Why the pill may not be your first choice in the management of your hormonal imbalance

You may have recently received a prescription for hormonal birth control pills, which may have not been prescribed, in your case, for contraception. For many conditions, such as irregularity in periods, PCOS, and even if you are facing fertility struggles, frequently the first line of treatment is a few cycles of hormonal birth control pills.

While clinically proven effective, it may not always be the right choice for you. Knowing what the pill is, and its long-term effects, can help you make a more informed decision for your health.

Birth control pills contain a variant of natural estrogen and progesterone. Some pills only contain progesterone.

They are taken daily (with a week’s gap every month) to suppress natural ovulation and prevent pregnancy. When used as per their instructions, birth control pills have only a 4% to 7% failure rate, or chance of pregnancy.

However, because of its composition of hormones, similar composition to our menstrual cycle hormones, birth control pills are often prescribed for other hormonal-related conditions. These include irregular periods, painful periods, fibroids, and endometriosis. Oral contraceptive pills are also sometimes prescribed to manage physical and mental health symptoms of PMS.

While there might be immediate benefits in short-term use of the pill in these cases, based on its adverse effect profile, does it warrant use at all without treatment of underlying medical conditions?

Community take:

I had never been to a gynecologist before. I am 23 and didn’t know whom to have the contraception discussion with, for fear of being judged as sexually active without being married. I found a doctor in my locality and went in for a prescription. I wasn’t asked many questions and recommended oral contraceptive pills to be taken for 28 days with a week’s break every month. Seemed easy enough. A few months in I noticed I had been frequently getting severe headaches. I didn’t initially link it to the pill. As soon as I stopped using them the headaches vanished too.

Hormonal birth control pills, while beneficial for many, are not without their side effects.

The pill has both long and short-term effects. To understand these, it is important to talk about your predisposing factors with your healthcare provider before you start yourself on the pill. Sometimes doctors neglect to have these conversations, but you shouldn’t.

There are some absolute contraindications to the birth control pills (and other hormonal contraception), which include:

• If you have a history of blood clots or are predisposed to them
• Have hypertension
• Are a heavy smoker
• Have a history of migraines
• Have breast or endometrial cancer

In all these cases, taking oral contraceptives can worsen disease, and increase risk of fatality. While the range of contraindications falls between 6 - 42%, many continue to take the pill because of over-prescription without a detailed health evaluation.

Additionally, even if you do not have any of these risk factors, birth control pills can result in other adverse effects. Short-term effects include:

• Nausea or rarely vomiting
• Breast tenderness
• Changes to your period flow
• Headaches
• Pain in your limbs
• Spotting in between periods

Long-term use of birth control pills increases your baseline risk for cardiovascular disease and breast cancer. Another systematic review shows an increased risk of cervical cancer.

Conversely, birth control pills lower the risk of ovarian and endometrial cancers.

It is crucial to understand that birth control pills only increase risk, not determining whether you will have the disease in the future or not. This risk subsides once you stop taking the pill.

Most imbalance is when our hormones lose their natural ability to sync to our bodies' requirements. Often this results from our daily stressors.

The first would be improving your daily nutrition for better health. Add more protein, lower sugar intake, add probiotics, and consume healthy fats. Next, a healthy weight, regular exercise managing stress and adequate sleep complete the list of lifestyle essentials for naturally balancing your hormones.

If you have already been prescribed the pill for an underlying health condition such as PCOS, consider talking to your healthcare provider about your alternatives. While PCOS benefits from lifestyle and nutrition changes, natural supplements such as inositol, a variant of vitamin B, are seen to lower testosterone levels and improve ovulation.

Similarly, a nutrition change such as a plant-based diet over a high-fat diet has been beneficial for patients with endometriosis, lowering estrogen activity and promoting anti-inflammatory effects.

Clinical studies have proven the pill safe for use. However, many women experience significant adverse effects after starting the pill. Continuous exposure to these external hormones increases your risk for cardiovascular disease, and breast and cervical cancer. For underlying imbalance, discuss alternative options to the pill to naturally improve hormonal irregularities.