birth control

Let’s Talk About Sex, Baby: Hormonal Contraception & Libido

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“If sexuality is one dimension of our ability to live passionately in the world then in cutting off our sexual feelings we diminish our overall power to feel, know, and value deeply.” –Judith Plaskow

This quote raises an interesting question. If owning our sexuality gives us power, then who benefits from limiting that power? And why is limiting that power an acceptable side effect of hormonal contraception?

During the Nelson Pill Hearings, Dr. M. James Whitelaw testified (page 6015): “How many adult males would be willing to take an oral contraceptive faithfully if they were told that instead of a possible 50-plus adverse side reactions only one remained, that being the possible loss of sex drive and libido? [Laughter]”

What is the implication here? Women can be denied their full sexual capability but the idea of men suffering the same is laughable? Holly Grigg-Spall speaks to that in her book Sweetening the Pill (page 50):

“The pill’s impact on the libido has been publicized but it is generally dismissed with humor. The libido is seen as distinct from women’s emotional and physical health, whereas with men it is linked. The female sex drive is not celebrated or seen as essential to her femininity or sexuality… Research that indicates that lowered libido is experienced by a large number of women on the pill is undercut by the cultural assumption that most women have little real interest in sex regardless of this drug.”

Sexy But Not Sexual

And she’s right. Women are constantly told to be sexy but not sexual. It would seem that hormonal birth control would provide exactly that type of woman. One who could have sex without the consequence of getting pregnant, therefore highly desirable to men; but one who could not fully embrace the power of her own sexuality due to a medication-induced lack of libido. Is this really what we want? A society of women that are physically available for sex but completely disconnected from the powers of her own sexuality? Again I will ask, who benefits from keeping women in that robot-like state?

“The quality of a woman’s sex life, unlike that of a man’s, does not seem to concern the drug companies or the (male) research establishment… Women who reported changes in their sex drive often heard that old refrain: ‘It’s all in your head.’ But the male sex drive is considered so important by the drug companies that it is always studied in conjunction with new male contraceptives, just as it is almost always mentioned in arguments against the condom.” –Barbara Seamen in The Doctors’ Case Against the Pill

It’s true. We hear the argument that condoms lessen sensation during sex. But for whom? Men. Yet for women who use hormonal birth control, low libido and loss of sensation during sex are some of the least dangerous side effects they can expect. Heather Corinna put it so well in her article “Love the Glove” that even Grigg-Spall quoted her:

“If we’re going to talk about condoms changing how sex feels, we need to remember that something like the pill does too, and, unlike condoms, it changes how a woman feels all the time, both during and outside of sex… Other methods of contraception can cause pain and cramping, unpredictable bleeding, urinary tract infections, depression and a whole host of unpleasant side effects. Condoms are the LEAST intrusive and demanding of all methods of contraception, even though some guys talk about them — without considering this perspective — like they’re the most. If guys could feel what life can be like on the pill, use a cervical barrier or get a Depo shot, they’d easily see condoms for the cakewalk they are.”

It’s not just the pill that is damaging to women. As Grigg-Spall explains, Depo Provera (“the shot”) is specifically used to decrease sex drive in sex offender rehabilitation programs. There is something seriously wrong when a birth control option offered to women is the exact same medication used as pharmaceutical castration for sex offenders.

FSD – Female Sexual Dysfunction or Female Sexuality Discouraged?

According to a study of female German medical students published today in The Journal of Sexual Medicine, women taking non-oral and oral hormonal contraceptives were at highest risk of Female Sexual Dysfunction (FSD). Interestingly, women using non-hormonal contraceptives were at lowest risk for FSD, more than women not using any contraceptive.

“Sexual problems can have a negative impact on both quality of life and emotional well-being, regardless of age,” said researcher Dr. Lisa-Maria Wallwiener of the University of Heidelberg, Germany. “FSD is a very common disorder, with an estimated prevalence of about two in five women having at least one sexual dysfunction, and the most common complaint appearing to be low desire.”

Side Effects – Affecting More Than Just the Patient

Why is this okay? Why do we accept this? If a woman is experiencing sexual dysfunction, it not only affects her but it affects her partner as well.

Dr. Philip Ball testified about this very problem at the Nelson Pill Hearings back in 1970 (page 6493): These unhappily newly married women do not know if it is the wrong man, the wrong town, the wrong job, the wrong year, the wrong apartment, or yet something else, when it is really many times the wrong pill.

And he’s not incorrect. Research now shows that taking birth control pills affects women’s taste in men. According to this article from the Scientific American, women on the pill seem to prefer men who are genetically similar to themselves.

“Women who start or stop taking the pill, then, may be in for some relationship problems. A study published last year in Psychological Science found that women paired with MHC-similar men are less sexually satisfied and more likely to cheat on their partners than women paired with MHC-dissimilar men. So a woman on the pill, for example, might be more likely to start dating a MHC-similar man, but he could ultimately leave her less sexually satisfied. Then if she goes off the pill during the relationship, the accompanying hormonal changes will draw her even more strongly toward more MHC-dissimilar men. These immune genes may have a “powerful effect in terms of how well relationships are cemented,” says University of Liverpool psychologist Craig Roberts, co-author of the August paper.”

How any of this is connected to relationship issues, divorce rate, infertility, one can only speculate. But it’s clear that the sexual side effects caused by hormonal contraception are no laughing matter.

Sex is a big part of life. The ability to connect with each other and derive great pleasure from sex is not just a perk of being a human. It is our birthright. And to deny that birthright is to limit our power as women. That’s not what I consider an “acceptable side effect.”

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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This article was published originally on July 14, 2016.

Nexplanon Side Effects: A Case Story

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As a mother of 4, having had all of my children in my twenties, birth control was always a part of my life. I tried birth control pills, shots, the ring, and lastly, the arm implant, Nexplanon. In 2019, at the age of 35, I had the Nexplanon inserted in my left arm. I was excited about it because it was a birth control that was hands off and there would be no need to think about it. I would be protected for three years.

The First Signs That Something Was Wrong

In the summer of 2022, after three years of use, my OB said I should get it replaced with a new one. I had it replaced in June of 2022. I noticed right away that the implant site on my left arm was itchy. I didn’t experience that with my first one. Then a month later, I started feeling like my throat was closing at night. I wasn’t sick and I didn’t have allergies. It made me nervous to have that feeling, like I would choke and not be able to breathe.

In August, two months later, I had a full blown panic attack while in the car on my way to a Yankees game with my husband. I was so excited about going to the game, but while in the car, I felt like I couldn’t swallow my saliva properly, like my throat was closing again. We ended up in the ER instead of the game where I had an MRI of my neck to check my throat and nothing was wrong.

