The Problem With Birth Control Pills + IUDs for Endometriosis

When it comes to “treating” endometriosis, the traditional medical system generally uses one of two avenues to “correct” the hormone imbalances present in endo in hopes of reducing pain and other symptoms.

The first is hormonal birth control, in the form of the pill, the patch, the shot or an IUD. The second is surgery, usually a laparoscopy or in more severe cases, a hysterectomy.

In this article I’m going to shed some light on why the various forms of hormonal birth control like the Pill and IUDs can be problematic for Endometriosis, despite what doctors may say.

I hope that this information is useful and helps you to come to a confident decision as to whether these medications are right for you or not.

Increases Inflammation

If you’ve read my post on why endo is so painful then you know that Endometriosis is in large part a condition of inflammation, and resulting immune dysfunction and pain.

So, it makes sense that when we want to naturally reduce endo pain and symptoms, decreasing inflammation is an important step, and one I heavily work on with my private clients.

When using birth control, inflammation rises. In one study, researchers looked at women using the Pill and their levels of the well-known inflammation marker, c-reactive protein. In this study, oral contraceptive use was the strongest predictor of low-grade inflammation in the body, and was quite prevalent compared to women not using birth control, and also compared with men.

More inflammation potentially means more symptoms in the case of endometriosis.

Gut Problems

Use of birth control has been linked to changes in our microbiome, or the environment in our gut. We need a delicate balance of “good” bacteria, or probiotics, to “bad” bacteria, like pathogenic viruses, yeasts, etc. When there’s too much bad, two things happen (well more than two, but two very relevant elements to endo).

First, imbalances in our gut microbiome impairs estrogen metabolism. Women with endometriosis are often estrogen dominant (too much estrogen in relation to progesterone), and this increased estrogen can develop into more endo tissue.

Second, gut bug imbalance (aka dysbiosis) leaves your body a breeding ground for inflammation- which we already know is a big no-no for endometriosis.

Bonus: The pill has also been linked to causing depression, due to nutrient depletion and dysbiosis, among other things.

Hormonal Imbalance

Using hormonal birth control like the pill or an IUD creates hormonal imbalance. True, doctors will often give it for this very purpose- to keep estrogen from going crazy and to stop periods altogether.

However, this is counterproductive.

When using hormonal birth control, you do not ovulate. Therefore, any bleeding you have between pill packs is known as “breakthrough bleeding”. This is because in order to have a true period, you must ovulate. No ovulation = no period.

When you purposely prevent your body from ovulating, your body will not have the normal ups and downs of estrogen and progesterone through the cycle.

Other Side Effects

There are so many other side effects of using these “treatments”, such as:

Spotting
Nausea
Breast tenderness
Blood clots
Female cancers (such as breast cancer)
Weight gain
Mood changes
Missed periods (see section above)
Decreased libido
Vaginal discharge
Headaches and migraines
High blood pressure
Heart attack and stroke
Gallbladder and liver problems, including benign tumors
Nutrient deficiencies
Candida (yeast) overgrowth

Delayed Periods: What’s Up With That?

How long has it been since you had a period? Three months? Six months? A year or more? I bet you’re super fucking DONE with not knowing when (or if!) it’s going to come and dealing with the PMS mood swings and weight gain that just don’t go away.

I hear you, I’ve been there. As you may be aware, I have Polycystic Ovarian Syndrome. Part of that issue means that my cycles were extremely irregular. When I first came off the birth control pill after seven years on the damn thing I didn’t get my first period for four months!!

I was extremely anxious, depressed, my weight shot up and my skin was breaking out like I was a thirteen year old girl again. Bonus: I was in nutrition school at the time. Not feeling ‘healthy’ enough to be there really sucked too.

After this, my periods came between every 45-65 days. The ‘PMS’ that many women experience maybe a week before their period was never ending in me. I bet it’s you too. There are many different reasons that your period may be delayed, and I’m outlining the top 7 of them below.

As always, get some tests done and check with your doc and your natural healthcare practitioner before beginning a protocol to deal with any of the following.

Polycystic Ovarian Syndrome {PCOS}

PCOS is a condition that is diagnosed on the following three criteria (at the time of writing):

Oligomenorrhea or anovulation
Clinical and/or biochemical signs of hyperandrogenism like cystic acne, hair loss (androgenic alopecia) and excessive body hair growth (hirsutism)
Cysts on the ovaries

All you need is two out of three! For me, it was the first two- my cycles were extremely irregular and I had many of the signs of hyperandrogenism like acne, facial/body hair and head hair loss.

