Choosing a birth control method is an extremely personal decision. There are so many factors that come into play — effectiveness, invasiveness, permanence, and discomfort. When you consider all the options, it’s no wonder the Pill became one of the most popular options out there. According to the CDC, 16 percent of women between the ages of 15 and 44 take contraceptive pills. That’s more than twice as many women that use intrauterine devices or contraceptive implants.
For many, deciding to take the Pill is an easy choice. With the Pill, women can have an active, healthy sex life with little-to-no risk of getting pregnant, and all they have to do is pop a tiny pill at the same time each day. Easy. It also comes with lots of perks outside of just preventing pregnancy like clearing up acne and lessening the pain of cramps. According to the Guttmacher Institute, during the years 2006–2008, 14 percent of women on the Pill used it purely for noncontraceptive reasons, while 58 percent of users cited a combination of contraception and other benefits.
But over the years, as “natural” has become not just a lifestyle, but practically a prerequisite for anything you put in your body, the desirability of a pill chock-full of synthetic hormones has quickly dwindled. Indeed, in September, the JAMA Psychiatry journal published a Danish study that confirmed a direct correlation between hormonal contraceptives and depression.
After almost a decade of being on the Pill, I couldn’t help but wonder — is this tiny pill that I’ve been dutifully swallowing for years actually good for me? I reached out to Dr. Raegan McDonald-Mosley, Chief Medical Officer at the Planned Parenthood Federation of America, to get some answers.
The not-so-great health risks
First, let’s look at the long-term, serious physical health issues associated with the Pill (that means we’re going to go beyond the weight gain and nausea, although these are also side effects associated with all hormonal contraceptives).
It’s long been rumored that the Pill may increase your chances of developing breast cancer, but Dr. McDonald-Mosley says that the most recent studies have debunked that myth. “In fact, studies also show that the combination pill actually offers some protection against endometrial and ovarian cancers,” she says. Score one point for the Pill!
However, there are proven dangers associated with the circulatory system, including increased risk of heart attack, stroke, and blood clots. “The hormones, particularly estrogen, change the amount of circulating proteins [in your blood], which causes a small increase in the risk of blood clots,” explains Dr. McDonald-Mosley. However, before you freak out, there’s a way to know if you’re a prime candidate for these serious health issues. “The risk increases if you’re 35 or older, are overweight, have diabetes, high cholesterol, high blood pressure, or certain inherited blood disorders, and if you smoke,” she says. If that’s you, a non-hormonal form of birth control might be a better choice for you.
Finding a happy hormone balance
Your body is a delicate, finely tuned machine. Hormones exist in your body naturally, created by the glands of the endocrine system, so adding supplemental hormones into the body can cause major physical and emotional changes. “When they are in proper balance, hormones help the body thrive, but small problems with hormones can cause serious and life-altering symptoms,” says the Hormone Health Network. Not to mention, taking synthetic hormones can mask menstrual disorders by covering up signals that your body might be trying to sending you in the form of physical symptoms.
And then, there’s the emotional effects associated with hormones — you’ve probably heard murmurs that the Pill can mess around with your moods, and there is evidence to support that claim. Let’s go back to that Danish study that recently confirmed that the use of hormonal contraceptives was associated with use of antidepressants and diagnosis of depression. When taking the Pill, you are pumping more hormones into your body, and the delicate balance maintained by your endocrine system can be thrown off. Depression can occur when your body has too little estrogen, which in turn causes serotonin levels to plummet (and vice versa), while lower progestin (called progesterone when it occurs naturally in the body) levels can cause anxiety.
Another weird side effect: Many women have reported a decrease in their libido while on the Pill. Why does this happen? “By shifting your hormones into a state where you’re not ovulatory,” says Dr. Robin Berzin of Parsley Health. “If your body thinks it is pregnant, this may affect vaginal secretions and cause vaginal dryness, and if there is a mood component, that can lower your sex drive. No one wants to have sex if their mood is flat.”
So, how do you know what’s right for you?
If you’re five seconds away from flushing your birth control pills down the toilet, stop and reconsider. “Hormonal birth control methods — the pill, patch, and ring — have been studied for over 30 years,” Dr. McDonald-Mosley assures us. “We know that most women can use hormonal methods of birth control safely. All medications have some risks, and certain conditions can increase the risk of serious side effects. Patient safety is a top concern when choosing a birth control method. Women should work with their providers to assess their individual risks when using certain medications, including hormonal contraception.”
That said, talk to your doctor about birth control. We’re only here to educate you — but they can help you assess what’s right for you. “The first thing to remember is that birth control methods are not one-size-fits-all. A method that’s perfect for one person may not be right for another,” concludes Dr. McDonald-Mosley. “There are many different kinds of birth control — and all come with different benefits and risks.”
So go do your homework — you may discover that hormonal birth control is in fact the best option for you. And that peace of mind will be totally worth it.