Doctors frequently dismiss irritability and depression as minor side effects of birth control – a mere inconvenience that can easily be treated. All you need is another prescription. In fact, we saw in my previous article on lupus how quickly some doctors will prescribe an anti-depressant for virtually any side effect triggered by The Pill.
Trivializing changes in the brain’s chemistry, or for that matter, any of the body’s chemistry is a dangerous game of roulette. It’s akin to the early days of The Pill when doctors recognized that synthetic hormones altered the chemistry in a woman’s breasts. Rather than be concerned about what these changes might mean in the long run, they turned it into a marketing point. It makes your breasts fuller! Only after it was undeniably linked to breast cancer did they acknowledge the changes could be a cause for concern.
First Generation Depression
A smattering of uncomfortable laughter danced through the senate chambers when Mayo-trained, Dr. Philip Ball testified on the side effects of birth control at the Nelson Pill Hearings, in 1970:
“In a fair number of these women, the husband will call me separately, and say, ‘My God, do something about my wife, she has just turned into a bitch.’ Or the mother or mother-in-law [will call], but these problems are often stated by other members of the family who have observed a total change of personality.” (NPH Page 6499)
Family members weren’t the only ones noticing these changes. A large-scale Swedish study revealed that ‘psychiatric reasons’ was the primary reason women gave for stopping birth control. (NPH Page 6452)
At the milder end of the spectrum, symptoms were compared to a ‘constant pre-menstrual tension.’ But, the other end of the spectrum skewed much darker. It included suicidal and even murderous tendencies.
Dr. Francis Kane, a gynecologist from the University of North Carolina, was among the first to begin documenting psychological changes in patients. In his testimony at the Nelson Pill Hearings, he shared the results of a British study that paralleled his findings that one out of every three pill users showed depressive personality changes, and a little more than one out of every 20 became suicidal. He added that women on birth control had ‘distinctly higher scores,’ meaning not only were more of them getting depressed, but they were also experiencing greater depression than the non-pill takers. (NPH Page 6456)
The Serious Side of Side Effects
In her landmark book, A Doctor’s Case Against The Pill, Barbara Seaman described the behavioral changes this way:
“A few pill users have become so hostile, suspicious and delusional that they have seriously thought of murdering – or have actually attempted to murder – their own husbands and children. Others attempt to commit suicide and some have succeeded.” (Page 166)
Dr. Harold Williams also authored a book, Pregnant or Dead, which came out the same year as Ms. Seaman’s book. In it, he attempted to quantify some of the collateral damage of The Pill. One of his most shocking finds came when he compiled suicide statistics from the most recent year (1967) and compared them to 1961 (representing the last year before birth control became commonplace). He recorded these changes:
Percent Change Rate
These increases were dramatically higher than their male counterparts. (Page 135) His conservative estimate was that an additional 223 women in the United States had committed suicide in that one year due to The Pill.
Even one of The Pill’s developers, Dr. Celso-Ramon Garcia, made this statement in the March 1968 issue of JAMA:
“Although oral contraceptives have revolutionized approaches to birth control, they do not represent the ideal approach for every individual. Furthermore, relatively little is known about various effects, especially those on personality and emotions… The fact that many questions remain unanswered points out the necessity for further investigation into the areas of emotional responses to the use of hormonal contraceptives.” (A Doctor’s Case, Page 166)
Below the Surface
As dramatic and dangerous as these behavioral changes sometimes are, recent studies suggest they could simply be the most obvious and immediate short range psychiatric complications, and unfortunately, the less obvious, long range complications could ultimately be the most pernicious.
A lot is left to learn about the complex role of hormones in the various functions of the human body, but scientists do recognize that estrogens play a key role in the immune system. Natural estrogen, estradiol, activates the immune system to provide an increased level of protection against infectious disease for women, especially during their reproductive years. However, the introduction of birth control or hormone replacement therapy into the system creates a cascade of problems. First, it floods the body with synthetic estrogen, which is molecularly different from natural estrogens. The body reacts to the overabundance of these potent chemicals by cutting back on the production of natural estradiol. From there, the consequences are many and varied.
In a properly functioning body, the first noticeable sign that estradiol has triggered the immune system is typically inflammation. Estradiol combines with receptor cells in the immune system to produce cytokines, which regulate inflammation. However, synthetic estrogens frequently throw this delicate system out of balance, and confuse the immune system in ways we will revisit in a moment.