The connection here to delayed periods lies in the first diagnostic criteria: oligomenorrhea or anovulatory cycles. If you cycles are longer than 35 days, it could be considered oligomenorrhea. The reason that cycles become so long is the lack of ovulation. Ovulation occurs (in a healthy cycle) fourteen days before the expected period. The means in a 28 day cycle, ovulation should occur on Day 14.

In women with PCOS, the constantly high levels of luteinizing hormone (LH), as well as high insulin and testosterone prevent the surge of LH which normally causes ovulation because levels of LH are consistently high all the time. No ovulation = no period. Some women may notice they get some spotting during their cycle, but this is not a true period. Rather it is known as breakthrough bleeding.

Balancing PCOS with natural methods is possible and I am living proof! If you have been diagnosed with PCOS, check with your doctor and a natural healthcare practitioner to make sure you get the best treatment for your needs.

Pregnancy

This is probably the most obvious reason for a delayed period. Sometimes accidents (or planned miracles!) happen. If you think you might be pregnant, take a pregnancy test!

Stress

The interesting thing about our stress and sex hormones is that they are made from the same starting molecule: cholesterol. Yes, that’s right! Cholesterol has gotten a seriously bad rap, because without it, you can’t make steroid hormones! Your body uses cholesterol to make a precursor to your sex and stress hormones first, known as pregnenolone. Then, depending on need, the pregnenolone will be used to make either stress hormones (cortisol, DHEA) or sex hormones (estrogen, progesterone, testosterone).

If you are someone who is chronically stressed, maybe you feel like you can’t even take another person cutting you off in traffic or another dirty dish in the sink, this section might be for you! When you are stressed out for a long period of time, cortisol will reign. Your body will be using most of the pregnenolone to make cortisol and other stress hormones, and saying a big “up yours” to sex hormones. Without the proper amounts of sex hormones like estrogen and progesterone at the right times, your period will be delayed.

My PCOS is mainly rooted in an adrenal androgen hormone known as DHEA. What this means for me is that if I want to balance myself and keep my cycles regular, I must manage my stress to the best of my ability. When I shifted my focus almost entirely to stress management rather than ‘PCOS management’, my cycles regulated. How about that!

Thyroid

The thyroid gland is intimately connected to both your state of stress (+ stress hormones) and your reproductive (sex hormone) virility. Generally it is an underactive thyroid gland (either from hypothyroidism or Hashimoto’s Thyroiditis) that reduces the frequency of menstruation rather than an overactive thyroid. If you are also experiencing dry skin, dry hair, extreme fatigue (like wanting to sleep 12-14 hours a day), hair and eyebrow thinning and unexplained weight gain, investigating your thyroid as the root cause could be worth your time!

Hormonal Birth Control

This includes the Pill, a hormonal IUD, the patch, the shot and anything else they come up with to stick synthetic hormones in our bodies! These medications put your body into a state of pseudo-pregnancy, essentially tricking it so you won’t become pregnant. This also means that you are not ovulating. No ovulation = no period. And as a loving FYI, the bleeding that you do experience on hormonal birth control isn’t a real period at all. It’s simply breakthrough bleeding. Many women do not experience bleeding at all while using these prescriptions as well.

If you have recently come off of hormonal birth control, it can take time for your body to balance itself out, potentially causing delayed periods. Depending on your individual body systems and the length of time you were on the drug will determine how long and the severity of your withdrawal.

Perimenopause

Are you over 40? Finding that you need a glass (or 5) of wine at night to unwind and have a good night’s sleep? Perhaps your flow has become heavier or lighter, or your cycles are longer? It could be perimenopause. What this means simply is that your body is getting ready for the final flow of your life. Menopause has officially happened when you haven’t had a period in over 12 months, and are of the right age.

Sometimes while your body is figuring all this out, cycles become delayed. There could be many reasons for this, including stress and low estrogen preventing ovulation.

Excessive Exercise or Weight Loss

This one is for the marathon runners and bootcamp addicts. If you are exercising very frequently (6-7 days per week) for long durations and at a high intensity, it can cause your body to delay or stop menstruation. This is because that type of exercise actually raises cortisol, and we’ve already talked about how stress can interfere with periods. Also, if your body fat percentage becomes radically low (from excessive exercise or dramatic weight loss), your body won’t have the necessary components (cholesterol, and others) to create the hormones in the first place.

