By Dr. Mercola
The birth control pill was first introduced to the American public for contraceptive use in 1960. By 2002, 11.6 million US women were on "the Pill" according to CDC statistics, making it the nation's leading method of contraception.
Eighty percent of American women have used oral contraceptives at some point in their lives, according to a paper in the Journal of the American College of Cardiology.
In my opinion, this is a tragedy as the Pills' benefit of convenience is largely outweighed by their very serious health risks.
In fact, long-term use of oral contraceptives (OCs) will invariably increase a woman's risk of developing a serious chronic illness. Yet they are passed out like expensive candy at most physicians' offices, with little regard for the known dangers.
The decision about which method of contraception to use can be overwhelming, and it seems that most women are not adequately informed of their options.
It is my intention to provide you with the information you need to make an informed choice.
First, I'll review the general categories of birth control methods, then move on to the relative risks of each, and finally I'll make suggestions about what I consider to be the safest and healthiest options.
Overview of Birth Control Methods
The most importantpoint to remember about birth control pills, as well as hormone patches or injections, is that they are potent synthetic hormones, whose adverse health effects have been well documented over the past 30 years.
For instance, most doctors who see women about contraceptive concerns underestimate the effectiveness of natural family planning options and rarely or never mention them. Many women turn to birth control pills because they are not aware that there are safer options available.
The different contraception methods act in very different ways and can be broken down as follows:
- Barrier Methods: These work by physically preventing the sperm from reaching the egg. It includes male and female condoms, the diaphragm, and the cervical cap.
- Hormonal Methods: Typically, hormonal birth control methods work by releasing estrogen and progestin into your body, preventing your ovaries from releasing eggs. They also thicken cervical mucus, making it harder for sperm to enter the uterus.
There are a wide variety of hormonal methods on the market including oral birth control pills, implants (Norplant), hormone shots like Depo-Provera, a vaginal ring called NuvaRing, and a contraceptive patch (Ortho Evra) worn on your skin.
- Spermicides: These are chemicals that kill or disable sperm so that it cannot fertilize an egg and cause pregnancy. Spermicides come in many different forms: foam, jelly, cream, film, and suppositories.
- Intrauterine Devices (IUDs): These are small, plastic, T-shaped sticks with a string attached to the end. The IUD is placed inside the uterus and prevents pregnancy by rendering the sperm unable to fertilize an egg, and by changing the lining of the uterus so that it is less supportive for an embryo.
- Natural Family Planning: In this method, a woman uses various techniques to determine when she is fertile during the month. Avoiding sexual intimacy, or using a backup method during the window of fertility can avert pregnancy.
Techniques include the ovulation method, the symptothermal method (which is a combination of the ovulation method and monitoring of body temperature) and monitoring your saliva with the Ovu-Tech magnification lens.
What You are Risking by Using the Pill or the Patch
While many drugs do provide some benefit in certain situations, birth control pills are rarely, if ever, necessary. In exchange for the convenience of preventing pregnancy—which you can do naturally just as well—you are putting yourself at risk for a barrage of serious health problems, including:
|Side effects of the Pill||Side effects of the Patch|
On top of this long list of major health concerns, birth control pills deplete your body of important nutrients, including:
- Vitamin B2
- Vitamin B6
- Vitamin B12
- Folic Acid
- Vitamin C
If, for whatever reason, you chose to use birth control pills, you will at a minimum want to address the nutritional deficiencies they cause. Of course it would be best not to use them at all.
There is also a risk to any baby you might accidentally conceive while taking birth control pills.
Do you think you won't get pregnant while using the Pill?
Statistically, this occurs about 5 percent of the time.
Many women become pregnant while on the pill and don't know it for several weeks or months because the Pill makes them feel like they are already pregnant, so they miss the signs they would otherwise notice if they weren't taking hormones.
Scientific studies show damage to the reproductive organs of baby mice whose mothers were exposed to low levels of estrogenic chemicals, and there is no way to know what the risks are for human babies.
