Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
19 Jan

The Pill: What You Need to Know About Oral Contraception

Over the years I’ve received questions about the Pill on a pretty steady basis. As one female reader put it, if you go Primal and do all the work of normalizing your hormones, does taking the Pill undo all the good? Are the cautionary rumors I hear just overblown, or are there substantial risks? What about taking the Pill for a longer period of time? Does it matter if I’m 45 as opposed to 25? Clearly, there are a lot of questions and nuances here. Let’s do what we can to unpack this subject.

Before I begin, let me offer the reasonable caveats. Yes, I’m a guy writing about a women’s medication – a rather personal one at that. I get it. I want to tread gently in these arenas. To be sure, the Pill marked a revolution in reproductive planning. It was the first convenient contraception choice over which women had full control. I don’t want to diminish the personal and social impact of that option. Nor do I want to overlook the convenience and effectiveness that the Pill (when taken as directed) offers to a woman/couple who aren’t looking to start (or increase) a family. There’s a reason some 100 million women around the globe turn to the Pill.

That said, I think most would agree we’re looking at a legitimate health question as well as intimately personal one. From my own humble perspective, I’ll go so far as to say the medical community has done a disservice to women by not being more transparent about oral (and other hormonal) contraception over the years. (Allow me to focus on oral contraceptives today, which are the oldest and most studied form of hormonal birth control.) Women understandably have a lot of questions, important questions. The problem is, the issue too often gets simplified by often well-intentioned practitioners whose main priority is respecting a woman’s choice on the issue. Yes, many personal factors go into the decision, but the conversation between a doctor and patient shouldn’t stop before it’s even begun. Physicians need to acknowledge that women care about the health implications of the decision.

As you all know, I’m first and foremost a supporter (okay, maybe diehard, soapbox, scream from the rooftops, full-on advocate) of full disclosure. People should have access to all of the details for choices they’re obliged to make – whether it be choices involving food, medical procedures, or medications. Although there’s a lot just on the medical side of oral contraceptives, let me do what I can (in the modest scope of a blog post) to at least get the ball rolling.

The fact is, when we’re dealing with matters of the body, there’s no such thing as a free lunch. I think we all know that. Taking hormones on a daily basis (whether natural or synthetic or both) will undoubtedly have repercussions. The body is a finely tuned machine of collaboration and interaction. The shifting amount of one hormone will have a corresponding effect on other hormones, which in turn influences a whole host of other physiological functions and biochemical secretions. But onward with the details….

First a little historical perspective… The dosage of today’s Pill (as many versions as there are) is minute compared to what was initially produced in those very early years. Formulations have changed over time to include lower levels of hormones. The so-called “mini-Pill” contains no estrogen at all. Nonetheless, side effects still exist in part because the human body hasn’t changed (the stubborn vessel it is) and because new formulations contain new versions of the hormones that appear to be riskier than the older versions. As for post-Pill fertility, the evidence suggests taking the Pill doesn’t impair future fertility. I can understand, however, that women would be wary of this possibility especially with new ingredients being added to formulations. I would hope the studies and reviews on this subject continue.

Now for the rundown of health risks – what you’ve heard and what’s true. There’s a lot to cover. Although I don’t claim that a single blog post can cover every study and nuance, let me hit on as much as I can.

First, the “good” news. You’ve likely heard that taking the Pill can lower a woman’s risk for ovarian cancer, endometrial cancer, uterine cancer, and endometriosis. These appear to be true. That said, I obviously wouldn’t suggest a woman take on other risks (forthcoming of course) to slightly lower the chance of developing these conditions.

Breast Cancer

According to research analysis, data from 50+ studies suggest the Pill confers a 10-30% higher risk for breast cancer. Higher estrogen pills are implicated more in this data as is prolonged use of the birth control pill and family history of cancer. Although this heightened risk is definitely worth considering, it is significantly lower than the risks of hormone therapy for post-menopausal women.

Cervical Cancer

In the last few years, there’s been some talk about abandoning pap smears (the procedure that tests for abnormal cervical cells) in exchange for an HPV DNA test. The problem is, HPV is not the sole cause of cervical cancer. The birth control pill is also considered another major risk factor, especially for women who have taken the Pill for five years or more (PDF). If this plan is ever adopted, here’s the message to millions of women on the Pill who are HPV negative: good luck catching any cervical changes early. It’s inflammation at work here, folks. The Pill, particularly estrogen containing versions, causes inflammation.