On September 30th, I woke up with a clogged feeling in my left ear, and lost my hearing a day later. I went to the ENT and they mentioned I had to get on a high dose of steroids for 3 weeks in order to try and restore my hearing. I experienced terrible side effects, such as anxiety, panic, fear of death, heart palpitations, heart racing, dizziness and blurred vision and extreme nervousness and depersonalization. I wasn’t able to work, drive, or go outside. Thank God, that after the first week of steroids, my hearing was restored. Now I just had to taper off the steroids, which were still giving me all the side effects even with the lower dosages.

As of November, I was no longer on steroids, but the side effects I was feeling, kept getting worse. I would cry all day, all night, and lost 15lbs in a month because I couldn’t eat. I went to the ER multiple times thinking I was having a heart attack from the chest tightness and palpitations. The doctors all said that I shouldn’t have any side effects from the steroids since I had stopped taking it months before. I had my vision checked, a full cardiac stress test, bloodwork, all with normal results. I didn’t understand and no doctor would help me. My primary care doctor recommended anxiety medications since that’s what I was exhibiting for the first time in my life. I refused them completely and just decided that I would continue waiting.

Was Nexplanon Causing My Health Issues?

It was then December, and no symptoms had improved. I was still having panic attacks daily, still having palpitations, heart racing, dizziness, blurred vision, depersonalization, and now muscle weakness and internal tremors. My legs would shake going down the stairs. I was only getting worse. I sat down and prayed one night, just hoping God would give me a sign. The next day I received an email from a family member saying her friend tried Nexplanon and was having severe panic attacks, so she removed it. I was excited. Could it be the Nexplanon? I never thought of it because I had used it for 3 years before the replacement with no side effects. I then looked up forums online and I found hundreds of comments with women experiencing the same side effects as me. It was unbelievable.

I made an appointment with my OB for December 15, 2022 to get it removed. A week later, no symptom relief or improvement. Two weeks later, still nothing. I became discouraged thinking it wasn’t birth control and I was feeling devastated and nervous, thinking the worst. But finally, after 3 weeks, almost every single side effect was gone. No more panic attacks, no more blurred vision, no more fear of death, heart racing, palpitations, throat tightness, nothing. Only one symptom remains, even now, over a year later and it’s the internal tremors. It was the last symptom to develop and I’m sure it will be the last to go. It is definitely less severe than before and I find that deep breathing makes the tremors go away. I am grateful that I was able to figure out what was causing all of my issues since even my OB said that it was not possible for the Nexplanon to give me the severe anxiety and every side effect I was experiencing. I am finally back to my normal self, happy go lucky, loving life and appreciating every minute of every day. I am grateful first to God, for answering my prayers and for all of my family and friends that supported me through this difficult time. I hope my experience helps other women that may not know to look at their birth control if they ever go through something like me.

Medication Side Effects?

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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Iatrogenic Illness and Pharmaceutical Side Effects

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Are you familiar with the phrase “iatrogenic illness”? An affirmative answer is more likely among the readers of this website than the public at large, but I would argue that even we (those of us who frequent this website) don’t give it the attention it deserves. In fact, if we changed the way we looked at iatrogenic illness, it could reframe the way we look at the entirety of medicine.

The Effect of Side Effects

Iatrogenic means an ailment that is actually caused by a medical examination or treatment. Perhaps the reason it receives less attention than it should lies in the fact that the classification would usually require an admission of guilt from the person most likely to identify it. Most doctors aren’t inclined to draw attention to the fact that something they did caused a new problem.

Consequently, we tend to associate iatrogenic illnesses with things like infection after a surgery, where it happens despite the medical team’s best efforts to prevent it. And, the only time we weigh the iatrogenic effect of pharmaceuticals being administered comes in extreme cases, like chemotherapy, where the patient and their family often weigh the quality of life versus the quantity.

However, we really should start considering the quantity of effect versus quality much sooner in life.

The Primary Effect

Think about the early development of a new drug and then consider this old phrase:

“There are no side effects, only effects.”

When a new drug is in development, the chemical engineers have a sense of what the desired effect will be, largely because most new drugs are variations on existing medications. But, this focus on a primary effect can lead us to discount the other effects on the body. It’s as if simply labeling an effect as a ‘side effect’ trivializes it in our minds.

What we must keep in mind is that by introducing these compounds into our bodies, we open ourselves up to the potential to experience any and all of the various effects. The doctor may give it to us to treat a specific ailment, but the reality is we’re susceptible to the entire array of effects.

Granted, these other ‘side’ effects may not happen as frequently as the ‘primary’ effect, but are drug makers still failing to give them proper attention as they weigh the benefit-to-risk simply because of how they may negatively impact marketing?

Creating a Drug Market

Let’s look at a couple of examples to see how marketing ultimately determines which is the ‘primary’ effect of a drug. We will begin with a brand so familiar it has almost become a generic term for analgesics.

In the late 1800s, an inexperienced pharmacist mistakenly sent acetanilide instead of naphthalene to a couple of French doctors who were experimenting with treatments for intestinal parasites. By chance, the doctors soon discovered the new compound reduced fever in some patients and later realized it offered some level of pain relief.

While unexpected, the ‘side’ effects were marketable. That’s why nearly 150 years later acetanilide, which metabolizes in the body to become acetaminophen, is still marketed under the brand name Tylenol, and has become synonymous with its ‘primary’ effects of pain relief and fever reduction, rather than its effect on parasite motility.

What about the other effects – the less marketable ones? Liver damage would probably fall into that category, And, despite the long history, researchers didn’t really start looking into the impact of acetaminophen toxicity on livers in both adults and children until this millennium. It makes one wonder how many people suffered severe liver damage before it caught researchers’ attention.

To some extent, the failure to notice the negative effects can be chalked up to human nature. As we look for the hook to hang our hat, we aren’t likely to notice the corner of the dresser until our little toe ultimately discovers it at a most inopportune time.

One Effect Stands Out

Drug makers aren’t completely oblivious to ‘side’ effects as they develop a new drug. In fact, they become acutely aware of secondary effects when they provide the potential for more profits.

It is a well-known story that the makers of one new drug being developed for high blood pressure and angina discovered that the drug also effectively induced erections in many of their male patients. Once they stripped away the labels of primary effect versus side effects, it probably didn’t take Pfizer’s MBAs long to recognize Viagra’s potential.

Rather than join the crowded, competitive field of blood pressure drugs, they had the opportunity to essentially create a new market catering to those suffering from impotence.

Of course, erectile dysfunction sounds much more like something that needs to be treated so they put their ad budget toward branding the ‘ailment’ as much as the new drug and it paid off in spades. Viagra managed to stay in the range of $2 billion in each year of its patent protection.

Don’t Take Your Eye Off the Ball

The drug and medical industries, which are so clearly on top of the ball when it comes to drug outcomes and profitability, have an abysmal record when it comes to drug outcomes and actual patient experience. It is precisely this focus on profits that clouds their vision, and turns side effects into new symptoms.