Oral contraceptives can also make your baby more vulnerable to allergies when you take OCs for up to a year before becoming pregnant, according to a Finnish study.
Interestingly, there are even scientific studies suggesting that birth control pills may negatively influence your choice of romantic partner!
Research has shown that birth control pills may alter your menstrual cycle in such a way as to alter the sexual appetites of you and your partner, which could impact future generations. A few small studies have found a genetic difference between the men that women find attractive during a natural hormone cycle, and the men that women find attractive while under the influence of synthetic hormones.
Birth Control Pills Alter Secret Sex Nerve
Chemical contraceptives also appear to alter your "secret sex nerve (Nerve O)," which has endings in your nasal cavity and helps determine who floats your boat. The problem arises when you quit using the Pill, as suddenly the partner you chose while on it, no longer matches your instinctive drives.
Do you really want your romantic life dictated by a pill?
Birth control patches (Ortho Evra) have resulted in an avalanch of lawsuits over the past several years due to the overwhelming health problems women have experienced from using them. One of the reasons the patch is so risky is that you absorb up to 60 percent more synthetic estrogen than if you were taking an oral contraceptive.
Fortunately, demand for the patch has seriously declined as the warnings have escalated.
Hormonal Birth Control Risks Clearly Outweigh the Benefits
Because the risks of hormonal pills and patches are so high, and safer options exist, nearly all patients who visit my Natural Health Center are asked to stop hormonal contraceptives like birth control pills as soon as possible.
If you're using birth control pills for reasons other than birth control, such as to regulate your menstrual cycle or treat irregular bleeding, cysts, endometriosis, or even acne, you are not treating your underlying problem.
You are simply masking it with a potentially dangerous drug.
In these situations, it is essential to balance your adrenal glands, as cortisol levels modulate and control the female hormones—especially progesterone. The Pill merely treats your symptoms, not the underlying cause, which adds to your problem as your body struggles in its state of dis-ease.
Risks of Injectable Birth Control: Depo-Provera
Depo-Provera, or depo medroxyprogesterone (DMPA), is a progestin that interferes with hormone signaling to prevent your ovaries from releasing eggs.
A progestin is a synthetic chemical that mimics the progesterone your body makes but is far stronger and, as a result, carries with it a huge number of negative side effects.
A study in the May 2004 issue of the Journal of Obstetrics and Gynecology found that Depo-Provera users had declines in bone mineral density averaging 3 percent per year. Those on the shot for two years had losses in bone mineral density of roughly 6 percent, compared with a loss of 2.6 percent among women on birth control pills.
Comparatively, women using no hormonal contraceptives had, on average, a 2 percent increase in bone density during the same period.
In addition to significant bone loss, the Depo-Provera shot is associated with a long list of additional health problems:
|Side effects of the Depo-Provera|
In short, Depo-Provera is a dangerous drug that should NEVER be used!
This hormone is so dangerous that, if you were to take it during the first stages of pregnancy, there is a high likelihood of spontaneous abortion.
Spermicides are Not Without Adverse Effects
Spermicides are essentially chemicals (usually nonoxynol-9 or N-9) that kill sperm by dissolving their outer membrane.
However, they also kill beneficial bacteria and skin cells. Disrupting the bacterial balance in your vagina can leave you more susceptible to yeast infections and urinary tract infections.
And it has been proven they add no additional protection to condoms.
According to a 2001 report from the World Health Organization, there is no evidence that condoms lubricated with nonoxynol-9 are any more effective in preventing pregnancy or infection than condoms lubricated with silicone.
Now, let's look at some natural birth control alternatives that are both safe and effective.
Natural Birth Control Options
There are two routes to take when using natural birth control:
- barrier methods, and
- natural family planning methods
The two categories contain techniques that can be used in combination, since they work well together for different situations and circumstances. In general, people are a bit more familiar with barrier methods than with natural family planning methods, which are a little more complex.
However, if you become well versed in a variety of natural methods, your possibilities are expanded for a happy, fulfilling sex life with minimal interruptions.
After all, who wants to interrupt the "right moment" by having to stop and consult your reproductive owner's manual?