Gastrointestinal Issues

It’s a known but little publicized fact that increased estrogen can contribute to irritation of the stomach lining and aggravation of existing gastrointestinal conditions like GERD and Crohn’s. Some women are more sensitive to the effect of the Pill on gastrointestinal health. Hint: if your doctor tries to put you on the Nexium (a.k.a. “the purple pill” or any of its assorted relatives), try going off the Pill first.

Cardiovascular Risks

The Pill, particularly traditional estrogen-progestin combination formulations, can raise blood pressure in some women, particularly those who already have high blood pressure. Research also shows that the Pill very slightly raises the risk of stroke in women without stroke risk factors (e.g. migraines and high blood pressure). The difference adds up to approximately a single added stroke per 25,000 women.

Blood Clots

This is one of the risks that’s gotten the most press over the last few years and for good reason. It’s an issue that has dogged the Pill since almost the very beginning. As formulations changed, people assumed the risk would be reduced. But there’s a wrinkle. Newer types of progestins (e.g. drospirenone, desogestrel or gestodene) heighten a woman’s risk for blood clots compared with the older form of progestin (levonorgestrel). Research has shown that women who take a birth control pill with one of these newer progestins have six times the risk of blood clots compared to women who don’t take the Pill. Women who use a Pill with an older form of progestogen have three times the risk of blood clots compared to non-users. The risk for traditional progestin is approximately 10 women in 10,000 each year.

Other Side Effects

Finally, then there’s the more sensitive research that’s come out in the last few years about the Pill’s effect on partner choice. Women’s monthly shift in hormones has implications for their attraction to certain traits in males. Women who met their partners while on the Pill were happier with their partners’ parenting and care taking and were less likely to separate than those who weren’t; however, they “scored lower on measures of sexual satisfaction and partner attraction” and “experienced increasing sexual dissatisfaction during the relationship.” (No comment here, btw.)

So, what’s the take home message? Readers have asked my overall opinion of oral/hormonal contraception. I know what you might infer from the course of evidence here, and you’d be mostly correct. Is there enough medical risk to give a woman pause? Absolutely. Is it enough to discount the Pill as a birth control option for a woman who is otherwise healthy, has no significant family history or risk factors in the relevant areas, and strongly prefers this contraceptive form? No, I can’t say I’d entirely take it off the table. The heightened risks for the above conditions were indeed measurable but generally not dramatic in otherwise healthy, non-smoking subjects who didn’t have significant family histories of relevant diseases. Age doesn’t appear to raise one’s risk except in the case that other risk factors develop (e.g. high blood pressure, etc.).

That said, let me throw in some caveats. I’d certainly favor the lower dose versions. I’d suggest close monitoring by a physician who acknowledges the risks of a hormonal contraceptive. I’d also strongly suggest regular exercise (not the inflammation boosting chronic cardio kind), a consistent anti-inflammatory diet (I think you know one I can recommend.), anti-inflammatory supplementation (fish oil, turmeric, etc.), and vitamin and mineral supplementation. And – although this bumps up against some rather personal factors – I’d recommend looking at other contraceptive options for the longer term. In other words, I wouldn’t suggest being on the Pill indefinitely as some physicians and medical groups say is just fine and dandy to do. Some of these heightened risks (e.g. blood clots, breast cancer) only diminish over a ten-year period after discontinuation. That’s pretty far-reaching.

Yet, I also won’t go so far as to completely count out oral contraceptives because I know every other method has its drawbacks (major or minor) as well. The reality is, there’s no 100% perfectly safe, astoundingly convenient, wholly unencumbered, completely foolproof way to dupe or circumvent nature on this front. It’s not about making a particular choice. It’s about making an informed decision. Not everyone is able to track their cycles with perfect precision. Not everyone tolerates an IUD or diaphragm or spermicides well. Not everyone wants to solely depend on the use of condoms for a host of reasons. Not everyone is ready to go the sterilization route yet. Take all of this, and that’s a whole other ball of wax – and another blog post than this one….