As you can see, there are numerous reasons your period might be delayed. The big takeaway here is to relax. Destress yourself as much as possible, get the help and support you need, and I bet you’ll notice a difference in your cycles!

Let’s talk! How long are your cycles? Have you gotten to the bottom of the cause? Please share in the comments!

Exciting Natural Alternatives to Hormonal Birth Control

Guest Post with Amy Sedgwick.

Robyn: Welcome Amy! As you are already aware, I’ve been a big fan and supporter of Red Tent Sisters for a long time now and couldn’t be more excited to share you with my tribe! What led you to becoming a top expert in the holistic fertility and contraception field?

Amy: Like so many other people in the holistic health field, my work was born out of a personal experience (several in fact!) that led me to natural birth control and healing of my decade-long menstrual problems. In 2005 I experienced side effects from hormonal contraception that caused me to produce an excess amount of breastmilk. My daughter was only a few months old at the time and the milk was coming out so quickly that she was choking every time she tried to nurse. So for the first time in my adult life I was forced to explore non-hormonal forms of contraception. I discovered the Justisse Method of Fertility Management, and not only did it provide me with effective, natural contraception but I also began healing menstrual pain and irregularities that I had been suffering with since my early teens. I was so astounded at the ways my physical, mental and emotional health were changing that I decided I wanted to share this gift with others. I enrolled in a training program to become a Fertility Awareness Educator when my daughter was just ten months old. Since then I have been teaching, lecturing and advocating about the benefits of Fertility Awareness Education for both contraception and conception.

Robyn: You talk a lot about problems hormonal birth control. What’s the big deal with taking these pills, patches, shots and IUDs?

Amy: As I see it there are four main problems with hormonal contraception. The first is that they put a very heavy hormonal load on the body which causes a number of problems – including increased risk for breast cancer, nutrient depletions, higher rates of Crohn’s Disease and various other health problems. The second is that it masks many pre-existing hormonal conditions, which means that important endocrine imbalances go untreated for years and sometimes decades. For example, the pill is regularly prescribed for women with PCOS, heavy periods, absent periods, and painful periods. These are all signs of underlying hormonal disturbances and sometimes inflammation and autoimmune conditions as well. Without regular periods as a “barometer” of our well-being, it can be easy to overlook serious health problems that require attention. Thirdly, hormonal contraception gets excreted by our bodies into the water systems. Research is showing a feminizing effect on our aquatic ecosystems as a result of hormonal contraception in the water. Lastly, I believe hormonal contraception disconnects us from the profound energy and wisdom of our wombs. This is a big topic, but suffice it to say that many women feel disconnected from their bodies, their sexuality and their partners as a result of having artificial cycles.

Robyn: For women who don’t want to get pregnant, and are scared to stop the medical contraception, what should she do first?

Amy: Contraception is a very personal choice – there is no “perfect” option. Every method has pros and cons so it’s about finding the method that fits a woman’s particular needs, values, and lifestyle. That said, I think a lot of women rule out FAM because they worry it will be too complicated or they don’t trust that it will work. So my suggestion is that women start learning to chart while using another form of contraception. She won’t see the same signs of fertility (women who are on hormonal contraception don’t actually ovulate), but it can help demystify the process to make it less daunting. Furthermore, getting into the habit of charting will make it easier if she does decide to use FAM for contraception in the future.

Robyn: What exactly is the Justisse Method of Fertility Awareness?

Amy: The Justisse Method of Fertility Awareness is an approach to teaching FAM (Fertility Awareness Methods). FAM is a set of skills that usually includes a combination of mucus checking (as this indicates a fertile vaginal environment for sperm survival), morning temperature taking (referred to as BBT) and cervical checks. The Justisse Method is a particular approach to teaching those skills. It is secular (unlike some of the large organizations that teach FAM from a Catholic perspective) as well as pro-choice and pro-woman. We support women in their reproductive freedoms and encourage them to make the best choices for them around their sexual and reproductive health. Justisse is the only secular organization worldwide that has its own system of charting, and also trains Holistic Reproductive Health Practitioners and Educators.

Robyn: It sounds a lot like the rhythm method. How effective is FAM compared with this outdated method?

