What You Need To Know About Perimenopause & Birth Control
Birth control is something many women take to prevent pregnancy and help with other conditions. However, as you enter perimenopause, you might have some questions about birth control. Our providers are here to answer your questions and help you make decisions about your health before, during, and after perimenopause. Its important to discuss the particulars of your situation with one of our medical providers. However, we do have a general guide to help answer some common questions about birth control and perimenopause.
You may still need birth control during perimenopause to prevent pregnancy.
The Best Birth Control
Were curious about a variety of topics at goop, but after a staff poll over lunch, it became pretty clear that we had a lot of questions about birth control. After some debate, we pared our list of questions down to the ones on the Pill, IUDs, etc. that could help us answer the really big question: Whats the best form of birth control for me? Below, Dr. Maggie Ney, co-director of the Womens Clinic at the Akasha Center in Santa Monica, shares her expert opinion.
What Your Symptoms Were Like Before Going On Birth Control
Your purpose of going on birth control is important because it is different for everyone and can determine how long for your hormones to balance after stopping birth control. Some women go on birth control for hormone management to help with painful periods, some for regulating their cycle, some for contraception, but others may go on birth control to regulate their hormonal acne or other non-contraceptive reasons. When birth control use stops, these symptoms from prior can return and may become worse for a certain amount of time before hormones regulate again.
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Recognizing The Onset Of Menopause
Its not always easy to know if youâre in menopause, especially if youâre taking birth control. In fact, theres a chance that youâre in menopause and still having a period because of the birth control since it contains hormones. Most women enter menopause at about the age of 51, which is why many doctors suggest ceasing the use of birth control after this age. This is especially the case if your goal is to determine whether or not youre in menopause.
If you stop taking birth control pills tofind out if youre in menopause, its often recommended that some other form ofcontraception be used until you know for sure. When you are in menopause, yourperiod will cease and you may experience symptoms like hot flashes, vaginaldryness, mood swings, depression, insomnia, tiredness, anxiety and changes inyour skin. While birth control probably wont delay menopause, it can delaythese symptoms.
Hormonal Birth Control Cannot Balance Hormones
To prescribe birth control for hormone balance is simply nonsensical. Birth control does not balance hormones it switches them off.
Birth control switches off ovulation and so switches off estrogen and progesterone. It induces a kind of chemical menopause and then replaces back contraceptive drugs as a substandard type of hormone replacement.
Which might be okay if contraceptive drugs were as beneficial as our hormones. But theyre not. Contraceptive drugs are not even hormones.
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Are Birth Control Pills Hormones
So, lets get to the nitty gritty of what the heck are birth control pills, what are their real impact on a womans body, and why you might want to avoid them, if possible? I know youve heard them referred to as hormonal contraception, but the reality is that theres not a drop of natural hormones found in any brand of birth control pill. Not even one drop!
Rather than containing natural hormones, theyre synthetic versions of endogenous estradiol and progesterone, and Mother Nature has never seen these at any time in human evolution. In a sense, these synthetic hormones are endocrine disruptors -chemicals that can be thought of as pseudo-hormones. They can do a few of the same things that hormones do, attaching to their receptors, like a key fitting into a lock. But they dont necessarily open the door or open it fully. The end result is a different outcome! Its like substituting diesel fuel for gasoline in a car. It may pour into the tank but its clearly going to deliver a different outcome when the gas pedal is pressed.
Contraceptive Content And Routes Of Administration
There is a wide variety of HC drugs available, and these might affect the female brain in different ways. The orally administered drugs can be combination pills that commonly consist of ethinylestradiol and a progestin, or progestin-only formulations. They may have different cycle regimens, such as mono-, bi-, tri-, and quadriphasic as well as flexible regimens. Both the estrogen and the progestin contents of these pills have been gradually lowered over the years in an effort to reduce side effects .
Different types of formulation may also be associated with different side effects. Some progestins are considered to have androgenic properties, while others may have anti-androgenic effects on brain and behavior . Progesterone may lead to reduced testosterone action due to affinity for the enzyme 5α-reductase, and this may reduce conversion of testosterone into the more potent dihydrotestosterone . Combined oral contraceptives with a progestin content considered to be anti-androgenic, such as drospirenone and desogestrel, have been postulated to be favorable in terms of mood symptoms in comparison with progestins displaying an androgenic profile .
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How Hormones Work In The Brain And Body
In order to feel happy and healthy, you need to have balanced hormones. Here is some important information to note about the differences between natural and synthetic hormones.
Natural hormones bind to specific receptors and keep your body in balance:
- Estrogen binds to the estrogen receptor.
- Progesterone binds to the progesterone receptor.
- Testosterone binds to the testosterone receptor .
- There is no cross-reactivity.
Synthetic progesterone acts differently on the body:
- Progestins do not limit binding with just the progesterone receptor, but many other receptors as well.
