Hormonal contraceptives cause a slew of problems, but so does a pregnancy that you aren’t emotionally, physically or financially ready for. So, what’s a woman to do? In today’s post, I’ll be presenting two viable alternatives to hormonal birth control for preventing pregnancy. Then, at the end, we’ll cover what you need to know about fixing period problems without the pill.
What’s the problem with the pill?
On its own, using hormonal contraceptives (which categorically includes the pill, the patch, the shot, and hormonal IUDs) does a few things to the body that spell bad news. First, the way they function is by preventing your ovaries from making their own hormones. Here’s the real deal: we need both natural estrogen and natural progesterone in order to be well, along with the other hormones that our ovaries make in smaller doses, like testosterone and DHEA. With terms like “hormone balance” the idea is to make sure that the body is able to produce its own hormones at the appropriate levels and also detox them. Using hormonal contraceptives gets in the way of both of these things.
- The whole point of hormone-based contraceptives is to prevent ovulation. Fake progestins trick your brain into thinking that you’ve already ovulated, so you won’t produce the necessary hormone surge to trigger ovulation (via estrogen) or any of the lovely hormones that come after ovulation (progesterone and estradiol.) Hormonal contraceptives are named as such not because they replace your hormones but because they block them. [Read: the “progestins” in the pill are not real progesterone, and ethinyl estradiol is not the same thing as the estradiol your ovaries make.] IUDs specifically also have a secondary effect of thinning the uterine lining to prevent implantation of a fertilized egg. This might be important to you for ethical reasons, so take note.
- Your body detoxes the drugs in hormonal contraceptives through your liver’s detox pathways. But the huge overload of drugs that come from contraceptive devices backlogs the liver’s activity, leading to inflammation, changes in the gut microbiome (and subsequent gut health) and even feeds forward into imbalances in other hormonal systems, like your thyroid and adrenal health. Yikes!
But here are a few other important notes: hormonal contraceptives are contraindicated in women with migraines or who smoke, who are over 35 years old, who have family history of breast or ovarian cancer. They also increase risk of fatal blood clots, cardiovascular disease, acne, weight gain, depression, hair loss, insulin resistance, fertility problems and more.
Concerned you have a hormone imbalance but not sure how to find out? Download my FREE hormone guide to figure out your symptoms once and for all!
Pregnancy Prevention Without Pills
I generally don’t recommend using hormonal contraceptives for any reason in my practice. The side effects are reason enough, but also because better options really are available! Here are two:
- Tracking Basal Body Temperature
- Tracking Cervical Fluid (i.e. Creighton Model)
I’ve already written a whole post about the mechanism and benefits of tracing basal body temperature so I definitely encourage you to go back and read that post if you haven’t already.
Meanwhile, you can also track cervical fluid as a marker of fertility.
How Your Cycle Works
I come back to the above graphic again and again on my blog, for good reason. It explains the hormones throughout the menstrual cycle and those hormones are everything. In your cycle, ovulation is the main event, not the bleed. Everything in the first half of the cycle is about gearing up for ovulation and everything in the second half is about enjoying the effects of ovulation. (Meanwhile hormonal contraceptives are all about preventing ovulation!) In order to prevent pregnancy, you need to avoid having unprotected intercourse in the 5 days before ovulation, as well as on the day of or day after ovulation.
Let’s take a closer look at ovulation for a minute. Immediately before an egg is released, the brain “pulls the trigger” with a huge spike of a hormone called luteinizing hormone. This hormone tells the ovary that it’s time for the fully developed egg to be released into the fallopian tubes. But what tells the brain that it’s time for the LH surge? Cue: lovely estrogen.
As the ovarian follicle (egg) develops throughout the menstrual cycle (in the so-called follicular phase), it realeases increasing levels of estrogen. When the estrogen level reaches a certain height, it tells the brain that everyone is ready for the big ovulation event. However, this estrogen also brings about other important changes in the female body. For one, it changes the texture and quantity of cervical fluid. Also known as vaginal discharge, this substance becomes increasingly watery as ovulation approaches. Immediately after ovulation, once progesterone takes the stage, cervical fluid quickly transitions to a thick, glue-like, white texture.
This transition from watery, to gel-like (so-called “egg white” cervical mucus or ‘ewcm’ if you’ve seen it on fertility boards) marks the transition from a fertile time in the cycle to a time when unprotected sex will have no subsequent influence on pregnancy, at least until the next cycle rolls around. If you track the texture and quality of your cervical fluid daily throughout the month, you’ll notice some important patterns: namely, when in your cycle you see the transition from water-rich, fertile mucus or thick, dry discharge. Sperm can’t swim through this latter type of mucus and even if they could, there would be not available egg around because the egg only lasts about 24 hours. That being said, if you were trying to conceive, tracking cervical fluid (and BBT) serve as a valuable tool for timing things correctly so you don’t need to wonder if you even have a chance that month.
The Catholic Church endorses this conservative method of contraception (often marketed as The Creighton Model) because it doesn’t carry the abortifacent risks that hormonal contraceptives do. That being said, you don’t need to be Catholic to use it. You also don’t need to be TTC, avoiding pregnancy, or even sexually active to benefit from the information it gives. One of my favorite things about both BBT and tracking cervical fluid is that they provide easy, at-home means for learning about your own body.
But what about the pill for period problems?
And that, friends, is a whole can of worms that I’m totally prepared to open! The pill does not “fix” period problems, or anything for that matter. Period problems are the menstrual manifestation of hormone imbalances, and taking the pill or using any other form of hormonal contraceptive not only doesn’t solve any problems, it actually creates new ones in its own right. Hormonal contraceptives shut the body down, interrupting the vital communication between the brain and ovaries, preventing hormone production, and overriding biology.
If you are dealing with menstrual problems like pain, PMS, mood changes, breast tenderness, irregular bleeding, acne, or anything else, I promise you that shutting down your hormones with the pill is not going to help. Here’s what to do instead:
- Start tracking your cycle! Get information about your hormones through BBT and tracking cervical fluid. Find out if and when you’re ovulating.
- Get some hormone labs run! If you need help knowing which ones to ask your doctor for, sign up here and I’ll send you my free hormone testing cheat sheet.
- Once your lab results come back, read them through a functional medicine lens! Getting an accurate diagnosis makes all the difference. You won’t know how to treat it if you don’t know what you’re dealing with. If you need help interpreting your labs, I have a lab guide available in both pdf and print that can help you: The Hormone Hacker
- In the coming months, I’ll be sharing more about what can be done about various hormonal imbalances and the implications they have for periods, health, and quality of life. Then, next summer, I’ll be releasing my next book which is all about treatment for these very conditions. It’s designed to be the only book you’ll ever need for understanding your hormones and your body. I can’t wait for it to help you, too. Stay tuned!
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I’m Dr. Alexandra MacKillop, a functional medicine physician, food scientist and nutrition expert.
I specialize in women’s health & hormones, addressing concerns like fertility, PCOS, endometriosis, dysmenorrhea (painful periods), PMS symptoms like bloating and mood changes and more.
If you’re looking for a new way to approach your health, I’m here to help you through it. Click to learn more.