This is problematic with any drug, but none more so than with birth control because the patient is typically young and healthy. Plus, I can think of no other drug that is designed to be given to a healthy patient with the intent of stopping a natural process.

Given the disease-free state of so many patients who begin birth control, you would think this is one drug where it would be easy to identify an iatrogenic effect when side effects begin to arise. However, this is rarely the case, and the story of a young woman who recently contacted me provides a perfect example.

A Pattern of Side Effects

After seven years of taking birth control pills, Alexa changed over to the Mirena IUD. She began to notice facial hair growing and mentioned it to her doctor. He ran some tests and discovered her DHEA-S levels were high. A subsequent ultrasound revealed the classic string of pearls on her ovarian tissue, and she was diagnosed with PCOS.

When she questioned her birth control, the doctor insisted that she NEEDED to be on birth control or she would likely end up with endometrial cancer. She felt almost like he was using cancer to threaten her into continuing with birth control. He began to discuss other medicines she would also need to treat her condition.

But, she knew that her ovaries had been fine before starting on Mirena, and just couldn’t accept what the doctor was telling her. She searched online and found the patient information pamphlet for her IUD and learned that the documented side effects include “cysts on ovaries” and “facial hair.”

Alexa opted to take supplements to help balance her hormones and began charting her cycle after removing the IUD. Her cycle normalized quickly, her mood stabilized, and her energy rebounded.

It was the first time she began to realize how much the synthetic hormones had dragged her down over the years. She began to take inventory of all the “symptoms” that she encountered after starting birth control that might have actually been “side effects.”

Not only had the doctor recently missed that the two symptoms (facial hair, ovarian cysts) he used to diagnose PCOS were clearly listed as side effects of the contraceptive device he inserted, but she began to question previous interactions.

The IUD contributed to multiple vaginal infections, which in turn, led to several antibiotic prescriptions, but her doctor never acknowledged that the IUD could have played a role, even though these types of infections had never been a problem prior to the IUD.

She could see a pattern developing.

Then, she remembered when she first started taking The Pill at age 15. She experienced her first bouts of depression, which triggered new scripts for Paxil and then Lexapro.

Depression and anxiety represent some of the most common side effects of hormonal birth control. Yet, they are treated as mere symptoms of a new, unrelated disease by a vast majority of doctors.

A Cascade of Symptoms

I wonder how many young women have lived a similar experience? They unwittingly trade in their health for a cascade of symptoms.

When you hear a story like Alexa’s, you begin to understand why 131 million people in the US take at least one prescription drug, with the average being 4 prescriptions. We lead the world, spending $1,376 annually per capita on these drugs, nearly 50% more than our nearest competitor, Germany.

I don’t mean to insinuate that these new symptoms aren’t in fact new diseases. The subsequent effects of birth control often manifest as long-term, even chronic, new diseases. It isn’t uncommon for synthetic hormones to trigger an autoimmune disease, nor is it uncommon for depression to linger long after a woman stops taking birth control.

These long-term consequences are precisely why the next time your doctor casually hands you a prescription and you feel compelled to bite your lip and not ask the questions bouncing around in your head, ponder the phrase “iatrogenic illness” and don’t be afraid to start questioning the doctor.

After all, you will be the one living (or dying) with the consequences.

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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This article was originally published on September 26, 2022.

Stroke, Birth Control and the Nelson Pill Hearings: What They Knew Then

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I had a stroke from hormonal birth control at the age of 28. Prior to my stroke, I didn’t think much about the side effects of hormonal birth control, or any other medication for that matter. Like many of us, I took for granted that if a doctor prescribed the medication, it must be safe. Especially one as widely used and as cavalierly prescribed as birth control pills. I was so wrong. Nearly dead wrong.

Since that time, I have become increasingly aware of how little we know about the side effects of many medications and how many are under-researched before being “approved.” We can see that in the number of medications that get taken off the market. The pressure of the pharmaceutical companies to make a return on their research investment and their exorbitant advertising budget is putting human safety, and especially the safety of women, at great risk. I wrote my master’s thesis on risk communication, how women are informed of the risks of hormonal birth control, and what they know about blood clots. I’ll write more on that later but suffice it to say, the results were not promising. It appears that we are intentionally misled where drug risks are concerned. “Well, of course,” the cynic in me says. “After all, who is writing the risk communication in the first place?” The very people that need to minimize risks in order to maximize profits.

As mentioned in previous articles, I’ve recently begun a research project involving the Nelson Pill Hearings. Senator Gaylord Nelson scheduled these hearings back in 1970 after a number of reports, books (especially Barbara Seaman’s “The Doctors’ Case Against the Pill”), and studies brought up concerns about the safety of the birth control pill. Feminist groups and women’s health advocates attended the hearings demanding that women who had taken the pill be allowed to testify. To which Nelson responded, “I stated in advance of the hearings that every viewpoint would be heard on this issue… There will be women who testify… I will give you all the time—if you ladies will come to see me—would you girls have a little caucus and decide which one will talk one at a time, we can then decide what ladies will testify. Your viewpoints will be heard, don’t worry about that.” Then they were kicked out. And much of the testimony was never made public.

After a great deal of work from Karen Langhart, with the help of Senator Bernie Sanders’ office, and perhaps an invocation of the Freedom of Information Act, we were able to get a near complete copy of the Nelson Pill Hearing transcripts. (I say “near complete” because I have already found at least one instance of a page missing. But more on that later.)

A Massive Experiment

As someone who has survived a stroke directly related to the birth control pill, you can imagine how strange and challenging it is to read these hearings. Here I am pouring over 1500 pages of testimony from countless doctors who are describing problems, side effects, and dangers of hormonal birth control and as far as I can tell right now, they all seem to agree on two things. One, that putting women on birth control pills was (and I would say, still is) a MASSIVE experiment with millions of healthy women. Two, that there simply wasn’t enough research to understand even the short-term effects, let alone the long-term effects. Though these hearings were 46 years ago, I believe we have yet to discover all the ramifications of this experiment.

They Knew: Pill Induced Stroke

From a personal standpoint, one of the most frustrating discoveries I have made so far was found in the testimony of Dr. David B. Clark, a professor of neurology. Imagine my shock as I read him describing the exact symptoms of my stroke. This was particularly frustrating as my doctors indicated that the reason I was misdiagnosed and left untreated for so long was because my stroke was so highly unusual. And now I’m reading testimony from 1970 that says they knew strokes in young women on hormonal birth control occurred this way. Over forty years ago, these risks (and many more) were identified and, for the most part, ignored. Here is some of his testimony:

“It has been thought for a great many years that spontaneous cerebral vascular accidents are quite rare in healthy, nonpregnant women, especially the younger ones.”- Nelson Pill Hearings, page 6137

So seeing an increase in these should tell us something…

“Further, it was rapidly found, which was embarrassing, I think to all of us, that we did not have a really accurate idea of the incidence of spontaneous cerebral vascular accidents, spontaneous strokes, in young, healthy, nonpregnant women. We did have some comparable information comparing incidence in women with that in men.” -Nelson Pill Hearings, pages 6137-6138

This really isn’t surprising given that women were often excluded from medical research and are still vastly underrepresented in clinical trials.

