Several months ago, on a mockingly optimistic sunny morning and the start of a new month, I told myself I'd quit hormonal birth control pills. It felt like I was in middle school again, potentially getting my period for the first time in years. My birth control had kept my withdrawal bleeding to a maximum of twice a year, which meant I rarely had to worry if I should be wearing black pants instead of the light-wash denim I picked out that morning. Still, I boldly threw the pack of tiny but powerful pills in the trash, not quite ready to be back in that adolescent mentality, but ready to dive into womanhood - something I didn't realize I'd been keeping at bay through synthetic hormones.
Back when I was 22 years old, I blindly trusted my physician and began taking the pill without education. I thought birth control was a simple solution to preventing pregnancy, and I'm not alone, as an estimated 151 million women of reproductive age use oral hormonal contraceptives. The process was fairly easy - I booked an appointment with a gynecologist referred by a friend and told her I wanted birth control because I wasn't ready for kids. She talked through a few of the different options, but when the pill was brought up, the only warning she gave was that I needed to take it at the same time each day and not skip any days for optimal efficacy. Easy, I thought.
But beginning hormonal contraceptives is one of the least informed decisions I've made. I was on it for a third of my life - a decade of swallowing a little white pill every morning that I thought would help alleviate stress, but eventually had the opposite effect. I believed not having a period was a way to "hack the system," and I felt like Superwoman when my friends talked about cramping or PMS and I could no longer relate.
But increasingly, women are talking about the potential drawbacks of hormonal birth control - and ones that aren't often communicated well to us. While there's definitely misinformation and myths circulating on social media about hormonal birth control, from my own experience, doctors can do a better job of warning of potential side effects for women with certain pre-existing conditions - like I had.
She also mentioned that people who experience migraines with aura - which I do - shouldn't use this hormonal birth control, but I'd never had my own doctor tell me that.It's why I stopped romanticizing ignorance and started listening to other voices in this space. As someone who has prioritized healthy fitness goals in adulthood, I had to make a shift when my body couldn't keep up, causing anxiety that prevented me from enjoying workouts. Understanding my cycle became a top priority, and it opened the door to endless resources about how women can support their bodies and its needs throughout the month. While I originally viewed getting on the pill as a quick fix, I think every woman should feel empowered to explore alternative paths.
According to Jessica Ritch, MD, a board-certified minimally invasive gynecologist, it's difficult for doctors to go over every possible factor with patients, but "it is critical to review the main cardiovascular and cancer risks, and common side effects" of hormonal birth control, none of which were communicated to me. She also mentioned that people who experience migraines with aura - which I do - shouldn't use this hormonal birth control, but I'd never had my own doctor tell me that. What's more, a recent study found that a common birth control pill with combined estrogen and progesterone increases the relative risk for heart attack and stroke twofold. Dr. Ritch notes that the absolute risk is minimal, but does show an uptick - translating to "0.021 percent increase in overall risk of stroke and a 0.01 percent increase in overall risk of heart attack per year." This means that those with pre-existing conditions should opt for other methods of preventing pregnancy.
While oral contraceptives can be beneficial for issues like Polycystic Ovary Syndrome (PCOS), acne, intense cramping, and more, their risks often aren't communicated to patients. Had I known that starving my body of these natural sex hormones and putting myself at risk for long-term bodily harm including liver complications, digestive issues, and impaired bone density, I would have stopped years ago. I gained awareness of dangerous side effects like these after I began experiencing other health issues. Bloating became a consistent problem for me about five years into taking birth control. Turns out, I could no longer process gluten without intense cramps. I went through two celiac tests, both of which came back negative.
I was lost, so a friend recommended "Just A Phase," a podcast hosted by three health coach sisters who discuss the phases of a woman's cycle, which I admittedly didn't know existed - partially due to hormonal birth control prohibiting me from fully experiencing each one. I thought it was binary - women menstruated for a week and the rest of the month they didn't.
In a recent sex education study by the women's vitamin company Perelel, only 60 percent of respondents knew the four cyclical phases - follicular, ovulatory, luteal, and menstruation. Apropos to how clueless I was, in a recent text, my phone autocorrected luteal to literal - a literal blindspot. In the same survey, only 32 percent of respondents knew how to take care of their bodies during each phase. Modifying activities, interpersonal interactions, nutrition, work focuses, and exercise patterns are beneficial for different parts of my cycle.
I continued to learn how birth control also strips essential nutrients and can change gut microbiomes. The fluctuation of female reproductive hormones is a contributing factor in the onset of digestive dysfunction, according to the National Library of Medicine. Consistently flooding the system with synthetic hormones, especially with extended use, can exacerbate the healthy bacteria that once lived in the gut - which can lead to issues like leaky gut, gut dysbiosis, small intestinal bacterial overgrowth, and gallstones. I could finally pinpoint the potential cause of my gluten intolerance.
A couple of months into doing more research, I made an appointment with the gynecologist I'd been seeing annually for additional clarity. She quickly told me there was nothing wrong with the pill I was taking and that the only potential side effect was blood clots, but that was for specific risk factors, none of which I possessed. She proceeded to tell me she'd been on the same pill since her twenties and referenced nothing about osteoporosis, which my family has a history of, and didn't address any of the studies about gut functionality, mental health, or migraines.
The doctor ended our conversation with, "The great thing about this pill is you only get a period once or twice a year. And I don't know about you, but I don't have time to be messing with that every month," before telling me to have a great rest of my day and leaving me in the room naked in more ways than one.
As I walked through the packed parking garage, I felt robbed. Anger welled up as I thought about all the women who'd come to this hospital for women's care and expected their doctors to provide them with all the information and research available to them - easily hundreds of women daily who weren't getting answers.
It's now been five months since I came off hormonal birth control and switched to tracking my Basal body temperature using the Natural Cycles app, but my cycle still isn't regular. My body went through a long period of living off artificial signals, so it's expected that it needs time to heal. But, in case you're curious, I'm in my follicular phase right now, which means my estrogen and follicle-stimulating hormone levels are increasing, and I'm at my most energetic and optimistic state.
I don't know if my gut microbiome will fully heal, but I'm hopeful, and I'm working to reinstate good bacteria into my body. Advocating for women and our needs is vital, and it starts with educating our women friends and relatives about how they can partner alongside their bodies during each phase of their cycle.
Natalie Bickel is an energetic writer who moves people to action with her words. She has bylines in the Los Angeles Times, Glamour, Darling Magazine, and more, and she's the author of the books "The Catalyst," "The Christmas Clue," and "The Volcano No One Could See." Read More Details
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