As outlined earlier, barrier methods work by physically preventing the sperm from reaching the egg. The four barrier devices currently available are:
- Male condoms: Male condoms have a 98 percent effectiveness rate when used correctly. A water-based lubricant will increase the effectiveness; do not use an oil-based lubricant, however, as it will break down the latex.
- Female condoms: These thin, soft polyurethane pouches fitted inside the vagina before sex are 95 percent effective. Female condoms are less likely to tear than male condoms.
- Diaphragm: A diaphragm, which must be fitted by a doctor, covers your cervix (the entrance to your uterus), so that sperm cannot enter. They are used and removed each time you have intercourse. When used correctly with spermicidal jellies, they are 92 to 98 percent effective.
- Cervical cap: This heavy rubber cap fits tightly against the cervix and can be left in place for 48 hours. Like the diaphragm, a doctor must fit the cap. Proper fitting enhances the effectiveness above 91 percent.
Natural Family Planning Techniques
Again, these methods involve learning how to track your ovulation, and then avoiding sex or using a barrier method during that time.
Many women prefer the natural family planning methods because they feel empowered and more in touch with their own bodies as they learn to notice and track subtle signs of fertility and ovulation. Of course, these ovulation-tracking tools can also be helpful if you are actively trying to get pregnant!
Although natural family planning can be very effective, it is not always foolproof, especially when you're still learning the process. I recommend that you learn your method from a reliable source, and use a backup (barrier) method until you have it down.
If preventing pregnancy is an absolute must for you, you may want to use barrier methods for extra insurance.
Some of the most popular family planning methods are:
- The Calendar Method: Abstention from sex during the week the woman is ovulating. This technique works best when a woman's menstrual cycle is very regular. The calendar method doesn't work very well for couples who use it by itself (about a 75 percent success rate), but it can be effective when combined with the temperature and mucus methods described below.
- The Temperature Method: This is a way to pinpoint the day of ovulation so that sex can be avoided for a few days before and after. It involves taking your basal body temperature (your temperature upon first waking) each morning with an accurate "basal" thermometer, and noting the rise in temperature that occurs after ovulation.
Illness or lack of sleep can change your body temperature and make this method unreliable by itself, but when it is combined with the mucus method, it can be an accurate way of assessing fertility. The two methods combined have a success rate as high as 98 percent.
- The Mucus Method: This involves tracking changes in the amount and texture of vaginal discharge, which reflect rising levels of estrogen in your body. For the first few days after your period, there is often no discharge, but there will be a cloudy, tacky mucus as estrogen starts to rise. When the discharge starts to increase in volume and becomes clear and stringy, ovulation is near. A return to the tacky, cloudy mucus or no discharge means that ovulation has passed.
- Ovu-Tech Method: The Ovu-Tech is an inexpensive hand-held mini-magnification lens about the size and shape of a lipstick holder that allows you to monitor your saliva for hormonal changes that indicate fertility.
Two natural methods I did not include in the above list because of their unreliability are the "withdrawal method" and the LAM. I will mention them for the sake of completeness, but please realize that they should be your last choice:
- Withdrawal: The man withdraws his penis from the woman's vagina before he ejaculates. This doesn't always work; even before ejaculation, the penis releases small amounts of semen that can contain sperm, so this is only 60 to 80 percent successful at preventing pregnancy.
- Lactational Amenorrhea Method (LAM): Some experts claim that breastfeeding protects a woman from pregnancy by curbing hormones that trigger ovulation. However, every woman's body responds differently to the hormonal influences of breastfeeding, so this method is unreliable.
The Next Generation of Drug Based Birth Control
As expected, in 2007 the FDA approved the first birth control pill to completely eliminate menstruation (Lybrel, by Wyeth).
Not only was this pill inadequately tested prior to approval, the synthetic hormones it contains are another prescription for disaster for women's health for all of the reasons already discussed.
But there is an additional concern—long-term suppression of your periods will minimize your blood loss and could contribute to iron overload syndromes that are so pervasive in men. Elevated iron stores are one of the primary risk factors for cancer and heart disease.