“In looking at this group of strokes, it seems their time of onset is often prolonged, for days, and even weeks. In a considerable portion of the cases, the onset was marked by premonitory migrainous headache. The patient may have attacks of double vision, they may have transitory weakness in various parts of the body, which recovers for a time: they often report giddiness and fainting attacks, and this finally develops into a full-blown stroke.”- Nelson Pill Hearings, page 6140

These symptoms are almost identical to mine.

He goes on to say that these types of strokes do not appear to be related to arteriosclerosis (hardening or thickening of the arteries) or hypertension (high blood pressure), two normal precursors for stroke. I also had neither arteriosclerosis, nor hypertension.

“So I think it is possible that such premonitory symptoms for days or weeks before the full-blown stroke develops may be a reason for assuming a seeming association with the pill.”- Nelson Pill Hearings, page 6140

Expletives and Indignation

Needless to say, when I got to this testimony, I let fly several loud expletives that served no purpose but to release a decade of frustration and scare my dog. This was 1970! My stroke was in 2006. Where did this information get lost? Why didn’t my doctors know to check for stroke when I presented with an ongoing headache and transitory weakness? Maybe my OB-Gyn wouldn’t have thought I had a migraine and a pulled muscle. Maybe the doctor at the local health clinic wouldn’t have suggested an appointment with a neurologist a week later. Maybe I wouldn’t have been sent home from the emergency room twice. Maybe I wouldn’t have had to suffer the fear and pain of massive seizures. Maybe I wouldn’t have had to relearn how to tie my shoes and relearn how to walk and relearn how to do math.

And as if reading a near-textbook list of my stroke symptoms that no fewer than four doctors misdiagnosed wasn’t maddening enough—the very next doctor to testify at these hearings, Dr. J. Edwin Wood, said the question of whether strokes are caused by hormonal birth control is debatable. He goes on to say that there is “a definite hazard to life while using these drugs because of the side effect of causing blood to clot in the veins” (Nelson Pill Hearings, 6156). Now, I’m definitely not a doctor, but I do know that the majority of strokes are caused by blood clots. More cursing ensued.

So where does this leave us? For my part, I’m going to keep digging. And I’m going to keep telling you what I find.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was published originally on April 18, 2016. 

Hormones, Birth Control, and Insulin Resistance

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Little known fact. Your reproductive hormones influence how your body responds to insulin. The artificial hormones in hormonal birth control also play a huge role in how your body responds to insulin. And, your body’s response to insulin determines how well you are able to use glucose to supply your daily energy needs.

In this article, we will discuss the basics of how your body creates energy. In this first section, we will unpack:

  • How your body creates energy from glucose
  • Glucose vs. fatty acids as an energy source
  • How insulin resistance impacts the shift between glucose burning and fat burning
  • How glucose enters your cells to become fuel for energy
  • How insulin resistance interferes with the transfer of glucose into your cells

Then, we will tie in how your natural reproductive hormones, estradiol and progesterone, impact your body’s use of glucose as a fuel source and discuss how hormonal birth control disrupts this natural balance.

How the Body Creates Energy From Glucose

Many of your cell types are designed to run on glucose, a metabolic product of carbohydrates, as their main source of energy, and in fact, certain cells that don’t contain mitochondria (or contain very few mitochondria) like red blood cells and cells of certain parts of your eye (lens, retina, and cornea) rely either exclusively (as is the case for red blood cells) or primarily on glucose as an energy source.

The reason for this is that mitochondria are responsible for aerobic (oxygen required) energy creation processes within your body, and cells with no or very few mitochondria rely mostly on anaerobic (no oxygen required) energy creation by glycolysis in the cytoplasm of the cell. As we will discuss in more detail later, when your body uses fatty acids as a fuel source, this pathway is purely aerobic, so it is not possible for fatty acids to be used in anaerobic energy creation processes within your cells.

When you eat a meal containing sugar (sucrose) or carbohydrates, enzymatic processes begin breaking the sugar and carbs down into their basic structures within your digestive tract. The structure of both sugar and carbs contain glucose.

Glucose fuels the creation of ATP in a process known as glycolysis, which happens within the cell, and through oxidative phosphorylation (OXPHOS), which happens within the mitochondria (substructures within the cell). When ATP is broken down within your cells, it releases energy, which is harnessed to power your mitochondria and other important cellular functions. The by-products of that ATP creation (pyruvate and ATP) fuel additional energy production cascades within the cell.

How the Body Switches From Glucose to Fatty Acids for Energy

Even when particular cell types prefer carbs (glucose) as their energy source rather than fatty acids, most cell types are capable of using either of these macronutrients (and also, when necessary, amino acids) as a fuel in order to survive periods of fasting (including overnight fasting).

Insulin plays a key role in regulating whether your body uses glucose (glycolysis in the cell’s cytoplasm and OXPHOS in the mitochondria) or fatty acids (lipolysis in the cell’s cytoplasm and fatty acid oxidation in the mitochondria) as its preferred fuel source. This is because insulin impacts the ratio of two key enzymes (malonyl Coenzyme A and acetyl CoenzymeA) that determine which of these energy pathways is preferred (here and here). The ratio of these enzymes is dynamic, changing throughout the day in response to when and what you eat, and in response to this fluctuating ratio, your body preferentially uses carbs (glucose) or fatty acids as its fuel source.

In an insulin resistant state, your body does not easily shift between glycolysis/OXPHOS (glucose as fuel) and lipolysis/fatty acid oxidation (fatty acids as fuel) and instead remains in a state of using fatty acids as fuel. We will talk about why this is the case in the next section.

How Glucose Gets Inside Cells

The glucose released in your digestive tract from the food you eat is absorbed into your bloodstream, and when your blood glucose levels start to rise following a meal (or any drink containing carbs or sugar), it signals your pancreas to release insulin.

Insulin is the messenger that lets your cells (specifically, your skeletal muscle, fat, kidney, and liver cells) know there is glucose available in your bloodstream.  Insulin does this by binding to the cellular membrane, and this activates glucose transporters on the cellular membrane.

Once blood glucose levels start to drop, a healthy body clears insulin fairly quickly so that it can maintain adequate blood sugar levels. Insulin must be cleared so that blood sugar doesn’t drop too low.

What Is Insulin Resistance?

