So, a big topic that comes up a lot within my friendship circle and also with some of my younger clients is: “What Hormonal Contraceptive do you think is the best?”
Firstly, the hormonal contraceptive is a powerful tool for women to regain a safe sex life back. It was also a great stepping stone for women to regain legal birth control.
However, as you may know, we now have a new problem. The pill is not just contraception anymore. It is used to control periods and also “treat” hormonal symptoms such as acne, painful periods, PCOS – being just a few.
This can only happen because we all persist in the illusion that the pill’s steroids are somehow equal to, or better than, our own hormones, when in fact nothing could be further from the truth.
Synthetic hormones are not better than our own hormones. In fact, they are not even hormones.
Pill drugs are hormone like molecules that are similar to, but not identical to, our own natural hormones. They have similar names to human hormones and have a similar molecular structure, but make no mistake: they are different molecules.
Consider the difference between your own natural progesterone and the synthetic pseudo-hormone progestins: levonorgestrel or drospirenone. Progesterone promotes embryo implantation and pregnancy. Levonorgestrel aborts pregnancy (which is why it is used in the morning after pill or emergency contraception). Progesterone promotes hair growth. Levonorgestrel causes hair loss. Progesterone decreases the risk of blood clots. Dropirenone increases the risk of fatal blood clots by seven times. Progesterone improves brain health and cognition. Dropsirenone causes depression.
Different Types of Hormonal Contraceptive
The classic pill is a combination of two synthetic hormones: ethinylestradiol plus a progestin. All combined pills are basically the same hormones, but they are branded differently according to the estrogen dose and type of progestin. Combined pills have cute names such as Yasmin – to make them more appealing.
There is nothing mini about the mini-pill. The word ‘mini’ means only that the pill contains one drug (progestin), not two. Most of the side effects come from progestin anyway. Side effects of the mini-pill include depression, weight gain, hair loss and loss of libido.
Arm implants deliver high dose of the progestin etonogestrel. They suppress ovulation and cause weight gain, depression and erratic bleeding.
The injection delivers a high dose of the progestin medroxyprogesterone acetate. It suppresses ovulation and causes depression, weight gain and bone loss. The risk to bones is so concerning that the Food and Drug Administration (FDA) ruled that Depo-Provera carry a black box warning (which is the strictest warning available for prescription drugs). A black box warning is given when there is reasonable evidence of a serious hazard.
NuvaRing is a brand name for an intravaginal delivery system of ethinylestradiol and etonogestrel. It works in the same way as the pill and the implant (suppressing ovulation). The blood clot risk from NuvaRing is much higher than the pill because ethinylestradiol goes straight into your blood stream (by passing your digestive system and liver).
Mirena is an intrauterine device that releases a small amount of the progestin levonorgestrel. I view the hormonal IUD as the least harmful of all the hormonal contraceptive methods because it does not aim to suppress ovulation. Instead it’s main aim is to thicken cervical mucous, inhibit sperm survival and prevent the build up of the uterine lining. Unfortunately, it does suppress ovulation around 50% of the time (because a small amount of levonorgestrel inadvertently enters the blood stream).
One of the main side effects of hormonal contraceptive is the loss of libido, but unfortunately there are very few studies. The main cause of this is because the pill reduces testosterone. There are some reports that libido can take months (or years) to return to normal after the pill is stopped.
Below is not a ‘how to guide’ to contraception, but I hope to provide enough information for you to make up your own mind as to which method is best for you.
A 2007 study showed that the Fertility Awareness Method, when used correctly, is almost as effective as the pill (0.6 percent failure compared to 0.3). This is using an App or finding out when you are most fertile and then avoiding intercourse at that time or using a barrier method.
There are ovulation signs coming from your body but that is for another blog post.
Hopefully you can make up your own decision for which contraceptive works best for you. I know women who have literally tried them all.
I’m not warranting that contraceptive doesn’t work for some women, however if you’e suffering with symptoms from taking synthetic hormones, then I would suggest talking to someone about coming off of it – and if there are issues being ‘masked’ them discussing the best plans to help address those symptoms.
Ref: Period Repair Manual, Lara Briden, Naturopathic Doctor (2015).