The pill, oral contraception, OCP (oral conception pill), birth control pill – all names used to describe a form of hormonal contraception pill that you take daily to prevent an unwanted pregnancy. And yet, they are so often prescribed to ‘regulate’ your period.
What is a period?
A period is a bleed that happens after ovulation (release of an egg from the ovaries). It signifies that you aren’t pregnant and the next cycle has begun. Just because you have a bleed during your cycle doesn’t mean that you have ovulated, however. We won’t go into this too much in this blog, outside of explaining a pill bleed.
Do you get your period on the pill?
The short answer is no. Oral contraceptives stop you from ovulating, which means that you can’t have a period. However after taking the sugar pills enclosed in the box, a ‘pill-bleed’ occurs. This appears like a period, and is often referred to as a period, however as ovulation has not occurred it should always be referred to as a pill-bleed.
What happens to my hormones when I take the pill?
Our hormones naturally fluctuate throughout the month. Our body prepares for ovulation, releases the egg, prepares for pregnancy or for a period if implantation of the egg did not occur. Multiple hormones control this naturally occurring cycle. The most well known being oestrogen. Progesterone, Testosterone, Luteinising hormone (LH) & Follicle Stimulating Hormone (FSH) are also involved in this natural ebb and flow of the menstrual cycle.
Taking oral contraception suppresses the ovaries (where eggs are released from), meaning that you do not ovulate. Your sex hormones (mentioned above) stop being produced.
But wait – isn’t ovulation the main event of the menstrual cycle?!
It sure is.
But doesn’t the pill regulate hormones?
The terminology around oral contraceptives ‘regulating the cycle’ simply refers to the ‘regular’ nature of the pill bleed – ie. You can have a monthly bleed and not get pregnant. This terminology was introduced in the 1960s, as a way to allow women access to contraception. Without this terminology, it would not have been as easily accepted to give women access to something which allowed them control of their fertility in this time. The pill was an incredible leap in the women’s liberation movement.
The ‘hormones’ in the pill are not the same as the hormones that our bodies naturally produce. They are synthetic versions of these hormones. And because of this, the effects of these pill-hormones are different from our naturally occurring hormones. While you’re taking the pill you are receiving the same amount of each synthetic hormone daily – except when you take the sugar pill – again contributing to the idea of regularity within the cycle.
So why are people still taking the pill?
The pill can help to reduce symptoms of:
- Period pain (for some people)
- Heavy menstrual bleeding (for some people)
- PCOS – by giving a regular bleed.
And of course oral contraceptives are excellent at preventing pregnancy (but are by no means the only way to avoid pregnancy – see below). There is a time and place for oral contraceptives.
Does the pill really work at reducing these symptoms?
ACNE: The answer is it depends. While you’re taking it, there’s a good chance. I’ve seen clients whose acne improves while taking the pill. And others who haven’t noticed a difference. Some oral contraceptives can actually cause acne (but it depends on which one you’re given). Generally though once you stop taking the pill, your acne will come back. Sometimes even worse than it was before. I have heard of people who have said that their acne did not return – but I haven’t seen these people in clinic.
PERIOD PAIN: Again, it depends. For some people it can make a huge difference. Taking the pill may reduce symptoms of endometriosis for some people. As this is a chronic condition affecting quality of life, the person may choose that it’s worth it to take the pill. In saying that, I do know that not everyone’s cramps go away while taking the pill. Besides that – what is your body actually trying to tell you by giving you period cramps anyway? Having debilitating period cramps or cramps that make you feel like you need to take pain medication isn’t actually normal – although it definitely is common.
HEAVY PERIODS: Maybe. Are you seeing a trend here? It might work for some, but not for everyone. And once you stop the pill, your heavy periods will probably come back when your own hormones start kicking in again. But hang on a second – why are your periods heavy in the first place? It sounds like your body is trying to tell you something. Are you listening?
PCOS: So polycystic ovary syndrome is where regular ovulation isn’t occuring. Oral contraceptives? Prevent ovulation. Does it make sense to prescribe oral contraception to those with PCOS? I’ll let you have a think about that one. When I see clients with PCOS, I’m usually working to help support their ovulation, not to take it away completely. There are other medications that you can talk to your doctor about prescribing for PCOS other than oral contraceptives. I highly recommend bringing this up with your doctor if you’re going down this path.
But what’s the alternative?
In Naturopathy & Holistic Nutrition we look at:
- What’s going on with your menstrual cycle & period?
- What is your period trying to tell us?
- What is causing the symptoms that you’re noticing with your period?
This allows us to look at what’s happening in your whole body – is your digestive system, or your immune system affecting your periods? How about stress? Are your periods impacting your mood? Why is that happening?
Lara Briden talks about the period as ‘your monthly report card’ which I think is clever & appropriate terminology. By listening to what your monthly report card is telling you, and working to find what the underlying cause of menstrual dysfunction is, we can set ourselves up for a periods that we don’t dread, without the PMS, that have minimal pain and appropriate amounts of bleeding.
I’m really passionate about increasing education around periods and contraception – I remember being a child and thinking that going on the pill was really normal, something most people did, and how you prevented pregnancy. Close family members had told me to let them know when it was time for me to go on the pill when I was a bit older to prevent pregnancy. It never sat right for me! In my later teens I started to get awful period pain and was losing far too much blood – I narrowly avoided being put on the pill (due to having migraines, a contraindication for taking hormonal contraception) & instead found myself seeing a Naturopath. After making dietary changes and addressing the root cause of my menstrual dysfunction, I now have predominantly pain-free periods – and decided to follow in my Naturopath’s footsteps, to now help other women regulate their periods.
I’m absolutely not against the pill – however I am a big advocate for not using it as a first point of call for menstrual dysfunction. In really serious conditions like endometriosis I have seen certain oral contraceptives be effective at reducing severe pain. Sometimes this is an appropriate time to work with the client to help prepare their body for when it’s time to come off the contraception while giving them some symptomatic relief.
In history, access to hormonal contraception has been an absolute game-changer for women. But we aren’t in the 1960s anymore. It’s important to look at the whole story – making an informed decision as to whether or not this is right for you, and considering all other options. If you’re considering taking the pill, I encourage you to read the list of side effects possible for the particular pill that you’re considering, and do some further research into what your other options might be.
Further resources –
Here are two resources that I’ve found helpful:
- Period Repair Manual by Lara Briden
- Lara Briden also speaks about hormonal and non-hormonal birth control in her book. I highly recommend reading this section.
- The Business of Birth Control – You can also watch this on Gaia
Another resouce? Dani & I. We can both help you to get to the bottom of what’s going on for you. A free 15 minute discovery call may help you decide if we are the right fit for you.
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This blog does not provide individualised health advise. The information mentioned in this blog is educational in nature and is here to help you make informed decisions regarding your health. It is essential that you work with your primary healthcare practitioner to assess what healthcare and contraception is right for you.