Often times, the production (and overproduction) of cytokines can be localized within the body. Studies have shown that synthetic estrogen contributes to overproduction of at least two cytokines in the central nervous system: interleukin-6 (which I discussed in my article on Multiple Sclerosis), and interferon-gamma. A recent study published in JAMA Psychiatry concluded that brain inflammation was 30 percent higher in clinically depressed patients, while another study correlated increased interferon-gamma secretion with major depression.
Not Immune to Depression
Groundbreaking new research from the University of Virginia has begun to reveal how the immune system influences mental disorders and neurological diseases. The headline on Science Alert in July 2016 read, “Freaky New Evidence Suggests Your Immune System Could Be Controlling Your Behaviour.”
“It’s crazy, but maybe we are just multicellular battlefields for two ancient forces: pathogens and the immune system,” said lead researcher, Jonathan Kipnis. “Part of our personality may actually be dictated by the immune system.”
The molecule in question is called interferon gamma, and it’s usually released by the immune system when it comes into contact with a pathogen, such as a virus or bacteria.
This type of immune response is part of the adaptive immune system, which learns to keep an eye out for nasty germs – and up until last year it was thought to be isolated from the brain as a result of the blood-brain barrier.
The discovery of meningeal lymphatic vessels that connect the brain to the immune system also came from the Kipnis lab. This revolutionary discovery changed nearly everything neuroscientists believed about the blood-brain barrier, and created a whole new perspective on the interaction of the immune system with the brain. This missing link suggests the neurological consequences of birth control could run much deeper than just interferon-gamma and depression.
Birth Control: Breaking Barriers
Establishing this physical connection to the brain makes it easier to connect the dots on causal relationships with other mental disorders and brain diseases. It suddenly seems less mysterious that women who take hormonal birth control are 50 percent more likely to develop a glioma brain tumor.
It also makes sense that inflammation is present, and the brain’s immune cells are hyperactive in schizophrenia patients. Is it any wonder that patients with an autoimmune disease have a 45 percent increased risk of schizophrenia, or that they are 20 percent more likely to develop dementia later in life?
Autoimmunity Attacks the Brain
Scientist believe that environmental triggers play a key role in activating autoimmune disease. Chemicals that mimic natural estrogen (hormonal contraceptives and hormone replacement therapy being prime examples) get in our body, and attach to the receptor cells of the immune system. Our natural estrogen normally communicates with these ‘soldier’ cells of the immune system, telling them where to attack – whether it be a virus, bacteria, or parasite. However, the chemicals that mimic natural estrogen don’t provide these ‘marching orders.’ The immune system gets confused, and begins attacking healthy tissue, resulting in an autoimmune (AI) disease.
Autoimmune Encephalitis (also known as anti-NMDA receptor encephalitis) typically affects the brain in a younger population, and (like most AI diseases) it targets women much more than men. Studies in animal models have shown an increased production of interleukin-6 associated with the disease.
Autoimmune Encephalitis is a relatively rare disease – or at least it is a rarely diagnosed disease. The disease was first identified by Dr. Joseph Dalmau in the early 2000’s. At a recent symposium in Houston, doctors offered a lowball estimate that at least 3.2 million Americans currently diagnosed with schizophrenia actually suffer from undiagnosed Autoimmune Encephalitis. Dr. Dalmau said, “These patients develop symptoms that can fool any psychiatrist.”
During his presentation at Methodist Friday, Dalmau played a video of a woman lying on her back in a hospital, mouth twitching as she stared vacantly at the ceiling. Then he played a video of her not long after beginning immunotherapy treatment, walking down the hall of the hospital. And then another, weeks later, showing her sitting up, smiling and talking normally. (Houston Chronicle, February 17, 2017)
Back to the Future
One of the things that most concerned doctors in the early days of birth control was that they didn’t know what they didn’t know. They saw things were changing. They witnessed certain side effects and complications, but they feared the unknown.
They knew The Pill hadn’t been sufficiently tested, and were concerned about what side effects might be flying below their radar. Here’s what one doctor shared with Barbara Seaman:
“Dr. Ayd told us, that some physicians were still giving patients tranquilizers to counteract pill-caused psychiatric symptoms. Some drugs, taken in combination, produce untoward effects in some people. Researchers were learning that the combination of the pill and certain psychiatric drugs could produce a broad range of dangerous and unpleasant effects. Among these were tremor and rigidity as in Parkinson’s disease.”… “It needs to be emphasized that if you give a patient one drug and counteract it with another, there is a rising curve of adverse reactions.” (A Doctor’s Case, Page 172)
Dr. Ayd was clearly concerned about the practice of giving psychiatric drugs to treat Pill-induced symptoms. Unfortunately, fifty years later, that practice has become the standard operating procedure.
Real Risk Study: Birth Control and Blood Clots
Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.
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