Amy: Being confused with the rhythm method is FAM’s greatest challenge. The rhythm method is what we call in the field “a retrospective method” meaning it takes past cycles and tries to use it to predict future cycles. A lot of apps on the market do something similar. FAM is different in that there is no prediction at all. We make daily decisions about our contraception based on empirical markers of our fertility. These markers are grounded in research on human physiology. Research consistently shows that when taught and applied correctly, FAM is 99.4% effective in preventing pregnancy.

Robyn: What other insights (besides contraception or fertility signs) may a woman discover when she uses FAM?

Amy: There are so many it is hard to know where to begin! In the first few months of charting a woman may discover things about her digestion. Certain types of mucus tend to indicate inflammation which can occur when we have a sensitivity or an allergy to a particular food or something in our environment. My clients and I have also discovered thyroid problems, nutrient deficiencies, and adrenal fatigue through charting. On the emotional side women typically discover there is a cyclicity to their energy, libido, mood and sense of introversion or extroversion. I think through charting we all become more aware of the things that affect us and how to recognize what we truly need in any given moment.

Robyn: Any final advice for women looking to change to natural birth control?

Amy: Trust your intuition. And don’t be afraid to challenge authority. Most physicians don’t understand what FAM is or how it works, so you will likely have to advocate for yourself if you want to make the switch. Don’t let your inner authority be overrun by the voice of “experts” who claim to know better. You are your own best expert on your body.

Kim and Amy are the real sisters behind Red Tent Sisters. Amy is passionate about teaching women how to manage their fertility naturally, and Kim loves to help women feel sexually empowered. They offerclasses, private coaching, a blog, and a YouTube channel. They also have an online, eco-friendly shop called ecosex.ca. They’ve been featured in every major Canadian news outlet, including The Globe & Mail, The Toronto Star and Maclean’s. For more on their philosophy and offerings check out their About Us video.

[Book Review] Sweetening the Pill by Holly Grigg-Spall

Ever since I first heard about this book coming out from the Red Tent Sisters, I knew I HAD to read it. As you may know, coming off the birth control pill is what led me to discover my PCOS and into the land of natural contraception. I received this book as a gift this past Christmas, and I have to say- it both delighted and angered me.

Now don’t walk away– I’m going to explain the reasoning behind this.

Sweetening the Pill is a book for every woman. Whether you have been, currently are or are considering taking a form of hormonal birth control like the pill or patch, this is a must read. There are countless side effects of hormonal birth control that many women don’t realize are caused by the medication. Things like insane mood swings, weight gain, depression + thoughts of suicide and much more.

Reading this book will empower you to make the right choice in your life for contraception. I love that Grigg-Spall also talks about men. Our cycles affect our partners whether we mean for it or not, so getting them involved in your choice of contraception is key. When I switched over to the Justisse Method of contraception, I talked with my man about it and the implications for our relationship.

Now on to the angry part. . .

“The pill is no longer about birth control; it is about being a better, improved woman.” – Sweetening the Pill, pg. 109

The pharmaceutical industry along with the government and medical industry have pulled the wool over our eyes. The birth control pill is no longer just a means of stopping pregnancy, it’s now a “cure-all” drug that prescribed for heavy and irregular periods, mood issues, acne, weight gain, among many others. Don’t be fooled! Hormonal contraception simply masks these symptoms while feeding us a huge dose of synthetic hormones our bodies aren’t meant to deal with.

Women no longer own their cycles, as Grigg-Spall explains, but rather if we are to be “liberated” we must be sexually and intellectually available 24-7. So what’s wrong with this picture?

We have natural ebbs and flows to our cycle- some weeks we feel energetic + sexy, where other times we may feel calm + introspective or just like a raving lunatic. But that is the BEAUTY of being a woman. If we are expected to be “ON” all the time, we will burn out!

Being on hormonal birth control takes away our choice- to be in tune with our bodies, to manage our life’s activities according to our cycles and much more. We are not actually more liberated by using these prescription drugs, but rather become more docile and easy to “manage”. Yuck, yuck, yuck!

I don’t know about you, but I want to feel my body in its ebbs and flows. I want to take advantage of my different perspectives throughout the month. Simply take responsibility for your body back from your doctor and the pharmaceutical industry. And be persistent! You WILL get your choice and it will be worth it in the end.

“The choice to come off the pill and be well rather than sick does not have to be a political action. To politicize this suggests that achieving personal wellness is not a good enough end in itself.” – Sweetening the Pill, pg. 191

BUY THE BOOK! You won’t regret it.