Thanks for reading today, everyone. Share your thoughts on the Pill. What information did your practitioner offer? Have the benefits outweighed the negatives for you, or the other way around? Do you have thoughts/suggestions for women who are considering the Pill? Have a good end to the week, everyone!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. i’m pretty sure my boobs are now massive as a result of starting to take the pill at age 15.

    la la solar wrote on January 19th, 2012
    • I agree. Not to mention, my hormones were so messed up for taking it for 6 years that after I went off, it took over a year for my hormones to re-adjust and I had severe acne and stomach issues.

      Anya wrote on January 19th, 2012
      • Same here, stopped a year ago after ten years of daily use and my acne isn’t very fun att all. Hope it’ll go away!

        Sofia wrote on January 20th, 2012
      • Does that mean your hormones eventually balanced and your skin and stomach issues stopped? Was there anything you did to help the process? I’m going through that now, after being on the pill only 3.5 years though, but, it’s been a year since I’ve been off it (for the second time, the first time around I got frustrated and started the pill again). I think I’m reaching the end because it’s no longer as severe. Any advice?

        Shelby wrote on January 21st, 2012
      • I’m having the same problem.. I’ve had severe acne issues for YEARS and went through multiple accutane treatments starting at age 15 (during which you are required to take BC pills). I strongly believe that I would have been better off had I not been treated with all these dangerous pills since now the only way to keep my acne at bay is by taking BC pills. I hate them…with a passion. But I hate having a face full of zits and the self image issues that come with it even more. I just finished the Primal Blueprint book and am starting my primal journey. My hope is that I can throw my pills away and live acne free without them. I strongly believe that our diet has EVERYTHING to do with what goes wrong in our bodies (duh…you are what you eat, right?). I will be sure to write a success story if and when all goes as planned. :)

        Alysia wrote on January 31st, 2012
    • Unfortunately I never got that result! LOL

      Laurie wrote on January 19th, 2012
      • Me neither, and I started in my mid-teens. No bloomin’ here.

        Janice wrote on January 19th, 2012
    • Same.
      My mother put me on the pill because I was a late bloomer and she was embarassed having a daughter that looked like a 12 year old boy at age 15.

      Now, my boobs are too big for my little frame and I have clots in my legs (purple vein) as a result of taking the pill for 5 years straight.

      Inge wrote on January 19th, 2012
      • I find this interesting. I have never been on oral contraception and am a 36J, while the rest of my family is fairly small chest or average. There may be some correlation between the contraceptive hormones and breast tissue growth, but whether it is causal or not hasn’t been established by any study I’ve seen.

        Still, I am vehemently against hormonal contraception for my own reasons, so I can understand you havering yours, as well! Either way, hormones are prescribed to young girls far too freely without enough explanation of the risks and that is an issue.

        Taryl wrote on January 19th, 2012
        • I took it for over 10 years straight and now that I have been off it for 5 years, it has been easier to manage my weight and pcos. I would never take the pill again..

          Marcela wrote on January 19th, 2012
        • I agree. I asked my doctor to go on the pill and I don’t remember her telling me about the risks or side affects. Granted that was 5 years ago. But obviously our conversation didn’t leave much of an impression on me, especially with side effects such as blood clots that could potentially kill me.

          Not that doctors need to fear monger, but they could at least try to relate the heaviness of the decision.

          Cat Grok wrote on January 19th, 2012
      • Interesting. I’ve had big boobs–at 28GG even bigger than my mom’s–and spider veins since adolescence, and didn’t get on hormonal birth control until I was 25.

        I think what we can take from this is that everybody’s body is going to react somewhat differently, but it’s difficult to really say what caused what when we’re talking long term development without controls or a rigorous study.

        Never Took Home Ec wrote on August 18th, 2012
      • I feel for you. There is nothing wrong with being a late bloomer and she shouldn’t have felt embarrassed for you like that.

        I am against putting hormones in our body. I was looking through contraceptive option that does not use hormones or invasive procedures and found about LadyComp which is a machine that monitors your monring temperature and predict your fertility through analyzing through their database. Worth checking it out.

        fangz wrote on February 14th, 2014
    • Hey, How come that didn’t happen to me? guess I should have started taking it before age 19

      bbuddha wrote on January 19th, 2012
    • OMG!! I totally agree! I think the Pill messed me up big time!

      The best I have felt happened last year when prior to trying for a third baby, I got off the pill and had already been eating Primal! I felt amazing..and my “libido” actually came back! I tracked my cycles and was amazed to see the my cycle went to a normal and consistent 28 days! It was nice to see how my body behaved normally when I wasn’t pumping it full of hormones designed to make your body “think” its pregnant!

