What they don't tell you about birth control
Missing cortisol, secret testosterone, anxiety tools, and your Weekly Wellness Tea.
Last summer, shortly after the below photo was taken, my obstetrician and I met for my 36 week exam and went over the final details before my delivery day. I got a flu shot. My C-section was scheduled. And she wrote me a prescription for an oral contraceptive to begin as soon as my daughter was born. I hadn’t asked for one, but I hadn’t asked for one when my son was born 19 months prior either, and my OB at the time had too.
When I was sixteen and was suffering painful cramps, a different doctor in a different state wrote me a prescription for a different brand of pill, as did about half a dozen doctors I’ve had over the last two decades.
Never once did any of them warn me about the long term side effects. Or, for that matter, share any of the grisly details of its history. So today, that’s what we’re doing. But first, the top health and wellness stories of the week:
Weekly Wellness Tea
Teen health is at a “tipping point”.
Around the globe, the standout concerns for teenagers has shifted from smoking and alcohol to obesity and mental health (link)
Bill Gates wants to give cash to moms.
Sweet! Especially since poverty has shown to far more damaging than screen time (link)
Mark Zuckerberg wants to keep his cash, but give AI friends.
In more tech billionaire savior-complex news, Meta big wig wants us to use his AI buddies as a solution for loneliness. Unclear on the “poking” practice (link)
NYC wants New Yorkers to celebrate Mental Health Awareness Month by acting like not New Yorkers.
I.e., engage in mentally healthy activities that promote community support. So, not taking the subway, looking at prices, or telling anyone “Hey, I’m walkin’ here!” (link)
Farmers are sweating RFK jr.’s MAHA report.
Word on the street is, he will have a worm to pick with pretty much everyone (link)
Wellness tourism is booming in India.
A shift from basic Ayurveda and meditation retreats to luxe spa safaris suggests India is becoming a major player in five-star travel, and perhaps a future setting for White Lotus (just speculating on the last part, but I could see it!) (link)
And now back to our top story:
What you probably weren’t told about “The Pill”
“The Pill” came out with a boom in 1960. For the first time, any adult woman could control their likelihood of getting pregnant, at least up to 96% percent. It was freedom; it was scandal; it was, not advertised that:
In order to obtain FDA approval, John Rock and Gregory Pincus had to figure out a way to conduct large-scale human trials. This proved tricky, so they bopped down to Puerto Rico in 1955 to run their tests down there.
Their first trials were 100% effective in preventing pregnancy when taken properly. Great! 17% of the women in the trial experienced dizziness, headaches, stomach pain, or vomiting though. Less great. They lowered the amount of synthetic progesterone.
Dr. Edris Rice-Wray, the medical director of the Puerto Rico Family Planning Association concluded the pill caused “too many side-effects to be generally acceptable”. Rock and Pincus were like, “nahhhhh”.
They also didn’t fully explain to the women involved in the testing that it was, indeed, a test. They played it like this drug was already done, effective, not risky. Not good. Worth noting the synthetic progesterone in the trial doses was crazy high to help them hedge their bets about getting approval. Informed consent fellas, ever heard of it?
They ran more trials in Boston. A bunch of women reported bloating, nausea, and three died. No one ever looked into these deaths, and Rock and Pincus dismissed the side effects as being mostly psychosomatic, aka ladies being dramatic. Oh boy.
(source)
The adoption of the pill did a lot of good for a lot of women. It allowed women to make great strides in the workplace and higher education, and countless families to plan their families instead of the old “wow, I guess we have 14 children now,” not-so-much-of-a-plan-plan.
However, even though today’s versions contain way less synthetic progesterone than the first one, since pretty much all testing was and is focused on its effectiveness in preventing pregnancy, no one’s really looking into its effects on mental health and other stuff that actually makes a pretty big impact on people’s lives. Such as:
Altering attraction
When in the progesterone phase of one’s natural cycle, we’re typically more into the provider types, with softer features, better dad-material, that sort of thing. Birth control is effectively a daily dose of that phase. So if you partner with a Jim Gaffigan-type, then go off it and learn you’re actually crazy horny for the rugged, testosterone-fueled type (no offense to Gaffigan), well, that’s not good for anyone.
