• Erika

A Jagged Little Pill - No, That's Not Ironic

Updated: Jun 28, 2020

This is one primarily for the ladies. And it's going to be a little longer than usual. So guys, you can stop reading here if you like. BUT, if there's any women in your life you care about OR you realise it might be a good idea to know what's going on for the other half of the population, please stay with me.

Don't be this guy...

So I'm going to be talking about a few things here. What having a period means for a woman's overall health. Why the contraceptive pill might not be such a great thing. And how diet can play a part in addressing the root causes behind some of the reasons women are put on the pill in the first place. But I need to start at the beginning of my journey...

At 10 years of age (in 5th grade) I had my first period. In the following year what was a "normal" amount of hormonal pimples you would expect at that stage of life, became a case of fully blown cystic acne. A painful lumpy redness that covered my face and extended down to my shoulders, chest and upper back. I was already a shy child and this further suppressed my self confidence. Realising how badly this was affecting my development, my parents decided it was time to see a specialist.

After attempts at using low grade antibiotics provided little to no effect, the dermatologist suggested bringing out the big guns, a drug called Roaccutane. The side effects weren't ideal, dry eyes/throat/nose/skin, but the results were consistently positive even in severe cases. My case wasn't quite severe, but it was bad and unlikely to get better any time soon. And this course of action was delivered to us as a sure fire "knock it on the head" solution.

Another side effect of this drug was the possibility of birth defects should I become pregnant while taking it. At this point I was barely 12 years old and nowhere near sexually active. But, seeing as I was having a period that meant it was possible for me to get pregnant, and going on the contraceptive pill was a requirement if I wanted to take it. For what was almost a guarantee of better skin, it was a no brainer at the time. We had no idea what I realise now. That there might have been a solution that didn't involve drugs.

So I started taking the pill at the tender age of 12 and the Roaccutane did it's job, my skin improved. Once the drug was out of my system I had the option to stop taking the pill. Seeing as my skin was better but not perfect, it was suggested that I may as well continue with it because this form of the pill was known to help with acne. Sounded like a good idea to me. Then as I became sexually active I stayed on it. I chose to stay on it when I heard the horror stories of acne recurring when people stopped taking it. I chose to stay on it because I liked being able to control my "period" and skip it if I wanted to. I use quotation marks there because when you are on the pill, it's not a true period. More on that later.

Would I have made those choices were I properly educated on how my body works and what kind of physical changes the pill can cause? If the pill wasn't freely handed out to women with little to no discussion of ill effects? Advertised as having no real consequence other than the positive of "you won't get pregnant"? Does your average GP even understand what it really does on every level?

To be clear, I'm certainly not saying women don't deserve the right to have control over when and if they choose to get pregnant. Hell no, I am ALL FOR that! What I AM saying is for one, we need to develop better methods rather than rely on 60+ year old technology, and two, there needs to be more education given to us on the current options. And for those of us being directed to take the pill due to health issues, a better understanding of how diet and lifestyle can play a part in helping us to heal before we resort to drugs.

In going low carb for my type 1 diabetes, my already mostly clear skin began glowing. I fully trusted that the way I was eating meant the acne wouldn't return if I stopped taking the pill. So removing these synthetic hormones and allowing my body begin functioning the way it was meant to seemed an obvious next step in my journey towards ideal health. After 2+ decades of taking the pill, in April last year I made the decision to stop. I didn't have another period for over a year. This absence of a period is known as secondary amenorrhea, which can happen when women come off the pill. My body had basically forgotten how to function after years of having it's own hormones quashed in the presence of artificial ones.

After 6 months or so, I decided to ask my GP for a referral to see a specialist and get some tests. Hopefully I could figure out if there were any particular hormones out of range or markers that didn't look right. Her first question was "are you trying to get pregnant?" semi excitedly... No... "well why do you want to get a period??"... Because it's something that a healthy woman my age should be getting... "oh ok, yeah i guess, if you want" Now my GP isn't at all uncaring, so I can't help but think this would be a common reaction. Very few doctors are taught about holistic health or seeking out a root cause for their patient's ailments. The focus is on which pill they can prescribe to hopefully fix it.

The tests (while not exactly comprehensive) all came back within normal range. Turns out I have more eggs left than the average woman my age! So all I could really do was persist with the changes I had made in encouraging my body to heal. The first thing I implemented was reducing my fasting window. I had been following a pretty strict 16/8 protocol. It was great for blood sugar control, and my ability to use fat as fuel meant I was rarely hungry in the morning. But if I wanted my period back and my hormones working right, ultimately I needed to let my body know "it's safe to have a baby". That there's no scarcity. That I have enough body fat in reserve should circumstances change.

In December last year I had a body scan that showed my fat percentage was down to about 17%. I hadn't been starving myself, but had swapped some fat for extra muscle after adding a small amount of weight training. While 17% is on the low side and I wouldn't think of it as bad or too low, when you want your body to be getting the message of "hey there's plenty of stored energy (fat) available in case we get pregnant" it's not ideal. I began breaking my fast a couple of hours earlier with butter and MCT creamer in my coffee. This would have minimal impact on my blood sugar, but still let my body know that it wasn't going to starve.

Fat is an important ingredient in the production of hormones. This is one of the reasons why anorexics and certain types of athletes will stop having their period. And it's not just hormones where fat is the key ingredient. It's utilised for many other functions of the body. Creating cell walls, carrying fat-soluble vitamins, immunity. If there's not enough fat to go around, keeping you alive will take priority over ovulation and the ability to get pregnant.