      Now that baby number three has been with us for 6 weeks….I am wondering what the best contraception option is…I don’t want to go back on the pill or any other hormone based contraception like and IUD. But we are not ready to make a “permanent” decision yet!


      Joanne - The Real Food Mama wrote on January 21st, 2012
      • Joanne,

        Hi! Sounds to me like your non-hormonal bc options are barrier methods like condom/diaphragm/cervical cap/the sponge, or charting your fertility based on your body temperature with something like the Lady-Comp (there are other cheaper versions of this made by other companies too.)

        I have a Mirena IUD now, but I was curious about the temp/cycle charting :) I am not a big condom fan, but they are pretty cheap and effective, heh!

        Sarah J. wrote on January 21st, 2012
      • What about a non hormonal IUD?

        Jenn wrote on January 22nd, 2012
      • I stopped taking the pill a couple of years ago because dosing myself with hormones daily seemed antithetical to everything else I was trying to do. Around five months ago, I had the non-hormonal copper IUD inserted, and thus far I am so happy with it!

        Some women experience heavier periods and cramping (which I have to an extent, but it’s definitely been manageable and so worth it as far as convenience goes). By far the most inconvenient side effect for me has been not being able to comfortably wear my menstrual cup. Aside from that (and right before my cycle when my cervix is really low), I forget it’s there. No method is perfect, but IUD’s are great, semi-permanent birth control options with efficacy rates similar to those of sterilization.

        Danielle wrote on January 22nd, 2012
        • I’m surprised it interferes with your menstrual cup – that’s a shame! I haven’t had problems wearing mine, although since I’m having heavier periods I have to be more diligent about emptying it.

          Gretchen wrote on January 22nd, 2012
        • Well, I’ve only tried wearing it a couple times. Since I’ve never had kids, I’m a little worried about expulsion, and I read a study claiming expulsion rates are slightly higher with tampons and menstrual cups. To be fair, it could all be in my head. It’s encouraging that you’re able to wear yours, though! I do plan on trying it again; I guess I’ve been waiting for my IUD to “settle.”

          Danielle wrote on January 22nd, 2012
      • I looooove my Mirena. I can’t take oral contraceptives because of a mood problem, but I had monthly bleeding that was so bad my docs were suggesting a hysterectomy. (I’m 34 and they could find no reason for the bleeding.) The Mirena hasn’t caused any of the side effects that the Pill did for me. Also, there’s the Paragard IUD, which is hormone-free.

        Charlotte wrote on January 22nd, 2012
      • Have you tried looking into NFP/FAM?

        It may be a little difficult to start with right after a new baby, but my husband and I practiced it at least 3 years and love it.

        Lindsay wrote on January 25th, 2012
      • Hi Joanne

        Check out Lady Comp. It is something I am consider using for family planning. it is similar to calender+basal temperature method except it does the analyzing for you.

        fangz wrote on February 14th, 2014
    • Me too, huge boobs as soon as I started it at 16/17.

      karen wrote on January 13th, 2013
    • I just went off oral contraception earlier this year after over 10 years of using it, and amazingly enough all my health problems disappeared with it. It think it’s important for every woman to evaluate the potential risks pumping artificial hormones into our bodies can have on us over the long term, because doctors seem more motivated by preventing pregnancy than dealing with the other consequences. For many years I suffered from abnormally large breasts, a very embarrassing problem for my 5’2″ frame. Then over time I began to gain weight for no reason and couldn’t manage to get the weight off no matter what I tried. I suffered from gall bladder problems and needed to have it surgically removed at the young age of 22 and began experiencing terrible anxiety and panic attacks. There was never any correlation made between all these things and my birth control so I never even considered it a possibility. Finally I saw an endocrinologist last year because my cortisol levels were extremely high, my blood pressure was starting to show as high, and I was experiencing new pain again similar to my gallbladder pain previously. She suggested I discontinue my birth control since there didn’t seem to be a different explanation for my cortisol levels being high (tons of blood tests were run) and recheck after a month. Within that first month, my pain had completely disappeared. I regained my appetite, and my anxiety started to improve. Now several months have passed and my breasts are more proportionate to my body, my weight is right where I want it, I am living pain and anxiety free, and it’s like I’m a new person! All this time my birth control was causing all my problems. Thousands of dollars wasted on medical care that was leading me nowhere, when one insightful doctor could’ve probably solved this mystery years ago. I have no respect for doctors who simply look for the easiest solution by treating symptoms rather than finding the root of the problem. This is the biggest issue with our healthcare system today. I’m so happy to say I’m done with all those idiots in the healthcare field and hope I don’t need them again for a very long time. Do not take the pill!!! It’s not worth it! I am in a monogamous relationship and now just use the calendar tracking method to track my cycle and know when it’s safer to have unprotected sex and when it’s not. Any responsible person can effectively prevent pregnancy this way or there are a variety if hormone-free barrier methods of birth control that exist. Keep all those artificial hormones out of your body! Humans were not made to live on synthetic hormones!