Libido changes
Females are on the prowl in the estrogen phase of their cycle, aka, when the ovulation naturally happens. If your body thinks that part’s done, you’ll always feel more like watching Seinfeld reruns than slipping into a LBD and hitting the town looking for mans.
Cortisol blunting
Oh, but at least that one’s good, right? Cortisol is the stress hormone. Nope. It’s not good. If your cortisol production is blunting, you still experience stress, you’re just less equipped to deal with it. Meaning more anxiety, overwhelm, and burn out, which leads us too…
Increased risk of postpartum mood disorders
Which is crazy, considering, as I shared in my own experience, it’s standard practice to recommend the pill to new mothers ASAP. Granted, this was the “baby pill” which has less progestin to avoid messing with milk production, but still. Informed consent, ladies and fellas, ever heard of it?
Problems with memory and detail recall
I forget the details for this one. JK. This is also due to cortisol blunting. I found one the most interesting takeaways in Dr. Sarah Hill opens her fascinating 2019 book, This is Your Brain on Birth Control (linked below) to be that hormones can’t really be targeted. So taking a pill, ring insert, shot, whatever, that tells your body not to ovulate will also unleash a bunch of crazy other things.
Changes in gut microbiome
Yuck.
Male attraction
Not that it’s all about the male gaze. But, if we’re talking about effects of birth control on straight women looking to mate or partner (and Dr. Hill’s book does focus almost entirely on that population group), it is worth noting. Many tests have shown that heterosexual men are most attracted to pheromones of women who are ovulating. Like male animals are to female animals in heat. No ovulating, no Pepe Le Pew.
Of course, there is also a risk of stroke and weight gain. That one we are warned about.
(source)
The tidbit in Dr. Hill’s book I found the second most shocking was that progestin, the synthetic progesterone in most hormonal birth control, is actually altered testosterone. Whaaaaatttt? Yes it’s true, turns out progesterone is difficult to artificially create, so this is the next best thing. Cool, cool, cool, except that some of the side effects of male sex hormones in a woman’s body often include:
Acne (fun!)
Irritability and moodiness (ugh!)
Libido changes (more? great)
Thinning or unwanted hair
Increased appetite, fluid retention, aka various reasons for more weight gain
Another fun fact is that in 2016, a trial on a male birth control shot was abandoned because, even though it was 96% effective, it caused moodiness, weight gain and acne. So they shut that one down. Huh. (source)
What’s the takeaway?
I have absolutely no opinion on who should or shouldn’t take birth control or what method they should use. I do believe that women (and everyone) has a right to fully informed consent. I’m not suggesting OB-GYN’s are intentionally prescribing medications to screw with our ability to manage stress, or that there’s, as one TikTok-er suggested, “some nefarious conspiracy”. Perhaps most gynos are also unaware of these long-term side effects, as I was until I started digging into this topic.
Many, if not most, women are first prescribed the pill under the age of twenty, when our brains are still developing. Just like one shouldn’t give ADHD medication or antidepressants without discussing all potential side effects, everyone should be warned of the long term effects of hormonal birth control on the brain as well as the body before they’ve been on it for decades.
Further learning:
Cheatsheet for The Monday-ist Tuesday Ever
The first day back at work after Memorial Day Weekend is traditionally one full of sunburns, tolerating uninteresting anecdotes, and, if you’re like me, extreme suck-i-ness. Whether you are in a corporate office or wrestling your kids into their school clothes (or both), one thing that can help is taking a cue from the 12 Step Programs’ saying, “take it one day at a time,” and push it further. Take it one hour at a time. Here’s how it works”
Break your day down into one hour chunks. 6am-7am. Take a break, even if it’s just a quick lap to the kitchen, or “canteen,” if you work in a hip start-up, or around the block if you’re lucky enough to have outside be an option.
Repeat as necessary. 7am-8am, take another mini break, etc.
You can do anything for an hour. Way more manageable than the whole day.
I did just lose my job, so don’t take too many breaks. A deep breath does the trick in a pinch.
Hope that helps. Have a great week!
Do you have any experience with surprising birth control side effects? Any other health and wellness trends or topics you want debunked and simplified? Share in the comments below or DM me here or @healthycomicexplains on Instagram and @laurelcummings on TikTok.
Disclaimer: I am not a doctor and The Healthy Comic is not meant to serve as medical advice. These opinions are my own and you should always consult a medical professional.