A number of factors influence how your cells respond to insulin. External influences (like stress, diet, and lack of sleep) along with internal factors (hormonal fluctuations) play a role in how the cells respond to insulin. And, different types of cells respond differently to insulin. Skeletal muscle cells are the most sensitive to insulin. Fat cells and liver cells are also sensitive to insulin, and so these cell types (skeletal muscle, fat, and liver) are the quickest to take up extra glucose from the bloodstream.

When your body becomes more insulin resistant, the cells are not as able to respond to insulin. My favorite analogy for this is to imagine that you are at a rock concert. You cannot easily hear the person next to you because the volume in the venue is so loud that your ears are overloaded by the background noise. In order to carry on a conversation, you must move to a quieter place. In this scenario, insulin is the background noise or the decibel level. When you are insulin resistant, your pancreas releases extra insulin to try to get your body’s cells to respond. This would be the same as somebody yelling at you in a concert hall so that you are able to hear them speak.

When you restore insulin sensitivity, it is like taking your body out of that loud concert hall and placing it somewhere quiet. Now, you are able to hear and carry on a conversation without any problems. When you restore insulin sensitivity, the cells are capable of responding to a much lower amount of insulin much more quickly and take the action of absorbing glucose from the bloodstream.

Insulin Resistance Begets Insulin Resistance

With insulin resistance, the cells are used to the high insulin environment (partially deaf to insulin), so they stop responding to insulin’s call. This prompts the pancreas to release more insulin in order to get your cells to hear the message to soak up the extra glucose circulating in the bloodstream. When insulin is unable to be heard because of the high background noise (because there is so much circulating insulin the cells are deaf to it), then glucose isn’t taken up by the cells. This then creates the false message from your cells to key organs to start releasing stored glucose (in a process called gluconeogenesis) to supply the body’s energy needs.

When we are talking about diabetes, this feedback loop often, but not in everyone with diabetes, results in a perfect storm of upward spiraling blood sugar levels.

 

insulin resistance cycle common in diabetes showing increased insulin resistance triggering gluconeogenesis resulting in higher blood sugar levels which increases insulin resistance
Figure 1. Insulin resistance begets more insulin resistance.

Even in conditions besides diabetes where blood sugar levels are dysregulated, you might have one condition (for example, insulin resistance), without the other (increased release of glucose from your body’s reserves).

With all of that in mind, let us take a look at how reproductive hormones impact insulin resistance and gluconeogenesis, the process of releasing glucose from stored reserves.

Estradiol, Synthetic Estrogens, and Insulin Resistance

Reproductive hormones play a key role in insulin resistance. Most scientific studies agree that estradiol (the endogenous estrogen produced primarily in the ovaries throughout the reproductive years) boosts the release of insulin from the pancreas. While at first glance, this looks like estradiol might contribute to insulin resistance because it prompts release of extra insulin, the opposite is actually true.

Estradiol is widely accepted as a potent compound to restore insulin sensitivity. Whether this is because of upregulation of insulin from the pancreas or whether it is also because of the influence estrogen has on the cells when it binds to estrogen receptors or a combination of both of these is not clear. What is clear, is that estradiol encourages cellular uptake of glucose and more rapid reduction of blood glucose levels after a meal. Estradiol also reduces gluconeogenesis in the liver suppressing the release of free glucose into the bloodstream from the body’s reserves, and this supports healthy blood sugar levels (here and here).

Estrogen Concentrations and Insulin Resistance

How estradiol affects insulin resistance is concentration dependent. Estradiol concentrations in the bloodstream within the normal circulating range (not more than 1 nanomolar abbreviated 1 nM) are associated with healthy insulin sensitivity and healthy blood sugar levels while concentrations higher than 1 nM are associated with insulin resistance. This may be why gestational diabetes is a common condition during pregnancy with up to 10% of pregnant women in America developing gestational diabetes. Progesterone also plays a key role in gestational diabetes as we will discuss in more detail below.

Non-bioidentical Estrogen and Insulin resistance

Ethinyl estradiol, the most common synthetic estrogen used in hormonal contraceptives here in America, also impacts insulin resistance, but like endogenous estradiol, the relationship is not straightforward. Ethinyl estradiol has been shown to impact insulin sensitivity and gluconeogenesis differently depending on:

  • its concentration in the hormonal birth control
  • what progestin (synthetic progesterone) it is paired with

Just as high concentrations of endogenous estradiol increase the chances of dysregulated blood glucose control, the synthetic estrogen, ethinyl estradiol, also increases chances of dysregulated blood glucose control. Chemical diabetes caused by hormonal birth control is also well documented in the literature. This is one of the reasons why, since the 1960s, the concentration of artificial estrogens in combined oral contraceptives has been dramatically reduced from upwards of 60 micrograms per pill to as low as 10 micrograms. Currently, most birth control options contain from 20 to 35 micrograms of ethinyl estradiol per pill.

Estrogen Binds to Insulin Receptors Affecting Insulin Resistance

Estrogens, whether synthetic or endogenous, affect blood sugar regulation differently at different concentrations because of their ability to bind to insulin receptors. This concentration-dependent effect of both endogenous estradiol and synthetic estrogens is often overlooked in the conversation regarding the impact of hormonal contraceptives on blood sugar control. Inasmuch as estrogens play a role in insulin sensitivity, insulin secretion, and in gluconeogenesis, and because estrogens are combined in hormonal contraceptives with a wide range of synthetic progestins, the effects on blood sugar regulation are quickly compounded and convoluted.

Progesterone, Progestins, and Insulin Resistance

As with estradiol, the concentration of progesterone also impacts whether progesterone improves or diminishes insulin sensitivity. It is generally accepted that higher concentrations of progesterone during pregnancy are a major contributor to gestational diabetes. Similarly, high concentrations of progesterone, even after menopause, are linked to an increased risk of developing type 2 diabetes.

The actions of progesterone on glucose metabolism is very much related to carrying a pregnancy to term, promoting glucose storage (rather than consumption of glucose for fuel) and promoting ketogenesis (fat burning) within the body. Even when not pregnant, progesterone is the dominant hormone during the luteal phase (second half of your cycle), and this effects how your body uses glucose and its sensitivity to insulin. This ties into common experiences during the second half of your cycle including carb cravings, potentially diminished appetite (if you are like me), and also weight gain.

Unlike artificial estrogens, of which there is only one used in the combined hormonal contraceptives available in the United States, for progestins, the synthetic forms of progesterone, there are four generations of progestins, with each generation containing progestins of different molecular structures. The class of molecules used in synthetic progestins are similar in structure to the endogenous progesterone molecule, but they are not the same. In other words, they are non-bioidentical.

Progestins bind differently to the progesterone receptors within the body (and also bind to a variety of other receptors), than the endogenous progesterone and their specific structure contributes to how much and whether insulin resistance increases. The molecular structure also affects how the body conserves glucose (increases glucose storage) or uses glucose (in the process of gluconeogenesis). It is generally believed that the androgenic nature of progestins determine their role in reducing insulin sensitivity (here and here).

