The Basics of Hormonal Birth Control

A couple of things before we start.

  1. I am not a doctor, so I will be either directly quoting cited websites or linking directly to those websites.
  2. This is not an all encompassing article about hormonal birth control, I highly encourage you to do your own research.
  3. The purpose of this article is to lay down the basics and encourage you to always stay curious about your health, which means talking to your doctor, and going to your yearly doctor’s visits!
  4. I am a very big proponent of birth control, but I am also a very big proponent of listening to your body and talking to your healthcare provider!

In my humble opinion, birth control is one of the most confusing and sensitive things to learn about. I don’t know very many people who can say they feel well educated about the topic, and most say that school did not teach them nearly enough about it.

It’s a pretty complicated topic, and for good reason. We have invented a way to stop one of our vital organs from doing the thing it’s supposed to be doing. It is also incredibly unfortunate, and frankly, completely unfair that a lot of the burden of birth control falls on women.

In the most basic sense, hormonal birth controls contain either progestin and estrogen or just progestin.

“Oral contraceptives (birth-control pills) are used to prevent pregnancy. Estrogen and progestin are two female sex hormones. Combinations of estrogen and progestin work by preventing ovulation (the release of eggs from the ovaries). They also change the lining of the uterus (womb) to prevent pregnancy from developing and change the mucus at the cervix (opening of the uterus) to prevent sperm (male reproductive cells) from entering.” Source

There are a handful of different delivery mechanisms of these hormones. There is “the pill” (there are lots of different pills dependent on the % of estrogen and progestin, as well as different doses of these pills). There are also IUD’s, shots, rings and patches. Each of these mechanisms of delivery have different side effects, and methods of consumption. Some allow women to keep their periods, others do not. Some need to be taken every day, at the same time, some need to be taken every 3 months, or even on a 5 year basis. Since there are so many variables, it becomes complicated to create an overarching guide for all hormonal birth control.

Many women are put on birth control at a very young age to help maintain and regulate heavy periods or side effects from those periods. For many women, birth control is extremely successful for alleviating the stress and side effects of a heavy menstrual cycle. Hormonal birth control is also generally more effective at preventing pregnancy than non-hormonal birth control methods like condoms. Overall, hormonal birth control is a net positive to society.

This all sounds pretty great so far, right? Honestly, it is pretty great, but like almost all medication, there are always going to be side effects. As emphasized by this pandemic, every single body is created differently. Each of us has a different response to viruses, diseases, medications and hormones. With this said, the hormonal birth control that your friend loves, may not work as well for you. Side effects depend on the type of birth control. Some short term side effects include, but are not limited to headaches, nausea, sore breasts, changes in period, weight gains, mood swings, depression, blood clots and many others.

Based on all of this information, it is incredibly important to talk to your doctor about your worries, prior health concerns and daily routines before starting birth control. It is also especially important to monitor your body for the first few months you are on birth control. Take note of the side effects, your mental state, and general habits while on the birth control. Check in with your doctor to see if you should continue on that birth control, or if switching to a different one is better. Some women prefer a more hands off method like an IUD or a shot that takes away from the error rate that comes with taking the pill every day at the same time. It can sometimes take a long time to figure out a birth control that works for you. You may even realize that all birth control doesn’t work for you. It is a true process of trial and error.

So far, I have mostly discussed the short term side effects of hormonal birth control. Many women stay on the same type of birth control for 10+ years. Generally speaking, hormonal birth control has been shown to not change fertility. However, it is incredibly important to talk to your doctor about family medical history in case one of the types of birth control does have a long term side effect that could worsen a long term health condition.

Studies have shown that there are no real severe long term side effects of hormonal birth control. However, if one day you decide to go off of birth control, some women notice that they go back to having the same side effects/symptoms they did before going on birth control. This could mean heavier periods or headaches if those are things you experienced before taking birth control. Some women also say that going off of hormonal birth control made them feel like themselves again, lifting the brain fog and fatigue that came with their birth control. As you can see, there are a wide variety of different long term effects.

The rest of the thoughts in this article are my opinions. Like I’ve stated a dozen times before, I think hormonal birth control is a really incredible and wonderful thing. I also think it needs to be coupled with education and body awareness while on the medication. Women in the United States are being prescribed birth control at very young ages with little to no awareness on how the hormones work or their side effects. Many women are prescribed birth control to manage their heavy periods without being given other non-hormonal alternatives. No matter the type of hormonal birth control you are on, you are ingesting levels of a hormone that your body does not naturally produce. It is important to sit with that thought and educate yourself.

From a young age, women are taught to hate their bodies, especially their periods. Yes, periods suck. If it were up to me I would choose not to bleed for 5 days straight every month for 20–30 years of my life. However, this is something that my body is literally built to do. It is a painful but beautiful gift. I understand that for many women, a menstrual cycle can be so painful that they simply cannot do anything for those 5 days. For those women, birth control is crucial. We need to have more options for women and the ability to take time off (with pay!) for times when we have women’s health problems. The societies we live in are designed for straight white men, and hormonal birth control is yet another example of that!

It is also important to note that the topic of hormonal contraception and fertility are still widely controversial topics. You will probably find articles and books that are written to promote a certain religious belief or “holistic-natural” fertility methods. Some of these books contain good information about contraception, but it is important to fact check and as always, TALK TO YOUR DOCTOR. Also, if you can, talk to your mom or any other women in your family. Sometimes, their challenges can be helpful in understanding your own body.

Lastly, I want to inspire you to always advocate for your own health. Come to doctors appointments prepared with questions, and speak up about any side effects. To all the men out there reading this, you need to take a genuine interest in women’s health. You may never have to take hormonal birth control, but it is an incredibly challenging space, and if it wasn’t for your sperm, most women wouldn’t take birth control at all! Anyways, if there’s anything I missed or any wrong information in this article, please call me out. If you have additional resources, comment them down below!

Books That I’ve Been Recommended

This is Your Brain on Birth Control — Sarah E. Hill (haven’t read this one)

In the Flo — Alissa Vitti (I’ve read this one and think the first few chapters are really interesting, the rest of the book is her promoting her holistic methodologies).

Taking Charge of Your Fertility — Toni Weschler (haven’t read this one)

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