At some point in her adult life, birth control often becomes part of a woman's life. This woman might look to the pill as a pregnancy prevention method, not yet ready to start a family or knowing she doesn't want to become a mother. She might also consider the pill for a number of non-contraceptive purposes, as OBGYN Dr. Kyrin Dunston says in an interview with Bustle, nearly half of women taking the pill use it for poly cystic ovarian syndrome, migraine headaches, painful periods, and more.
Dr. Dunston, a board certified OBGYN with over 20 years of experience, counsels women on the pros and cons of birth control daily, and is well aware of the side effects that are often dismissed or ignored. "Most women are not aware of the subtle risks associated with taking the birth control pill, including low thyroid function, fatigue, hair loss, low sex drive, weight gain, and increased risk for breast cancer among other things," Dr. Dunston says.
Though the potential risks are "subtle," as Dr. Dunston declares, it's essential for a woman to be educated on the ways the birth control pill is working in her body and how its contents could alter everything from her skin, to her weight, to her health. Here are 11 facts you should know about taking the pill.
1. There Are Three Varieties Of Birth Control Pill
"In regards to birth control pills, there are the regular, low dose, ultra low dose, and progestin-only varieties. Some of the older, regular dose pills have 50 micrograms of estrogen; while low dose pills have 35 micrograms, and ultra-low dose only 20 micrograms of estrogen. Progestin-only pills have no estrogen," Dr. Dunston says. "All birth control pills prevent pregnancy by the same mechanism: It is the progestin that prevents pregnancy. The estrogen component of the pill is typically what regulates blood flow and not contraceptive efficacy."
Still don't quite understand how progestin and estrogen work together in your body? Dr. Dunston lays it out like this, "I like to think of the progestin as the cake and the estrogen as the icing on the cake. That is why progestin-only pills are just as effective as combination pills."
If you opt for a low-estrogen-dose pill, "The drawback to the lower estrogen or no estrogen pills is typically abnormal bleeding patterns. The benefits include fewer side effects such as weight gain, bloating, headaches, and others," Dr. Dunston tells Bustle via email.
2. Birth Control Pills Replace Naturally-Occurring Sex Hormones With Chemically-Altered Sex Hormones
"Birth control pills prevent pregnancy by stopping ovulation. This is accomplished by the progestin component of the pill. Stopping ovulation prevents a women from maturing an egg each month that could be fertilized and cause pregnancy," Dr. Dunston says. "It also stops a women from producing her own sex hormones: estrogen, progesterone, and testosterone. It is common to see women on the pill have the same low sex hormone levels as a women in menopause because of this suppression."
In place of naturally-occurring hormones, the pill feeds the body artificial, chemically-altered sex hormones. According to Dr. Dunston, "[These artificial hormones] are similar enough to trick the body into thinking it doesn’t need to produce its own but different enough to not successfully replace what a woman stops producing. Hence, this is partly the cause of the common side effects of low sex drive, fatigue, hair loss, headaches, and others."
3. Missing A Day Of Birth Control Opens A Window For Pregnancy
"If the pills is taken at different times of the day, particularly the lower dose pills, irregular bleeding can result. This is not a sign of lack of efficacy but can be troublesome," Dr. Dunston explains why some women experience spotting throughout the month.
Though spotting is less of a worry than it is a burden, forgetting to take your birth control pills for a day or more can have more serious side effects.
"Missing even a day and certainly missing two days in a row can stop ovulation suppression and allow pregnancy to occur. It also wrecks havoc on a women’s sex hormone balance and can cause exacerbation of symptoms such as fatigue, irritability, weight gain, and others," Dr. Dunston says.
4. Plan B Prevents Pregnancy In Three Ways
An emergency contraceptive is another form of birth control that has become increasingly common, albeit proper education about pills like Plan B One-Step is considerably lacking.
"Plan B floods the body with high doses of estrogen and progestins that can prevent pregnancy in three ways. First, it can prevent ovulation. Second, it can prevent fertilization of an already-released egg. Last, it can cause an already-fertilized egg from adhering to the uterine wall and creating a pregnancy," according to Dr. Dunston.
5. You Can Safely Skip Sugar Pills Every Month
"Up to 15 percent of women on the birth control pill will stop having periods after being on them for a prolonged period of time. ... There is usually panic when this occurs because menstruation is the outward sign that no pregnancy has occurred in a woman not on the pill," Dr. Dunston explains.
Though the absence of menstruation might incite a tiny anxiety attack at the possibility of pregnancy, it's common for women on the pill to stop having periods altogether. In fact, it's fair to assume a woman can enjoy the lack of bleeding every month with peace of mind, as Dr. Dunston clarifies, "If she is on the pill, lack of menses usually does not mean pregnancy has occurred, but most women like to see a period each month, as it is a source of comfort to them."
If you're not part of the 15 percent of women who have stopped having their periods on the pill, you're likely included in the majority who have skipped those monthly placebo pills in favor of convenience and timing. And according to Dr. Dunston, it's completely safe to do so.