- When a synthetic hormone binds to the wrong receptor, that receptor may convey inaccurate signals, which throws the body off balance.
Because synthetic hormones may bind to the wrong receptors, birth control pills may cause hormone imbalances and detrimental side effects. Not all women experience these problems, but for those that do side effects can be quite miserable.
Its Actually Used For Doping In Men Sometimes Belinda Pletzer
Its actually used for doping in men sometimes, says Belinda Pletzer, a cognitive neuroscientist at the University of Salzburg, Austria. It helps build muscle, so its popular with powerlifters and boxers: the former heavyweight world champion Tyson Fury recently served a two-year suspension after testing positive for the steroid in 2015
The hormone used by the pill is a close relative of an androgen that male boxers have used for doping
Weve known about these side effects for decades: the first progestin ever made, norethindrone, was androgenic.
Back in the 1940s, 50s and 60s, pregnant women sometimes took norethindrone in large doses to help prevent miscarriage. But the hormone also caused some unsettling changes to their bodies.
The women were sweatier, hairier and spottier. Some noticed that their voices had deepened. Nearly one in five baby girls born to mothers taking it had masculinised genitals. Some of these unlucky children required surgery.
Today androgenic progestins are much less androgenic. The doses in contraceptive pills are much smaller, and the hormones are usually combined with synthetic oestrogen, which cancels out many of the masculine effects on our bodies.
But there are some side effects.
More recent types of contraceptive pill are designed to be anti-androgenic, often prescribed to treat acne or excessive hair growth
Even small amounts of testosterone can make some parts of the female brain get smaller and others to get bigger
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What Are The Side Effects Of Birth Control Pills
Most women have no side effects when taking birth control pills, but some women do have irregular periods, nausea, headaches, or bloating. Each type of pill can affect each woman differently.
Spotting or Irregular Periods: Very light bleeding may occur during the first 3 weeks of taking the Pill and may continue for several cycles, but this is not serious. Irregular bleeding is common if you are late taking your pills or you miss a pill. If the bleeding is new and you are sexually active, get checked for Chlamydia infection. If the bleeding becomes heavier , call your health care provider.
Nausea: Sometimes a young woman can feel nauseated , but the feeling usually goes away if the pill is taken with food or with a bedtime snack. Sometimes a pill with less estrogen is prescribed if the nausea doesnt go away.
Headaches: Sometimes, young women may complain of headaches when they start taking birth control pills. Most often headaches happen because of stress or other reasons such as skipping meals, not enough sleep, sinus infections, or migraines. If your health care provider thinks your headaches are related to the Pill, he/she may prescribe a different pill with a lower amount of estrogen or may take you off of it completely and watch to see if headaches get better.
Breakouts: Usually the pill helps cure acne, but a few women feel they get acne from certain kinds of birth control pill.
Can I Take The Pill While Breastfeeding
The combination birth control pill contains estrogen, which can decrease milk production. If you are breastfeeding, your healthcare provider may recommend taking the progestin-only pill instead. However, some women may use estrogen-containing pills once milk supply is fully established, and a womans risk of blood clots is minimized.
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The Truth About Birth Control Pills And Hormones
About 150 million women all over the world use oral contraceptives, also known as birth control pills. Oral contraceptives are most commonly associated with preventing pregnancy, but they are also frequently used to reduce symptoms that may occur with menstruation, such as irregular periods, premenstrual syndrome , premenstrual dysphoric disorder , cramping, pain, heavy flow, endometriosis, polycystic ovarian syndrome , fibroids, and more. Many women have misconceptions about how these hormonal contraceptives affect the body and brain and how they influence overall health. Its time to clear up the confusion.
The Pill Is Convenient
Taking the birth control pill is easy, but remembering to take it every day can be hard. Luckily, pill packs are small about the size of a cell phone so you can carry your pills with you wherever you go. You can use our birth control app to remind you to take your pills everyday.
The pill is birth control you dont have to think about during sex. If you take the pill correctly, youre protected from pregnancy all day, every day. Many people say the pill makes their sex lives better because they dont have to interrupt sex or worry about pregnancy.
You need a prescription from a nurse or doctor to get birth control pills. But you may be able to pick up many packs at once or have them mailed to you. Depending on where you live, you can even get birth control pills online.
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Reset Your Circadian Rhythms
This is important for 2 reasons. One, the body heals while sleeping. Two, melatonin plays a huge role in healthy hormonal balance and healthy periods. Depleted melatonin can turn into low progesterone. Without ample progesterone, periods can be more painful and maintaining pregnancy can be more difficult.
Connecting with the natural cycles of light and dark can help to restore healthy hormonal balance and play a role in full body healing. Try doing a circadian reset by only using natural light after sun down. So after sunset, no screens, TVs, or unnatural light. Try using candles and notice how your body responds to the absence of light.