      Mandi wrote on April 26th, 2014
  2. Wow, I want to thank you profusely for providing a cautionary, but balanced perspective on hormonal contraceptives.

    My doctors have been very good about discussing the risks of hormonal options, though that’s partially because I’m already well-read on topics that I go to my doctor for. In the past ~10 years, I’ve used a couple of forms of combined pill, the mini-pill, Implanon (a progestin-only subdermal implant), and NuvaRing. Because my blood pressure is sensitive to estrogen (I’m already hypertensive due to PKD), doctors have recommended Depo Provera a couple of times, but I’ve absolutely refused due to the osteopenia and slow return to fertility that result from long-term use.

    Overall, I think a copper IUD is a better choice for women looking for longer-term birth control, but the various forms of hormonal birth control are nice choices for women that tolerate them well.

    Christine M. wrote on January 19th, 2012
    • The IUD is not recommended for women who have not given birth because it tends not to stay put.

      SusynK wrote on January 19th, 2012
      • Actually, it is now considered perfectly safe for women who have never been pregnant to have an IUD. There is a slightly higher risk of it slipping or perforating the ovarian wall (and insertion hurts like a b****), but the risks are still very small.

        I am 23 and have Mirena, the hormonal IUD. The hormone levels are much lower than any other form of BC and localized. I’ve never been pregnant. Also, it’s good for 5 years and only cost $40 with my insurance!

        If your doctor is still following the older recommendation that only women who have given birth can get an IUD, go to Planned Parenthood. They’re up on the most recent research and recommendations, and will be able to give you one.

        Kate wrote on January 19th, 2012
        • I considered an IUD, but the doctor has to verify that your uterus is large enough to keep it in place if you’ve never had children. Mine wasn’t. Also, I’m 29 and plan to have children in the next couple years, so a 5- or 10-year device wasn’t the best option. I had been off the pill for a couple of months (and being off feels wonderful!!!) but I reluctantly started again. Everyone thinks there are so many options for birth control, but there’s actually only a few! Rule out IUD, partner hates condoms (and has a latex allergy) and you’re basically back to the pill. I don’t trust natural planning right now because I’m getting married in a few months and a slip would mean a growing belly under my fitted wedding gown!

          Thanks for a great informative article, Mark. I know birth control isn’t exactly primal and I appreciate the balanced perspective. Those of us who aren’t ready for babies need a realiable method – at least we can be aware of the risks involved and measures we can take to counteract them somewhat.

          ltruss wrote on January 19th, 2012
        • I agree about IUDs! They’re awesome (particularly the non-hormonal, copper IUDs)!

          I have had a copper IUD for seven years. I have never been pregnant, and have no interest in having children–or taking hormones. It is true that some doctors are still under the (outdated) impression that women who have not had children shouldn’t have IUDs. Fortunately, the doctors who are up to date on the current research know that it is a viable and excellent option for most women. I love that the copper IUD works apparently by changing the pH balance of your uterus — it’s similar to the change that happens when you’re eating Primally!

          I have never had any issues with the IUD falling out, tearing the uteran walls, or anything else, other than the initial pain when it was inserted. In my opinion, if you have a regular partner (remember: the IUD provides NO PROTECTION from STDs, nor does the Pill), the copper IUD is a fantastic form of birth control. There is literally no opportunity for user error. The doctor inserts it and, with the copper IUD, you don’t have to remove or replace it for 10 years. (I think the hormonal IUDs have to be replaced a little more regularly, but I’m not sure.) It’s incredibly cost-effective, incredibly easy, and relieves you of the constant need to “remember to take your Pill” and all of the worry that can accompany those days when you forget to take the Pill (or forget to renew your prescription, etc.).