"The sugar pills are really just place-holders and can be skipped altogether. These sugar pills have nothing to do with the efficacy of the pill. They can be discarded, and those days that would have a sugar pill, no pill can be taken, or they can be discarded and the active pills be started right away so there is no break in taking active pills.
"This can be done for one month, several months or all the time. It does not affect efficacy in pregnancy prevention. The biggest side effect is irregular bleeding. There is no harm in doing this," Dr. Dunston tells me via email.
6. The Pill Does Not Affect Pregnancy In The Long-Term
Women on the birth control pill are not in danger of infertility, as Dr. Dunston says, "It is a myth that the pill causes infertility. The reason this myth exists is that while a woman is on the pill, her body is still aging and life is having its effects on her body. Many of these effects can prevent pregnancy, including developing female health issues like endometriosis, fibroids, contracting STDs; or global health issues like low thyroid function, one of the most common causes of infertility."
"Taking the pill just prevents a woman from knowing she is developing infertility because the system is not being tested. When she gets off the pill, she is older, her eggs are older, and a condition may have developed that can prevent pregnancy. If she can’t get pregnant, the most obvious change, being on the pill and getting off of it, is often blamed. But it is never the issue. The true issue was just masked," Dr. Dunston assures.
7. The Risk Of Blood Clotting Is Roughly .001 Percent
Though blood clots are among the biggest concerns when it comes to side effects of taking the birth control pill, Dr. Dunston assures, "The risk of getting a blood clot while on the birth control pill is about 1 in 1,000. If a woman has a family history of clots, she should be checked for a clotting disorder that could be exacerbated by the pill prior to being started on the pill, as her risk will be exponentially higher."
8. The Pill Decreases A Woman's Risk Of Developing Ovarian Cysts
For women prone to ovarian cysts, the pill is actually a proven standard for treating the issue, according to Dr. Dunston.
"It’s not necessarily that the pill causes cysts to shrink or resolve, but in a woman with one cyst, her risk of getting others is increased. The pill prevents subsequent cysts from developing and already present cysts from getting larger," says Dr. Dunston.
9. The Pill Helps To Alleviate Period Symptoms By Balancing Sex Hormones
When first opting to go on the pill, many women are looking forward to lessening the burden of painful periods every month, marked by debilitating cramps, migraines, and more.
Dr. Dunston explains how the pill works to alleviate these symptoms, saying, "Heavy, painful periods are generally caused by an excess of estrogen and a lack of progesterone in the body. Estrogen is the heavy, painful period, fibroid, endometriosis, and ovarian cyst hormone. Progesterone is the antidote to all of this. It causes regular, normal-flow, pain-free periods and helps to alleviate symptoms from fibroids, endometriosis, and ovarian cysts."
"Despite the fact that the pill is not the same as a woman’s naturally-occurring sex hormones, it packs enough of a hormone punch to decrease this estrogen-progesterone discrepancy and stop the troublesome symptoms," Dr. Dunston says.
10. Long-Term Use Of The Pill Can Have Serious, Undiscussed Risks
As previously mentioned, blood clots are the main concern for women taking the pill; however, there are a number of undiscussed risks many women are unaware of.
According to Dr. Dunston, "These [risks] include an increased risk of breast cancer if a woman starts the pill at a young age and takes them for longer than 10 years, low thyroid function resulting in weight gain, fatigue and hair loss, decreased sex drive and the toxicity of taking a chemical that has to be eliminated by the body, bone loss, increased risk for heart attack and stroke, migraine headaches, gall bladder disease, increased blood pressure and mood changes."
"The pill fosters yeast overgrowth in the body which is a source of inflammation contributing to fibromyalgia, PMS, digestive disorders, psoriasis," Dr. Dunston adds, which could also explain frequent yeast infections in many women.
"Most physicians are not aware of how the pill affects a woman’s naturally-occurring hormones because they don’t routinely check them. ... I frequently see women on the pill with hormone levels like a woman in menopause, and they feel like it! Because the pharmaceutical companies have ad campaigns that really depict the upside of the pill and downplay the potential risks, it becomes normalized to take it. Kind of like soda commercials that depict happy, thin, healthy people drinking soda and deny the reality of millions of diabetics diagnosed each year," says Dr. Dunston.
11. The More Estrogen, The More Short-Term Side Effects
If you're feeling moody, bloated, or generally off as a result of taking the birth control pill, consult with your gynecologist about other brands, like those with lower estrogen levels.
"The varying estrogen levels in pills affect a women’s body in different ways. Estrogen is the weight gain, water retention, anxiety, depression hormone, while progesterone has the opposite effect. More estrogen means more weight gain, water retention, etc. Hence the trend to decrease or eliminate the amount of estrogen in pills recently," according to Dr. Dunston.
Depending on your lifestyle, birth control is a strong, considerable option for many women, not only for pregnancy prevention but also for general wellness. Before making a decision, it's important to become aware of the facts and side effects, both positive and negative, associated with birth control.
When it comes to taking care of your body, don't cut corners.