Is this where birth control technology is headed?
According to an article on Medicine.net, in addition to pills that prevent menstrual periods, the next generation of birth control is marked by several trends, some of which are rather disturbing when you consider their physiological implications:
- A "Career Pill": Canadian researchers are studying the possibility of a pill that will delay ovulation during your teens and 20s, resuming it when you are ready to have children.
- Male birth control pills: New hormone therapies for men, which have been unsuccessful in the past, are gaining steam; the next sperm-suppressing agents will also "protect against prostate and testicular cancer," according to manufacturer claims.
Of course, that's what Wyeth said about Premarin—and look what that got us!
In an effort to turn straw into gold, some researchers are working on a way to use phthalates in male birth control pills since they are known to depress testosterone levels and sperm counts.
- The "Dry Orgasm Pill": Researchers are trying to develop a medication that capitalizes on a side effect of some existing blood pressure and schizophrenia medications—that is, freezing the muscle contractions that propel sperm through the male reproductive tract. Men would have a normal orgasm, sans sperm.
- Reversible Inhibition of Sperm Under Guidance (RISUG): Considered the most promising male contraceptive, a chemical is implanted or injected directly into the vas deferens, which renders the sperm unable to fertilize an egg. The effects of one injection can last for 10 years, and it's reported to lack hormone-based side effects. It's already in phase II clinical trials in India.
- Spermicidal Creams: Future creams under development will not only kill sperm but will also kill STD-related pathogens, including HIV and herpes virus.
- Emergency birth control pills to stop conception after sex: Companies are attempting to gain "over the counter" status for "morning after pills."
- Vaccines against pregnancy: Called immunocontraceptives, vaccines are being developed that affect fertility by regulating the body's immune response. They would stimulate your immune system to shut down some of the functions necessary for pregnancy.
Sounds like playing with fire to me!
Recommendations for Further Reading
No matter how advanced medical technology becomes, disrupting the balance of your endocrine and immune systems is bound to result in untoward effects. This is true intuitively, as well as being borne out in history.
Therefore, you must use caution and common sense every time a new drug or device comes out that seduces you with glowing claims. When it sounds too good to be true, it usually is.
Your best birth control plan is the natural one, choosing family planning methods that have been around for decades (or thousands of years, in some cases).
As you transition over from synthetic hormones to natural methods of birth control, there are many resources available to guide you. Three great books to start with are:
- The Ovulation Method: Natural Family Planning, by John J. Billings
- Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health, by Toni Weschler
- Honoring Our Cycles: A Natural Family Planning Workbook, by Katie Singer
No matter which method of birth control you use, opting for one that does not involve hormonal manipulation of any kind will be one of the best moves you can make for your health.
-  Mosher W. D., Martinez G. M., Chandra A., Abma J. c., and Wilson S. J. Use of contraception and use of family planning services in the United States: 1982-2002" (December 10, 2004) CDC Division of Vital Statistics
-  Shufelt C. L. and Merz, C.N.B. "Contraceptive hormone use and cardiovascular disease," J Am Coll Cardiol (2009) 53:221-231
-  Official Web Site for John R. Lee, M.D.
-  Berenson A.B., Breitkopf C.R., Grady J.J., Rickert V.I., and Thomas A. "Effects of hormonal contraception on bone mineral density after 24 months of use," J Obstet Gynecol May 2004; 103(5 Pt 1):899-906
-  Ovu-tech website
-  Mann D. (2003) "The future of birth control," Medicine.net
-  "India to market first male contraceptive injection in 2009" July 15, 2008 Thaindian News
-  "A vaccine against pregnancy?" Feminist Women's Health Center (FWHC)
-  Billings, J.J. (1984) The Ovulation Method: Natural Family Planning, Liturgical Press, 5th Ed.
-  Weschler T. (2006) Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health, Harper Paperbacks, 10th Ed.
-  Singer K. (2006) Honoring Our Cycles: A Natural Family Planning Workbook, NewTrends Publishing