the ingredient list. Look at what form of folate is in the product. We want it to say “Methyl Folate” (or 5MTHF) instead of Folic Acid. If the label says Folic Acid, it’s not a high-quality product. Then look at the B12, if it says Cyanocobalamin, it’s not a high-quality product. It should say Methyl Cobalamin instead. This way you know you’re getting active forms of the B vitamins. If a company is putting in those active forms of B vitamins in their products, they’re much more likely to be a professional grade company that’s invested in getting the nutrients that you need.

It’s also important to be doing regular blood work to identify nutrient deficiencies. And it’s important to do the right tests to get the correct information. That’s why it’s so important to have a practitioner who can guide you. I guide each of my patients on how to get the correct blood work and what the results mean. For example, it’s not that helpful to only measure folate in the blood – we need to be measuring homocysteine. 

HPV and Cervical Cancer:

Furthermore, I believe that one of the connections between HPV risk and birth control pills is related to the nutrient deficiencies. In cases where HPV is persisting and resisting treatment, I recommend doing blood work because I often find nutrient deficiencies exist. When you have low antioxidants and low B vitamins, that already increases the risk of HPV related abnormal cells and cancer risks. So, an important preventive step you can take is to make sure you’re meeting your nutrients needs and monitoring your blood levels.

There are many studies connecting birth control pills to cervical cancer risk. One study in particular shows there’s a 10% increased risk of HPV causing cervical cancer with less than five years of birth control use, and a 60% increased risk for five to nine years of use, and a doubling of the risk with 10 or more years of use.

If we talk about hormonal IUDs, there is also an increased risk with cervical cancer whereas the copper IUD does not have that risk, so the risk does seem to be related to the synthetic hormones. There are studies where the researchers try to identify exactly what’s happening – there are multiple mechanisms besides the nutrient deficiencies where these synthetic hormones also are signaling to the immune system locally and the way that our body manages cells even at a local level on the cervix. 

Cardiovascular Issues: 

Birth control pills are also associated with increased risk of certain cardiovascular issues including heart attack, stroke, as well as blood clots in general (like DVT which is a blood clot in your leg). I really want you to know the associated risks so that you’re monitoring for yourself and deciding intentionally, is this a risk that I’m willing to take? 

One of the things that increases the risk of stroke with birth control pill use is having an MTHFR gene variation. If you want to know more about this gene variation you can watch Episode 29 of How Humans Heal here. MTHFR is a gene variation that affects our ability to activate folic acid into folate and it already carries a risk of stroke, so when combined with birth control pills, it elevates your risk of stroke even more. 

How To Promote Healthy Ovaries Function After Having Taken Birth Control Pills

So, what I encourage you to do is weigh out all the information against the reasons why you’re taking the pill, and what would be the criteria for yourself for how you will decide when you want to stop using the pill. 

Then you will want to make a plan for how you’re going to prepare your body for coming off the pill, so that you can transition to healthy ovary function. You want to be addressing the negative effects of the pill and start addressing your health in general before you stop the pill so that when you stop, you have a safety net there for yourself. You want to create a healthy environment so when you stop the pill your body is ready and your ovaries are ready to start functioning again.

When our bodies overall are functioning at our best, that’s when our ovary function is going to be at its best too. Our ovaries can pick up on so many signals from our environment, like any kind of stress signals. We should be especially careful with new diet plans, whether that’s intermittent fasting or a ketogenic diet, or if you’re going to do some more exercising. 

Exercise and diet are important for healthy ovary function but if we overdo it, that can also inhibit our ovary function. If we fast for too long, or we aren’t eating enough, or we are exercising too intensely, it will decrease signals to the ovaries and then the ovaries are not going to ovulate or produce hormones as optimally.

We need to focus on optimizing what I call your SelfC.A.R.E. C is for clean eating, A is for adequate sleep, R is for recovery activities, and E is for exercise. This is the foundation of health in general, but definitely the foundation for healthy ovary function, including fertility. 

Clean eating includes things like managing your blood sugar levels, eating protein every few hours and identifying inflammatory foods. If you are experiencing inflammation issues, I suggest doing a food sensitivity panel that I use in my office. It is my favorite because I can see any sensitivities to dairy proteins, gluten, eggs or other foods that you may not even realize like almonds and bananas for certain people can be inflammatory. 

When we ingest inflammatory foods, that inflammation affects our whole body, including ovary function. I can’t tell you how many cases of women have come into my office where we identify the inflammatory foods and we start healing the digestion, healing leaky gut, balancing their biome, and all of a sudden, the ovaries start working better.

How Is Cortisol Related?

One of the key hormones to balance when it comes to optimal ovary function is cortisol. Cortisol is our main stress hormone and if cortisol is too high or too low, it inhibits healthy ovary function. So that means we need to know what your cortisol function is up to – we can measure cortisol morning, midday, evening, bedtime through the urine or saliva and we can see what is your cortisol up to.

Is it too high at certain times of the day or is it at too low at certain times? And wherever it is then we can use the correct herbs and nutrients to get it back on track again. If you would like to know if your cortisol and adrenaline are out of balance you can do a home test that you can order here.

I describe this in my latest book: Master Your Stress Reset Your Health. In this book I describe how to individualize SelfC.A.R.E., how to know what’s happening with your cortisol as well as your adrenaline levels according to what I call your Stress Type. If you would like to know which stress type are you so you can start recovering from stress you can take the Stress Type Quiz here. 

