Then What?? Understanding My Birth Control Options

Unfortunately, not all health practitioners present birth control measures objectively.  According to Dr Christine Northrup, MD, during her experience “in medical school and residency, there was a tendency to push oral contraceptives as the optimal method of birth control and to downplay the reliability of the diaphragm and condoms... The pill is easy to prescribe, easy to take, very reliable, and very convenient.  We can use it to manipulate our menstrual cycles, avoiding periods all together or on weekends.  In short, it fits our cultural ideal.”  

To simplify the discussion of various forms of birth control, let's divide methods in two camps: Hormonal and Non-Hormonal Contraceptive options.   

There are a number of Hormonal Contraceptives.  They can be injected (‘The Shot’), implanted (IUS and ‘The Ring’), applied to the skin (‘The Patch’), or taken orally (‘The Pill’).  These methods contain progesterone and or estrogen in order prevent ovulation and limit the fertility phase of the menstrual cycle, or eliminate the cycle all together.  

Menstrual suppression, via Birth Control, for an entire month, or year(s), seems extreme when the window of fertility is a matter of a few days.  However, birth control is easy to take and places 100% control of a woman’s fertility in her own hands - requiring nothing of her partner.  

If a woman chooses that Birth Control is the best option for her, an oral contraceptive is the best way to go (in my opinion).  Eliminating the cycle for a year or longer is devastating to the endocrine system and physiology of the body.   Monthly suppression is the better choice, in this case.  Though she is not truly cycling - her body does get a reprieve from the suppression every three weeks.  Be mindful not to place metal in the body.  Be mindful not to stay on birth control long term.   Be mindful to choose this option only if you are actually sexually active.  

The next logical question would be, if not The Pill (or any other hormonal method), then what?  How do I prevent pregnancy?  What are my other Non-Hormonal options?

There is one other common contraceptive method that is non-hormonal but is not natural.  The IUD is a copper intrauterine device that is inserted into the uterus.  It is a long acting (5 year) contraceptive that changes the environment of the uterine lining and prevents the sperms ability get through the cervical mucous and to fertilize the egg.  In my clinical practice, there seems to be a correlation between IUDs and an increased risk of acidity in the female as well as a significant need to detoxify the body in order to increase fertility.  Women with IUDs do have an increased risk of infection and are associated with an increased risk of tubal pregnancies.  Just as I mentioned above, be mindful not to place metal in the body.        

There are a number of options for natural pregnancy prevention that does not include traditional birth control.  These options require more education about the body and more active participation than the pill.  The level of responsibility and accountability increases depending on the method a person chooses.  

Current culture would assume that fertility and the responsibility for birth control measures lay solely in the hands of the female.  While it is imperative for a woman to come to know and take responsibility for her own body, birth control methods (in my opinion) should be a shared responsibility between partners.  

Charting a woman’s cycle in order to be informed about where a woman is in her fertility is always my first choice.  There are a number of charting methods for fertility awareness.  Natural Family Planning or the Creighton Model Ovulation Method are excellent choices.  Couples who use fertility awareness as their chosen form of birth control experience no side effects and often find increased intimacy in their relationships.  Three major studies regarding Fertility Awareness Methods showed effectiveness rates to avoid pregnancy between 95% and 97%.  

A woman who knows her body and her cycle reclaims her power and creative force.  Since there is a small period of time that a woman is fertile throughout a given month, barrier methods or abstinence can be utilized during this window. Condoms, Female Condoms, and Diaphragms would be the most effective if utilized properly during the fertility phase of a cycle.  

Condoms require the male partner to be cooperative and share responsibility of prevention.  They have a 98% effectiveness rate if used conscientiously.  Condoms can protect against STDs and help decrease the risk of cervical dysplasia.  

There are also female condoms that have a 95% effectiveness rate.  Much like condoms, they protect against STDs and require a one time use only.  Diaphragms with contraceptive cream or gel is another option during the fertility phase of a cycle.  Diaphragms will need to be fitted by a health professional and faithfully used at each intercourse.  They have a 96% effectiveness rate.  

Cervical caps are used as well.  The caps come in three sizes and are not fitted specifically for the individualized female.  Therefore, accurate fit is not always assured.  The effectiveness rate for a cap is 74% (compared to the 96% of a diaphragm). This effectiveness rate drops drastically in women who have already had children.  For these reasons, I recommend a diaphragm over a cap.  

These four methods of birth control (Fertility Awareness, condom, female condom, and diaphragm) help to maintain the normal, natural cycle of hormones without suppression or dis-regulation.  They require cooperation and mutual responsibility for a couples combined fertility.  

Below is a chart that diagrams the effectiveness of each choice.  It is important to distinguish between the failure of a birth control method itself and the failure of a woman or couple to use it properly. I prefer this chart because is shows both perfect use and typical use (accounting for user error). 

http://www.sexualityandu.ca/uploads/files/refContraceptiveComparativeChartFinalENG09.pdf

This post was intended to be a starting point for discussion regarding various birth control options outside of typical oral contraceptives for sexually active individuals.  

Women or teenagers who are not sexually active and are having hormone dis-regulation or severe periods should seek natural care to help balance their systems.  Birth Control is not the best option to reduce symptoms and balance their bodies.   

The Basics of Birth Control

Birth Control is widely used to help regulate a cycle, eliminate acne, reduce painful periods, help prevent against pregnancy or to eliminate a cycle all together.  A common misconception about birth control lies in thinking that it actually regulates hormones, which it does not.  Rather, birth control suppresses your hormones, eventually turing OFF your hormone production.  