I'd also read about the need for women to increase the amount of healthy carbs in their diet but had resisted due to the effect it might have on my blood sugar. A month or two ago I relented and bought some lower carb potatoes. It's not like I went crazy with them, but allowed myself to have a meal here and there with a few more carbs than usual. And hey presto, possibly the first real period of my adult life turned up 1 week ago! Magic potatoes??

(Of course, It's most likely a combination of things - I also ate a bit more and kept cardio exercise to a minimum - but that GIF is priceless!)

Notice I'm specifying "real" period here again. The period you get when you are on the pill is all smoke and mirrors. It's technically called withdrawal bleeding, referring to the withdrawal of hormones during those sugar pill days. The drop in hormone levels causes the uterine lining to shed. Which is why if you decide to keep taking the active pills, you will skip this bleeding altogether. It seems creating this simulation of a cycle for users of the pill had more to do with Catholicism than any therapeutic need. You are probably aware that many women are put on the pill as a way of 'regulating' their cycle. But in truth, all the pill can do is replace that irregular cycle with a fake one. Sweeping under the rug what may be the symptom of a hormonal imbalance caused by an underlying health issue.

Well that's all well and good you say, but what is it exactly that's so bad about the pill? Why did I decide it would be better for my health if I stopped taking it? Firstly, ovulation should be considered a sign of health for a woman of reproductive age. The synthetic hormones contained in the pill tell your body not to ovulate, removing that key indicator. Ovulation leads to an increase in progesterone, a hormone which communicates between the brain and the ovaries. In addiction to this signalling function, progesterone converts to allopregnanolone in the brain. This metabolite is a neurosteroid, positively modulating GABA receptors in a way that is similar to the action of benzodiazepines, which are known for their calming effects and are used to treat anxiety and insomnia.

In place of progesterone, the pill contains progestins - varying forms of synthetic hormones that activate the progesterone receptor causing similar effects in regulating the cycle. These progestins cannot create allopregnanolone and when they are used to prevent ovulation, they suppress the body's natural progesterone levels. Could low allopregnanolone be playing a role in the increased rates of depression we see in women taking the pill? And while progestins are a 'close enough' match for progesterone receptors, they may also bind to other receptors such as those for androgens and oestrogens, possibly causing side effects associated with these hormones depending on whether the receptor is blocked or activated.

One of the receptors that could end up being effected is testosterone. In recent years, scientists have started to realise that the brains of women on the pill look fundamentally different when compared to women who aren’t taking it. Some regions of their brains seem to be more typically ‘male’. Another is the cortisol receptor, which over time can lead to a dis-regulated stress response. The stress hormone profile of pill-taking women is similar to people who have experienced chronic stress.

Sadly the list of side effects is a long one. Particularly for 'combined' forms containing oestrogen. These have been linked with increased insulin resistance leading to a higher risk of developing type 2 diabetes. There is an increased risk of blood clots forming and causing issues such as deep vein thrombosis and in some cases ischaemic stroke. And one last point I'll add before wrapping up, it can deplete your body of several B vitamins (B6, B12, and folic acid), vitamin C, magnesium, and zinc. Low B12 is another potential cause of depression.

Of course not every woman taking the pill will encounter every one of these symptoms. The pill takes many different forms, and each one will effect each of us in different ways. But the point that needs to be made is there has to be better education given to us on the possible risks and side effects, so we can make informed choices.

Maybe we need to turn our focus towards methods that don't wreak such hormonal havoc. There are a few already such as copper IUDs that can create the necessary physical changes without the use of hormones. While many women are choosing this as their best option, there may be some drawbacks such as heavier periods. And finally we are getting serious about the idea that maybe the whole contraception conversation shouldn't revolve around our lady parts alone.

While there have been male contraception alternatives in varying stages of development for quite some time, they never seem to get off the ground. Putting a stop to those millions of pesky sperm seems to be a slightly harder task than preventing a lone egg from popping out once a month. But recently, a government-funded biomedical research agency in India, has successfully completed a clinical trial on an injectable male contraceptive. And no, it's not as bad as it sounds.

It's a once off injection of a polymer substance into the vas deferens, effectively blocking sperm from leaving the testicles and is designed to take the place of a traditional vasectomy. It lasts for roughly 13 years and has shown to have an effectiveness of 97.3% in preventing pregnancy with no reported side effects. It's also reversible, with another shot that can break down the polymer and free up the blockage. Finally, in a world of cutting edge technology, something has been invented that might lessen the contraceptive burden on women.

Women should no longer have to suffer in silence with side effects that might actually be changing who we are and the way we behave. The pill has played a major role in liberating women, allowing us to take control, making it easier step to out of the homemaker role and given us the freedom to create careers and lives like never before. But just as we can now carry a phone in our pocket with more processing power than all of NASA back in 1969, it's time for the technology of contraception to take a leap forward.

If the pill is your best option for now, that's alright too. I'm not being hyperbolic and claiming it's practically suicide. I was on it for a looong time and I'm doing ok. I just think it's important that women be shown the whole picture. To have all the facts, pros and cons before making a decision on what is best for our bodies in our current life situation. And if you are using hormonal birth control in some form, hopefully being aware of the downsides means you can take action to negate them.

To any men reading this (high fives for making it to the end!) if there are women in your life that need to hear this message, please pass it on. And don't be a wuss when this 'once every 13 years' injection becomes a viable option. I have to inject myself with insulin multiple times a day to stay alive, suck it up bro!😉



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