This even helps with perimenopausal symptoms, and it helps with postmenopausal symptoms as well. So even once the ovaries calm down and they go into menopause, we still need your adrenal glands to be functioning optimally because now you’re even more reliant on your adrenal glands to help you feel good. 

It’s also important to have optimal neurotransmitter levels so this is serotonin and GABA and dopamine. It may come as a surprise that chemicals in the brain have anything to do with optimizing your ovary function, but they are incredibly interrelated. Neurotransmitters can also be measured in urine, and I offer those tests through my office, and you can then balance your neurotransmitters using precursor nutrients. 

It can be scary to think about coming off the pill, as a doctor and as a woman, I completely understand this fear. What I can tell you is from my experience and from my patients’ experience, it’s absolutely possible to help rebalance and prevent menstrual related symptoms with natural approaches, nutrients, and herbs without having to rely on synthetic hormones. 

What Are Some Contraception Alternatives to Birth Control Pills?

My recommendation for non-toxic alternatives includes the nonhormonal copper IUD and the fertility awareness method, which includes tracking your ovulation and menstrual cycles so you can either avoid sexual activity or use condoms in the time frame where you are most likely to conceive. You can also measure your basal body temperature on a daily basis where fluctuations determine when you able to conceive. 

I will host a future episode for those listeners who are interested in learning more about how to conceive. 

I hope this episode has been helpful for you and understanding birth control pills more and understanding their connection especially to HPV and cervical cancer risk, as well as some of the other conditions that we talked about today. 

I invite you to reach out if I can be of more help or if you have any questions, and definitely if you are in a situation where you’re working on fending off HPV. 

I’ve been helping women with their health now for over 23 years. I’m a naturopathic Doctor, as well as midwife. I love helping women with understanding their bodies and what they can do to support their bodies to be as healthy as possible, as well as to prevent things like cervical cancer. 

If you’re interested in learning more about my approach to addressing HPV, including why healing leaky gut is essential, you can find my HPV Recovery Guide here. If you would like more help getting HPV to negative, and are really committed to erasing it from your life forever, you can sign up for the upcoming 5 Days to Heal HPV Workshop here or my Say Goodbye to HPV 12-Week Program here.

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If you’re interested in a safe and effective body, mind and spirit detoxification that will actually make you feel better and that you can do without affecting your daily routine, you can check out my 14-Day Detox Program here. The Detox Program includes a gluten-free, dairy-free meal plan, along with a protein shake (the protein shake is included), as well as videos to guide you every step of the way. 

If you want to learn more about how stress and trauma have affected you, in terms of your cortisol and adrenaline levels, and how to recover so that you can get back to feeling your best, you may want to read my book Master Your Stress Reset Your Health. 

To know your Stress Type, which is your unique cortisol and adrenaline levels based on how stresses have affected your adrenal function, you can take the quiz I developed. You can find the Stress Type® Quiz in the book and on my website.

If you’re ready to start rebalancing your cortisol and neurotransmitters, to help your adrenals reset after stress exposure, you can start by ordering this home test kit. And you can also sign up for my Stress Warrior Online Program to guide you here.

You can also subscribe to my newsletter, where you’ll receive a newsletter from me every Thursday with the latest episode and additional resources and tools for your success with achieving optimal health.

For the most comprehensive support, even with the most difficult health issues (physical or mental), it is best to meet with me one-on-one, which is available to you no matter where you are in the world (via phone or zoom). You can set up a one-on-one appointment with me here.

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References:

1. Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13. PMID: 23852908.
2. Slooter AJ, Rosendaal FR, Tanis BC, Kemmeren JM, van der Graaf Y, Algra A. Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke. J Thromb Haemost. 2005 Jun;3(6):1213-7. doi: 10.1111/j.1538-7836.2005.01442.x. PMID: 15946211.
3. Marks M, Gravitt PE, Gupta SB, Liaw KL, Tadesse A, Kim E, Phongnarisorn C, Wootipoom V, Yuenyao P, Vipupinyo C, Sriplienchan S, Celentano DD. Combined oral contraceptive use increases HPV persistence but not new HPV detection in a cohort of women from Thailand. J Infect Dis. 2011 Nov 15;204(10):1505-13. doi: 10.1093/infdis/jir560. Epub 2011 Sep 29. PMID: 21964399; PMCID: PMC3222104.
4. A duration of OC use of 5-9 years was associated with an almost three-fold increase in risk of cervical cancer in women with HPV, compared with never-users, and a four-fold increase for usage of 10 years or longer. https://medsafe.govt.nz/profs/PUarticles/OCHPV.htm.
5. Oral contraception is associated with a 1.5-3.3-fold higher relative risk of cervical carcer, but only in users for >5 years and especially in HPV-positive women. Ten-year oral contraceptive use from the age of 20 years is associated with an increase in the cumulative incidence of invasive cervical cancer at the age of 50 years of approximately 1 case per 1,000. copper IUD users had a lower risk of cervical neoplasms compared with levorgestrel-releasing IUD users The European Prospective Investigation into Cancer and Nutrition (EPIC) showed that, in a cohort of 308,036 women, current oral contraceptive use was associated with a 1.8-fold higher RR (95%CI=1.4-2.4) of CIN 3 compared to never users (15). https://ar.iiarjournals.org/content/40/11/5995.
6. 1. Smith JS, Green J, Berrington de Gonzalez A, et al. Cervical cancer and use of hormonal contraceptives: A systematic review. Lancet 2003; 361(9364):1159–1167. [PubMed Abstract] https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet#r9.