Hormones and Body Composition

An interesting note, whether we are talking about natural reproductive hormones, estradiol and progesterone, or artificial hormones, ethinyl estradiol and the various progestins, these are all fat-soluble hormones. That means, these hormones may be stored in, and thus, impact the behavior of fat cells. One study evaluated the response of fat cells (adipocytes) in the presence or absence of treatment with artificial hormones and found that in the presence of artificial hormones, the adipocytes were more insulin resistant. This suggests that fat cells may serve as a reservoir for artificial hormones and endogenous hormones alike. They essentially soak up circulating hormones from the bloodstream, and these absorbed hormones in turn impact how the fat cells behave.

This finding means that body composition affects how you respond to hormones, whether endogenous or synthetic, and vice versa. It also suggests that, among other things, we ought to consider dosing hormonal contraceptives relative to body composition. Women with higher body fat may store more of the hormones than those with lower body fat and this may initiate or exacerbate insulin resistance.

Summary

In summary, reproductive hormones are intricately intertwined with metabolism, both with how the body creates energy and how it stores fats and carbs to meet energy demands between meals. Hormonal birth control impacts this finely choreographed dance between reproductive hormones and insulin sensitivity, and this seemingly small influence has a dramatic ripple effect. Insulin sensitivity dictates things like weight gain, oxidative stress, and even, as we will discuss in the next article, susceptibility to UTIs and UTI like symptoms.

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Hormonal Birth Control Plus Poor Diet Is a Recipe for Disaster

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I am a 29 year old female who began experiencing a decline in my health at 25 years old. This was in 2020. At that point, I had been on hormonal birth control for nearly 10 years. I suspected the birth control was contributing to my ill-health but my doctor disagreed and continued to prescribe different forms to alleviate my symptoms. That did not work and only made things worse. When Depo-Provera was added, I completely crashed and have not recovered, nearly two years later.

When I first began to experience extreme fatigue, abdominal bloating, irritability, restlessness, and massive amounts of hair falling out, I went to my primary care doctor who could find no reason for it on basic bloodwork, except for a low vitamin D level (27mg/mL). They checked CBC, CMP, autoimmune markers, B12, a complete thyroid panel, Lyme titers, mono titers, and iron levels. Since everything was basically normal, my primary care doctor blamed it on my stressful job. At the time, I was working in the emergency room on the night shift. I was not getting the best sleep, and not eating that well either. I was lucky to eat one meal a day and then maybe a snack especially on my busy shifts. On my days off, I was so exhausted that I would eat maybe twice a day. My diet consisted of easy meals like grilled chicken, salads, granola bars, processed cereals, pizza, chicken nuggets, chips, bananas here and there, and overall not a lot of fruits or vegetables.

Enter Depo-Provera

Fast forward to the fall of 2021, after these symptoms persisted, my doctor decided to switch my birth control to the Depo-Provera shot. After taking this shot, havoc was wreaked on my body and brought me down to a level of non-functioning that I never knew existed. Over the next couple months and after taking only one depo shot, I began to experience debilitating symptoms of headaches, fatigue, achy joints/all over body pain that eventually progressed into episodes of heart-racing anytime I would change position. I also experienced shortness of breath, chest pain, difficulty swallowing, a complete loss of appetite, GI issues, brain fog, severely decreased ability to concentrate, severe restless leg syndrome, insomnia, and neurological symptoms so extreme it felt like my brain was “short circuiting” for lack of a better word.

One side of my body would become extremely numb, tingly, and feel weak without any clear deficits. I experienced severe muscle weakness, where it would feel like my body was doing everything it possibly could to keep me upright and breathing. It was so bad, I felt as though I couldn’t even grip my phone and just talking on the phone to family felt like I was dying. I could barely concentrate. I developed severe visual issues, a condition called visual snow syndrome, and still am dealing with it with no improvement. I also developed tinnitus and have a constant high pitched ringing in my ear. I am unable to handle any type of stress, multi-tasking, or any emotional upset without truly feeling like my body is dying from severe neurological symptoms. I became scared to leave the house alone because of these debilitating symptoms. I lost over 30 pounds from feeling so awful and a complete loss of any desire to eat. I would have to force myself to put in fluids or food.

Over the course of many months, I saw multiple neurologists, neuro-ophthalmologist, cardiologist, electrophysiologist, primary care doctor, ENT, TMJ specialist, otologist, binocular vision specialist, rheumatologist, had numerous ER visits, two hospital admissions. I even participated in vestibular/neurological physical therapy over the course of several months. I had multiple head MRIs and CTs of my head and neck, MRIs of my spine, and so much bloodwork looking for autoimmune causes. I had a colonoscopy, a camera down my nose to look at my throat, an audiogram, a sleep study, a tilt table test, an echocardiogram, a stress-echocardiogram, and they even attempted a lumbar puncture on me as well. Conditions such as blood clots, multiple sclerosis, any type of cancer or tumor, etc., were ruled out and the only thing they came up with was a diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS), a suspicion for “some type of migraine variant” and a deficiency in vitamin D and phosphorus on my bloodwork.

Could This Be Thiamine Deficiency?

Fed up and worsening, I paid out of pocket to go to a natural medicine doctor who did heavy metal and mold testing on me along with hormone testing. Nothing really turned up there and so I took it upon myself to order a full vitamin and mineral panel paying over a grand out of pocket. This panel revealed that my serum thiamine was one point away from being flagged as low (8 nmol/L). I then returned to my primary care and two different neurologists to ask if a thiamine deficiency could be the problem or at least part of it, especially after my own research and the known research that birth control depletes many B vitamins. All of the doctors told me that there was no possible way I could have a thiamine deficiency since it is added to so many foods in the United States. They also told me that I could just take a B complex vitamin if I was worried. Even after I told them I was hardly eating because I felt so sick and that when I was eating it was mostly foods like processed toast, frozen chicken nuggets, cans of soup, and other things of that nature, they still dismissed the idea of thiamine deficiency.

May-Thurner Syndrome

On top of all of the debilitating POTS and neurological symptoms, throughout my time on birth control I had complained to my GYN about persistent left sided pelvic pain. It felt like my labia was swollen and at times like something was bulging into my pelvic area. In 2019, I had a CT scan of my abdomen and pelvis done due to some GI symptoms I was having. An incidental finding on it was suspicion for pelvic congestion syndrome (PCS). The report stated that I had very prominent peri-uterine vessels and a dilated left gonadal vein. I took these results to my GYN at the time who clearly stated “PCS is a fake diagnosis and you don’t need to do anything with that.” Since I was young, in my early 20s, I didn’t take it too seriously. Again as time went on, I continued to have the pain and over the years my GYN kept changing my birth control and mentioned endometriosis and small ovarian cysts as possible causes. The birth control would help a little bit for a while but then I would have irregular bleeding and the pain would always come back. It wasn’t until after I took the Depo shot and came off of the hormones that things became worse.