The process of birth control is like asking the body to stop cycling (stop menses); which is the same as asking the body to pause menses; which is the same as asking the body to go into menopause.  

And women are on birth control for 5, 10, 15, sometimes 20+ years.  In menopause for YEARS.  And when women come off birth control, they wonder why they struggle to become pregnant.  They wonder why they struggle with fertility, after they have asked their bodies to be infertile for years.  Years.  

Rest your heart.  In most cases of fertility, hormone balance can be restored.  We will discuss this at length.  Today we need to understand what birth control does and how the body is effected by it.  

There are other misunderstandings we need to clarify when discussing birth control.  First and foremost, cycling is extremely important for a woman.  A period allows the female body to cleanse, shed, detoxify, purify, release, and balance.  It prepares the uterus to hold life.  To build a lining, to strengthen the muscle, to perfect the womb.  Not allowing ourselves to bleed undermines some of the most creative and healing cycles of the female form.  Birth control puts women in menstrual and fertile suppression.  

Second, a woman does not have a true period on birth control.  Bleeding on birth control is with-drawl bleeding, not  cyclical bleeding.  Hence, a woman will not cleanse, balance, detoxify, etc.  The following is an explanation of menstrual suppression from the Association of Reproductive Health Professionals.  

Understanding Menstrual Suppression:

“Menstrual suppression, sometimes called “skipping your period,” is a way of using certain types of hormonal birth control to avoid having monthly bleeding. With many birth control pills, women take three weeks of pills containing active hormones, which prevent pregnancy by stopping ovulation (when an egg is released from a woman’s ovaries) and keeping the uterine lining thin. During the fourth week of their cycle, women take pills that do not contain active hormones; this is the time when they experience bleeding. This monthly bleeding is not a “true” period; instead, this is withdrawal bleeding – the body’s reaction to not having the hormones it gets the other three weeks of the cycle."

Consider a normal Cycle:

                  

At the beginning of the cycle, the ratio and balance of estrogen and progesterone communicate with the pituitary to release FSH (Follicle Stimulating Hormone).  The ratio of estrogen and progesterone significantly alters and signals to the pituitary that the follicle is fully developed and it is time to ovulate.  Therefore, the pituitary releases LH (Leutinizing Hormone) in order to tell the ovary to release the follicle/egg and hence, ovulation occurs.  In the first phase of the cycle, the uterine lining sheds, we know this as a period.  The second phase of the cycle rebuilds and thickens that unterine lining.  This shedding and thickening does not fully occur on birth control. 

On Birth Control, there remains a static level of hormone throughout the cycle, preventing the signaling for the need and release of FSH or LH.   On Birth Control, the woman's body will make less of her own hormone, since the pill provides hormone for her.  Therefore, the pititary and the ovaries step down in a way.  Eventually, after years, they will shut down.   

Dr Lesley Miller, at the University of Washington in Seattle, describes that “when a woman is on the birth control pill, every day becomes the same hormonally.  The woman has a set dose of progesterone and a set dose of estrogen. (Therefore) every day becomes the same pattern.”

On the minipill (progesterone only) estrogen will flux, progesterone will remain ‘stable.’  

The important aspect to remember about the body is that it is a dynamic system that continuously moves toward homeostasis/balance.  Eventually, after a period of time when the hormones constantly remain the same (which they are not supposed to do) and the pituitary does not need to release FSH and LH, it will eventually STOP producing certain hormones that they body is asking for it not to produce.  Prolonged suppresson causes a cascade of hormone disruption that effects the pituitary, hypothalamus, adrenal glands, ovaries, thyroid, etc.  

Hormonal suppression is only one aspect of the side effects of birth control.  The endocrine system is intimately linked to the immune system and the nervous system.  Therefore, headaches, digestive issues, endometriosis, PCOS, infertility, autoimmunity, thyroid disorders, toxicity in the body, mood swings... the list is endless.  The body is not made up of separate parts that work in their own little cubical.  The body is a dynamic organism that constantly works in concert with itself, every aspect of itself.  

Third, birth control cannot only lead to hormone dis-regulation and suppression, it can also lead to reproductive disorders

                              

Diagram Explained: 

Endometrial tissue is stimulated by estrogen to thicken the uterine wall, break down, and bleed EACH month.  

Endometrial tissue that is located outside the uterus thickens, breaks down, and bleeds.  HOWEVER this blood/tissue cannot exit the body as it is not in the uterus.  

The blood becomes trapped and forms cysts or irritates the surrounding tissue.  Leading to more endometrial tissue surrounding the uterus or other organs and cause pain (back pain, shoulder pain, etc).  Endometrial tissue has found and surgically removed from the abdominal cavity, shoulder joints, brain tissue, etc.  

Or the blood forms cysts as it adheres to the ovarian wall or within the ovarian wall.  This leads to scar tissue and adhesions.  This leads to infertility. 

Lastly, as if the aforementioned was not enough, lets add a cherry on top!

The Association of Reproductive Health Professionals consider it common and acceptable that “hormonal contraceptives can be used by women to decide when, or if, they get their monthly withdrawal bleeding. Women may choose to have shorter or less frequent withdrawal bleeding, skip bleeding when it’s inconvenient, or eliminate bleeding completely for up to a year or more. Menstrual suppression also helps women cope with or get rid of uncomfortable side effects or conditions that are connected to their bleeding. For years, women have suppressed their periods for things like honeymoons or vacations, and new surveys show that many women are interested in bleeding less than once a month, or not at all.”

Clearly we are missing the mark.  Clearly we misunderstand the importance of a normal cycle.  Birth Control prevents pregnancy, it does not regulate hormones.