• Dr. Saru Bala

How does birth control work? And how does it impact your hormones?

Updated: May 19

Were you told that birth control would fix your irregular periods? This seems to be a popular thought among many women, because they were told by their doc that birth control would solve their issues. Unfortunately, that's not the case.

NORMAL HORMONAL RHYTHM:

Let's take a look at what your hormones should be doing in a normal female hormonal cycle, aka your period.

Chart of Hormonal Rhythm

As estrogen rises, your uterine lining starts to build. Estrogen is our builder hormone. As you start to approach ovulation, estrogen reaches its peak and this triggers LH and FSH to have a spike to signal to your ovaries to release the mature egg. That release of an egg is ovulation. After ovulation, your corpus luteum makes progesterone and this helps to thicken the uterine lining that estrogen helped build. If no fertilization occurred during ovulation, then progesterone starts to drop, and your uterine lining is shed. This shedding of your uterine lining is a period!

HORMONAL CYCLE WHEN ON BIRTH CONTROL:

This is what your hormones are doing when you take a hormonal birth control.

Chart of Hormonal Cycle When on Birth Control


The bleeding that you get with hormonal birth control is known as a withdrawal bleed. If you took the sugar pills every 50 days or 200 days, you'd bleed every 50 or 200 days. Your hormones aren't following that cyclic pattern of building, ovulating, and shedding, so it's arbitrary. HOW BIRTH CONTROL SEEMS TO "FIX" YOUR HORMONAL ISSUES

Many women who come to me are under the impression (because they were told by their OBGYN) that birth control helped to solve their hormonal issues.

When you take birth control, what's actually happening is that your body stops producing its own natural hormones. The synthetic hormones found in birth control will stop ovulation. No FSH, no LH. Which means no estrogen or progesterone either.

Can't have hormonal issues if you have no hormones, right?

If your hormonal acne cleared up and your heavy flow and cramps went away, that's because you don't have anymore of those hormones that were causing those issues in the first place. Birth control stopped them! So that's how hormonal contraceptives "fix" the issues. They're more of a band-aid to cover up the issues. Kind of like just sweeping it under the rug. But as soon as we lift that rug, we'll find those problems again.

This is why so many women who get off birth control notice their problems come back, and often with a vengeance. Because when they're getting covered up, the root cause is going unaddressed for months, years, decades even. HORMONAL DISORDERS

If you have irregular periods, PCOS, or any other hormonal disorder that is affecting your period, your hormones likely won't look like that first picture. Estrogen and progesterone likely aren't following those patterns or signaling to your hypothalamus to secrete FSH and LH to release an egg.

Will birth control "fix" that? I wish it would. How easy would it be to take a pill to make your period problems disappear, right?! Unfortunately, if you're having hormonal issues, it means there's deeper issues going on with your health that we need to check in on.

Addressing the root cause of your hormonal issues will not only bring back your periods, but they'll also address all those other problems you have been dealing with! Like those headaches that show up for no reason, or that brain fog and fatigue you can't seem to shake.


Or maybe it's your libido that disappeared. Whatever the issues may be, when you start to address the underlying causes of hormonal imbalances, your overall health starts to improve. And who wouldn't want to feel good again?! HORMONAL BENEFITS

Your hormones aren't just there for fun or purely reproductive purposes! Oh no ma'am. They do so many different things for your body.

Estrogen not only is important during puberty, but it also has benefits for your bone health, cognitive function, mood, and heart health. It's important for our memory and libido, our cholesterol, it provides vaginal lubrication, and maintains healthy vaginal flora, it improves our bone strength, reduces moisture loss in our skin and even keeps up collagen production!

This is this hormone that drops dramatically during menopause and why so many women dread those years. Because estrogen does SO much for us! It's our feel good hormone. It's not JUST bringing our period every month, it does all these other things!

Progesterone is responsible for metabolizing into allopregnanolone and enhancing GABA activity to calm down our nervous system and combat insomnia, anxiety, and depression. It helps with opposing estrogen and preventing estrogen related cancers. It plays an important role in insulin regulation, and it also helps maintain the uterine lining during pregnancy until the placenta takes over. Our hormones are amazing!

If you’ve been on birth control in the past, or you’re currently taking it and notice that you feel all the symptoms that progesterone is supposed to help with (insomnia, anxiety, depression, etc), that’s because, like I mentioned before, you don’t get any natural hormones while taking birth control! So, you’re missing out on all those benefits when taking birth control! #FOMO, am I right?

When we work with them instead of against them, we can enjoy all these amazing benefits! HOW DO I KNOW IF BIRTH CONTROL IS A GOOD FIT FOR ME?

If you're looking for symptomatic relief without addressing your hormonal concerns, or you're looking only to prevent pregnancy, then birth control would be a great option for you! If you're looking to address the deeper hormonal issues you're facing and wanting to feel better, then birth control might not be the best option.

But don't worry, because there's so much more we can do to address your period health and hormones to make sure you can enjoy the best parts of your hormones without all the yucky parts you don't want (acne, fatigue, weight gain, etc). Imagine a life where your period and hormones don't control your life and you don't have to just deal with side effects from a birth control. It's possible!