I began to have severe left pelvic pain that persisted for months. I had transvaginal ultrasounds every 6 to 8 weeks to monitor recurring small cysts that they swore were not the cause of my pain. I was tested for PCOS and was negative for that too. It wasn’t until the end of 2022, that I had another transvaginal ultrasound and this one read as having a hydro-salpinx. I had a new GYN at the time who referred me to get an MRI done of my pelvis. This MRI came back as also showing “likely hydro-salpinx” on the left. Since I was having such severe pain, I was referred to a GYN surgeon who said in extremely painful cases it is recommended to take out the tube and it was pretty much nonfunctional when it was as swollen as mine. I elected to proceed with the surgery, as the pain was so extreme. Funny enough, after the surgery when the pathology came back there was no hydro-salpinx and my surgeon said he did not see any endometriosis when he performed the laparoscopy. He said he believed my MRI may have been misread since he did not see any indication of hydro-salpinx during the procedure.

As if that wasn’t enough, after the procedure I had a severe neurological reaction to the scopolamine patch they put on me during the procedure. I had so much testing for this. I was even in the hospital for 5 days with what they thought was “scopolamine patch withdrawal” even though I only had the patch on for 3 days like they told me to wear it.

Fed up and still in pain, I let it go for a few more months thinking it was just “scar tissue” from the surgery or some other easy explanation. It wasn’t until my POTS doctor recommended me to wear an abdominal binder/compression device around my stomach that things worsened so much that I was forced to figure this out. I began having severe left pelvic, hip, and leg pain after wearing this device for only 3 days. I went to the ER because the pain was so bad, but they could only find a small ovarian cyst on my left ovary. They didn’t even consider doing any other work-up. I was then sent to an orthopedic to look at my hip and back to my GYN. Neither could really give an explanation for this pain. Finally enough was enough, I went to a vascular doctor on my own accord to get this PCS, which no one seemed to take seriously, looked at.

At the vascular surgeon’s office, they did a vascular scan of my pelvis and abdomen and were quickly shocked to find that my left iliac vein was almost completely compressed causing my peri-uterine vessels to get almost no blood flow. They diagnosed me with something called May-Thurner Syndrome and said that they usually only see severe cases like mine in women who have had “5 or 6 babies.” I was 28 at the time with one previous ectopic pregnancy many years ago. They quickly scheduled me to get a stent of my left iliac vein placed, as my left leg had begun swelling bigger than my right due to the limited blood flow.

On the day of surgery, my left leg was 2 inches bigger than the right and I was in severe pain. They did a venogram with internal ultrasound and were able to tell me my left iliac vein was 85% compressed. So basically, I was getting no flow through it and hardly any return through that vein up to my heart. They also informed me that the birth control was probably masking the problem but also could have been worsening it when I was on estrogen-containing birth control. They said I was extremely lucky that I did not develop a blood clot, especially when I had taken Beyaz for several years. Now, I am on blood thinners for several months post stent, while waiting to see if this helps with my POTS symptoms at all. So far, I have not seen any improvement except that my leg is no longer swollen.

Still Seeking Answers

I don’t know if thiamine deficiency could be causing my issues, but I have not received any answers other than POTS and my recently discovered May-Thurner Syndrome. I have seen so many doctors and spent so much money with no improvement in my health. This all severely worsened after I took the Depo shot. I have been unable to work for months, was bed bound for a long time, and was completely unable to eat during the worst of my symptoms. Now, I am at least able to move around more than I was and leave the house for doctor appointments, but I am still not working and I am still searching for answers. I would like to feel better and get back to some type of semi-normal life.

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Ding, Dong! Hormones at Your Door!

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The side effects of hormonal birth control are notoriously under-recognized. So much so, that I filmed a documentary about them, entitled, Hormoneously Alone, highlighting the severe lack of research since the 1950s. What I learned was shocking. Because hormonal birth control has been available for over 60 years, everyone, doctors included, presume these drugs are completely safe and have very few, ‘rare’ side effects. I spoke to experts in women’s health who have researched the effects of the pill and other forms of hormonal birth control and, contrary to the general consensus, these drugs do elicit many ill-effects that are detrimental to health. These side effects can develop while on the pill but also upon withdrawal as the body struggles to adapt to the loss of synthetic hormones.

My original post on this website documenting my own experience is what drove me to investigate the side effects of hormonal birth control, and ultimately, make a documentary to inform other women. Over four years, hundreds of women have left comments indicating they had similar experiences with hormonal birth control and even more have reached out to me personally for advice. Research on this website and other case stories concur.

With all of the potentially negative health consequences attributed to hormonal birth control, imagine my surprise when I learned that these drugs can be ordered online, without so much as a physician consultation. Of course, since most physicians do not recognize the side effects, I guess ordering online is no less safe than from a physician who ignores the health or experience of his/her patients.

My goal is that women will research and educate themselves about the risks they are taking when ordering birth control online. I hope my articles and my documentary will encourage them to speak up, and ask questions, but what if that does not happen? At least when these drugs are prescribed by a physician there is a small chance the more serious side effects will be recognized. When ordered online, with no health intake or counseling of any sort, the possibility for potentially dangerous health interactions between the pill and the patient increases. This risk is increased for young girls, who do not have the experience to understand the side effects associated with these drugs.

Ordering Birth Control Pills Online

Anyone can order hormonal birth control online. While doing research for my documentary, I investigated the process.  There are no safety mechanisms in place to determine whether the information one inputs is truthful or not, or whether the individual might have a family medical history that can affect the choice of the type of hormone prescribed. I know this because I tested it. I went online and created a fake profile with fake information and submitted a request for a three month trial. It took me about five minutes from start to finish. I tried multiple vendors, some of the more popular ones, and none of them had any issues with prescribing a pill for me. Surprisingly, none of these vendors asked when my last OBGYN appointment was or if there was a family medical history for any cancers that the birth control pill may help promote or any other health issue that might be exacerbated by the pill. A genetic predisposition may increase one’s risk for certain illnesses and cancers. Breast cancer, for example, may be exacerbated by certain synthetic hormones. Autoimmune disease may also be exacerbated by these hormones.

I wanted to see how far I could push the dial, so I also falsely claimed to smoke cigarettes daily, had high blood pressure and migraines with aura. These are all cases where hormonal birth control is clearly contraindicated because of the elevated risk for blood clots. And yet, even with these risk factors, I was able to order a prescription. There was no dialogue with an online doctor or chat system. It was just me, my mouse, and my keyboard.

I am all for women’s rights and easy access to medications, but as a woman who understands the risks of these drugs, who has experienced some of them, this enraged me. Why are women not told of these risks? Online prescriptions seriously lack the ability to oversee a patient’s full chart and medical history, to understand a patient’s concerns, and to have the foresight to avoid a medication that may catalyze a genetic predisposition. This seems totally careless.

