SHORT AND LONG-TERM IMPACTS OF THE PILL
Risks Of The Birth Control Pill
The Naturopathic Perspective on Oral Hormonal Contraceptives for Women
Should You Take The Pill?
What are the risks of taking the birth control pill? Like with any intervention, there are risks and benefits associated with a woman of any age taking an oral contraceptive pill.
Often it is automatically assumed that the benefit of avoiding an unwanted pregnancy outweighs any short and long-term health outcomes that come along with this medication, and often this is the case. There is still, however, the need to have a thorough conversation of the risks and benefits in order to make a fully informed medical decision.
In our practice, we often see women starting on a hormonal birth control in their teenage years, and continuing on it until they are deciding to get pregnant, or until they reach menopause. The is a VERY long prescription length, and exposure to exogenous hormones for such a long period of time is not without risk.
Oral hormonal contraceptives offer significant benefits but also come with risks and side effects that need to be carefully considered. Here, we will explore both sides of the equation to provide a balanced view.
Benefits of Oral Hormonal Contraceptives
- Contraception: The primary benefit of birth control pills is reliable birth control, allowing women to plan and space their pregnancies.
- Regulation of Menstrual Cycles: Many women experience more regular, lighter, and less painful periods while on the pill.
- Acne Reduction: Hormonal contraceptives can help reduce acne, making them a popular choice for those with persistent skin issues.
- Suppression of Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) and endometriosis often see symptom improvement with oral contraceptive use.
Potential Side Effects
Despite these benefits, there are several side effects associated with oral contraceptives that must be considered:
- Nausea and Weight Gain: Some women experience nausea and weight gain, especially when starting the pill. Sometimes nausea can be reduced by taking your pill before bed.
- Mood Changes: Hormonal fluctuations can affect mood, sometimes leading to anxiety or depression. A significant percentage of women prescribed oral hormonal contraceptives are subsequently prescribed an antidepressant within the next year. The type of hormones in the medication matters, so selecting the right option is important if you have a history of depression.
- Breast Tenderness: Increased breast sensitivity is a common side effect.
- Headaches: Hormonal changes can trigger headaches or migraines in susceptible individuals.
- Spotting Between Periods: Breakthrough bleeding can occur, particularly during the initial months of use.
Long-term Health Risks
When considering long-term use, it’s crucial to weigh the potential health risks:
- Cardiovascular Issues: There is an increased risk of blood clots, stroke, and heart attack, particularly in women who smoke or have underlying health conditions. This is particularly true for oral estrogen use (whether that is for contraceptive purposes or menopausal hormone therapy).
- Breast Cancer: Some studies suggest a slight increase in the risk of breast cancer with prolonged oral contraceptive use.
- Bone Density: Unlike menopausal hormone replacement therapy (HRT), which can help maintain bone density, oral contraceptives do not offer this benefit and may even decrease bone density in some cases.
Comparison with Menopausal Hormone Replacement Therapy
Menopausal hormone replacement therapy is often used to alleviate menopausal symptoms and has its own set of risks and benefits:
- Bone Health: HRT can help prevent osteoporosis, a significant benefit not provided by oral contraceptives.
- Heart Health: The impact of HRT on heart health is complex, with timing and individual health history playing critical roles in determining risk. For most eligible women, menopausal hormone therapy does not increase cardiovascular risk if initiated within 10 years of their last period and if they are under the age of 60. In fact, it may improve cardiovascular outcomes.
- Breast Cancer Risks: Menopausal hormone therapy with topical estrogen alone does not increase the incidence of breast cancer, but progesterone and progestins may. It is important to reassess HRT after 5 years. However, combined oral contraceptives (estrogen and progestogens) increase the risk of breast cancer just as much. If the benefits still outweigh this risk, it is important to improve other modifiable breast cancer risk factors like obesity, alcohol intake, smoking, nutrition, etc.
Should You Take The Hormonal Birth Control Pill?
It depends. And the choice is exclusively yours. It is also not a forever decision. At some points in your life the birth control pill may be the very best option, at other times it may be a mistake. Reassessing your risk and benefits of any medication periodically is important and worthwhile.
Need help doing the math on the statistics of your health?
In naturopathic medicine, the goal is to support the body’s natural processes while minimizing harm. For some women, oral contraceptives offer invaluable benefits and necessary health management. However, it is essential to consider the potential side effects and long-term risks. Individual health profiles, lifestyle factors, and personal preferences must all be considered when deciding on the use of oral hormonal contraceptives. For those seeking a more natural approach, exploring alternatives like lifestyle modifications, dietary changes, and herbal supplements may provide the balance they are looking for.
Your Doctor: Meet Dr. Sarah
Dr. Sarah Goulding is a licensed naturopathic doctor in Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