Repeat this practice for 6-7 nights or better yet, try to make this a regular part of your lifestyle. Set your designated days each week when youll honor the natural cycles of light and dark.
Ensure That You Are Taking In Enough Energy
Under-eating is closely linked to hormonal imbalances, which can make the side effects of the pill worse. Not eating enough can be both intentional, such as during restrictive eating as a means to lose weight, or unintentional , such as being a result of being so physically active that your energy intake doesnt keep up. It is super important to make sure you are eating a well balanced diet that is adequate in fiber rich carbohydrates and includes a variety of food groups. Following strict/rigid diet trends during this time is not recommended.
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What Birth Control Helps With Hormonal Imbalance
hormonal birth control any form of hormonal birth control work? In addition to pill, ring, and patch treatments, combination birth control whether in the form of a pill, ring, or patch is the most popular and recommended treatment for PCOS. Progestin-only pills may be recommended by your doctor if you are unable to take the combination pill or use other combination methods.
Sterilization When Approaching Menopause
Of course, sterilization is the most effective form of birth control. Although it doesnt have any of the symptom-smashing effects of the hormonal methods, it is a one-stop solution to unwanted pregnancy.
Its a relatively simple procedure for a man, indeed quicker and safer than it is for women, so if you are in a committed relationship with a special man, you could ask him to brave the snip.
If you want to be sterilized, speak to your doctor about the procedure. Usually, it involves surgery called tubal ligation . The surgeon cuts or clamps the fallopian tubes preventing eggs from traveling from the ovaries to the uterus.
However, some women realizing they are maybe only a year or two off being fully menopausal and therefore infertile choose to use more temporary measures to bridge the gap.
Whatever you decide you can revisit your choice of birth control, and once its been established that you are entirely through the menopause, you can forget the hassle of it once and for all.
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What Are Alternatives To The Pill
If youre not confident you can remember to take a daily pill, talk to your healthcare provider about these other birth control options:
- Etonogestrel implant .
- Depo-Provera® progestin injection .
A note from Cleveland Clinic
The birth control pill is a highly effective way to prevent pregnancy when you take it consistently every day. The pill can also lower your risk of certain problems, such as uterine and ovarian cancers, migraines, and acne. Some women experience medication side effects like nausea, though this is usually temporary. You may need to try several different brands of the pill before finding the one that works best for you. Talk to your healthcare provider if you have questions or concerns about the pill.
Last reviewed by a Cleveland Clinic medical professional on 07/21/2020.
References
Lack Of Pure Adolescent Samples
In addition to hypothesizing about the ability of HC to affect structural and functional aspects of the brain, we expected effects to be larger in adolescent subjects than in adult subjects. However, as we identified only one neuroimaging study ever to be performed on a purely adolescent sample, this hypothesis remains unresolved and the effects of such drugs on developing brains remain undetermined. The studies included many older subjects, making it impossible to disentangle potential differences between effects on the adolescent brain and effects on the adult brain. None of the studies investigated structural changes related to the use of HC in drug-naïve teenagers, but rather included convenience samples with mostly adult subjects. Only one functional study included a strictly adolescent sample, but there was no direct comparison with older subjects, nor any statistical test of age-covariates.
Given the evidence from the animal literature, as well as clinical registry studies such as that by Skovlund et al. , which strongly indicate an increased vulnerability of the brain during adolescence, combined with the fact that girls are using these substances from an early adolescent age, we argue that there is a strong need for future studies to be carried out on adolescent use of HC.
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+ Birth Control Withdrawal Nutrition Protocol
Because being on the pill often results in nutrient deficiencies its critical to replenish. Nutrients derived from whole foods are one of the most impactful ways to rebalance your hormones, steady your energy levels, and eliminate the pills side effects.
Try incorporating the following into your diet:
+ Vitamin-B Rich Foods Wild-caught salmon or sardines, grass-fed, organic animal protein, bananas, walnuts
+ Magnesium Rich Foods leafy greens, nuts and seeds, sprouted beans or grains, avocado
+ Estrogen Balancing Foods cruciferous vegetables support your liver in eliminating excess artificial estrogen. These foods include kale, cabbage, turnips, Brussels sprouts, broccoli and cauliflower
+ Progesterone Balancing Foods these include foods rich in b-vitamins as well as vitamin-c rich foods like oranges, bell peppers and grapefruit
+ Gut Healing Foods bone broth, collagen powder, fermented coconut yogurt or kefir, miso, sauerkraut, raw apple cider vinegar
Why Do Birth Control Pills Contain Estrogen
As Ive mentioned, combined birth control pills with estrogen and progestin, trick your pituitary gland into thinking you are pregnant. The constant doses of estrogen each day are pivotal to this trickery because of the estrogen:
Prevents your pituitary gland from producing the follicle stimulating hormone and luteinizing hormone so that ovulation doesnt take place.
Thickens the lining of your uterus, making the environment more hostile to conception.
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