Women’s Rights

In today’s highly politicized landscape, it is difficult to talk about birth control safety and side effects, especially with the current onslaught of attacks against women’s health care options. Recently, over the counter hormonal birth control has been approved by the FDA. This eliminates any and all preliminary precautions and the online ordering has become even easier. Regardless of where we are buying these pills, I think we have to acknowledge that talking about safety and accessibility is not an attack on women’s rights, rather a concern for their well-being. I believe the ability to order medication online is generally a good thing. The accessibility of these online birth control pills not only allows a user to obtain them quickly, but also, discreetly, and inexpensively. It is, for the most part, hassle-free. This works well for the quick-click generation and society that we have evolved into. Women should always be in charge of their bodies, and this new technology affords them that opportunity, which is a really powerful and important idea in and of itself. I do, however, struggle with the idea that we might be missing possible interactions that could result in serious side effects and health issues. These websites do not have a warning anywhere, just, in my opinion, a vague questionnaire. As you will see below, there is little to no health intake when ordering and no counseling regarding side effects.

The Age of Consent

In my research for the documentary, I wondered about the accessibility of online ordering to young girls. As I flipped through the magazines that I once read religiously as a teenager, now, from an adult’s perspective, I see just how targeted the ads can be. In the most common teenage magazines, there are ads almost every 5 pages that push ordering hormonal contraceptives online. These ads are impossible to miss and can be very persuasive to young girls.

Imagine a parent and not knowing what medications your child was on. Imagine a child not understanding the seriousness of the birth control pill and taking too many because they missed a few? Imagine a child taking the pill not knowing why they are feeling poorly, suddenly getting migraines, a possible sign of neurological issues including stroke, or having labored breathing, a sign of pulmonary emboli. These side effects are more common than you would think. Is it smart to have such accessible medications with potentially severe side effects available online without so much as a health warning? Will teenagers read the fine print? Yet, the FDA allows online ordering. It would be easier for a child to click and order rather than having the uncomfortable conversation with their parents or their doctor. A fake profile and credit card is all that is needed.

Since most patients do not ask questions when being prescribed the birth control pill by a physician and, from my experience, most doctors do not offer this information up, what would prompt the conversation online? Is a child who is taking the pill going to read the pamphlet, and if so, will they understand it?

Candy From Strangers

When the package of hormonal birth control came to my door about a week after placing the order, it had some candies and chocolates with it. This felt ironic. “Don’t take candy from strangers,” feels oddly similar to “Don’t take pills from the internet,” or the idea of candy not being healthy for you accompanying the controversial birth control pill. It all felt wrong. Because of the emphasis that providers put on the safety of birth control pills, it seems to negate the impact these pills have on the female body. The pill may be generally safe to take every day, but what are the effects that we are missing under the surface? Are they actually safe even if we do not see the effects immediately? Is the pill for everybody?

It is extremely important that women be in charge of their bodies, but having autonomy means having an understanding of the full picture. Women should absolutely be able to order pills online, but they should also be given adequate information to make that decision and protect themselves against possible harm. Omitting critical health information in favor of accessibility does nothing to serve women’s health interests. Women need to understand the side effects associated with these drugs in order to make an informed decision.

I believe we, as a society, are sacrificing leniency on a topic we truly do not know much about for quick and cheap pill availability. I think we need to revisit the accessibility of these pills and take a step back to understand the potential harm we are causing.

Hormoneously Alone

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Why I Made a Documentary About the Birth Control Pill

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I began using the birth control pill in my early 20’s. After 3 years of using the pill, I decided it was time to stop. I didn’t expect the process of coming off birth control to be so harsh. I was wrong. The withdrawal symptoms were unlike anything I had ever felt before. I developed extremely high blood pressure, had tingling and weakness throughout my body, brain fog, and a frightening sense of depersonalization. Not a single doctor could give me any information about what was causing these symptoms, when they would end, or even if they would end. In fact, most of the physicians I saw denied that pill withdrawal was a thing. They said that my symptoms were anxiety and suggested an antidepressant. I knew that couldn’t be the cause of these unique, first-time symptoms. I felt like there was no hope in sight. Through research, I found that I was not alone. There were many women who experienced similar symptoms while withdrawing from hormonal contraceptives, In fact there were thousands of women just like me.

I wrote an article about my full experience coming off the birth control pill and published it on this website, here. Since then, the article has received hundreds of comments from women who developed similar withdrawal symptoms. I decided to make a documentary about hormonal birth control in an effort to help spread awareness, and, to comfort other women who were struggling. Filming a documentary with no crew, no production money, and no experience, will fully test one’s sanity, but I was determined to uncover and document the health effects of hormonal contraceptives. After 4 years of work, I released the documentary entitled, “Hormoneously Alone,” on YouTube.  It can be found here.  I learned a lot from filming this documentary, and over the next few months, I will be writing a series of articles about the topics discussed in the film as well as other information that I was not able to include.

Ninety-eight percent of the female population will use a hormonal contraceptive in their lifetime. This is likely because it is 99% effective at preventing pregnancy when taken regularly. Using the pill alleviates worry and it is easy to use. In the US alone, this means that about 13 million women use hormonal birth control, with 6 million between the ages of 15-24 and 7 million between the ages of 25-34. I also learned that about 60% of women who have taken the pill have done so for other issues unrelated to pregnancy. Acne, bloating, and cramps are some of the main catalysts for using the pill.

What you may not know, and what I did not know before I began taking the pill, is up to 60% women who use hormonal contraceptives, whether for the prevention of pregnancy or for other reasons, stop taking the pill within 6 months because of side effects.  Unfortunately, there is little research on pill withdrawal and why it effects some women and not all. Through my own research, I’ve personally estimated that about 15% of women will experience withdrawal symptoms.  This is troubling because these withdrawal symptoms seem to only be recognized by the women who use these products. There are few experts in women’s health who understand pill withdrawal. Most doctors and gynecologists seem unaware of these effects. This leaves most of us struggling to recover on our own.

If a significant amount of women use hormonal contraception at some point in their lives, and the side effects both on and off the pill are not well studied, do we really know enough about the well-being of the girls and women who use them? With teenagers especially, are we doing more harm to the developing brain and body when we prescribe artificial hormones for things like acne and painful or irregular periods? Given the large number of girls and women who use the pill, do we as a society, not just as women, understand what we are committing to when we take the pill? From what I experienced and what I learned while producing the documentary, even though the pill has been on the market for over 60 years, we still do not fully understand the implications of using artificial hormones. Over the next few articles, I will be tackling some of these big issues that many women wonder about while on the pill, and off the pill. Hopefully, what I have learned will help others make more informed decisions and feel empowered to know what’s right for their body, and their body only.

Hormoneously Alone – A Birth Control Documentary

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