          My mom suffered very negative effects from the Pill when she was a young woman, so I was wary of hormonal birth control from the start. I am happy–and hopeful–that the growing body of research about the risks associated with the Pill and other hormonal contraceptives will reach more and more women, so that they can all make educated decisions about what it best for their own reproductive health. Thanks for this great article, Mark!

          MKM wrote on January 19th, 2012
        • I never had kids and have a copper IUD and am a huge fan. Pain is intense but shortlived. But I am sure there may be other side affects here, but certainly preferable to side affects of the pill

          Amy wrote on January 19th, 2012
        • The Mirena made me crazy. After about two years, I starting having major anger issues. I could barely control it. I also lost my will to try new things and became depressed. It was totally out of character for me. I finally figured out it might be the Mirena and had it removed. That was a year ago, and I was totally back to normal after a couple months. I’m afraid to try the copper one, so we chart to avoid pregnancy until he gets a vasectomy when we feel we are ready.

          wendy wrote on January 20th, 2012
        • I have a few friends who have said the Copper IUD gave them major cramps and heavy bleeding during their periods!?!? Sounds horrible really!

          Joanne - The Real Food Mama wrote on January 21st, 2012
        • I recently switched over to the copper IUD (From Nuva Ring). I was nervous as I have never had children, so I knew my risk for my IUD not sitting right (and insertion does hurt like a b****!). But I actually had no problems, everything is going great. Yeah my first period was hevier than usual, but I think my cramps were more from my body adjusting. And it doesn’t hurt to check with your insurance, I received my pre-testing visit, my insertion visit, and my follow-up ultrasound for one co-pay of $25!! And that will last me 10 years if so choose to keep it in the whole time.

          Ashley wrote on January 23rd, 2012
      • The reason that the IUD has only been associated as an option for women who have already had kids for so long is because back in the early days of it getting approved by the FDA, it was easier for them to get approval for it under that clause than for all women in general. It does seem to be true that slightly more issues tend to arise with women who have not had kids, but that doesnt mean it isnt good for any woman who hasnt been pregnant. It has been approved for all women in other countries with different medical approval regulations for almost its entire existence.

        This article in, believe it or not, Wired is actually a very good discussion of the history of the various types of IUD

        I got the copper IUD (paraguard) last fall after many, many years of being on hormonal birth control. So far I am happy with it, although I am starting to worry that so many years of HBC might have thrown my hormones for such a loop that I will never be able to recover fully.

        cTo wrote on January 19th, 2012
        • I had the copper IUD for 10 years, but the monthly cramping and flow was terrible. I switched to Mirena, but I do worry about the hormones, even though they are very small. Good thing: the cramping and flow are now minimal to none.

          Jennifer wrote on January 19th, 2012
      • My doctor told me I couldn’t get the IUD — because it can sometimes cause permanent infertility!

        Christine wrote on January 19th, 2012
        • That’s exceedingly rare now and usually the cause of poor insertion on the physician’s part.

          Jen wrote on January 19th, 2012
        • I’m a women’s health practioner (midwife, actually) and IUD’s don’t cause infertility. This is info from the 70’s. Back when they hadn’t identified chlamydia, and there was a lot of unprotected freelove going on…and Pelvic Inflammatory Disease. PID is easier to develop with an IUD in place, however it you are no more likely to contract chlamydia or gonorrhea with an IUD than without. It’s actually unprotected sex that causes infertility, if you want to look at it that way. IUD’s are the safest contraception yet invented in the history of trying.

          Jennifer wrote on July 14th, 2012
      • I have never had a child and I have an IUD. I also have multiple lady friends that are in the same situation and none of us have had any issues with it. It’s a little more painful to insert if you have never birthed a child.

        I have paraguard (copper, no hormones) and I love it. My libido was goinf extinct on oral bc. Now, it’s back and my body feels so much better. :)

        Babs wrote on January 19th, 2012
      • From what I understand it is 100% ok to have an IUD without having a kid first. I have a copper one.

        I think that the insurance companies in the US want the monthly money vs. the one time 5-10 year cost. I could never get one when I lived in the States, but have not problem living in Europe (Norway exact, where we have Social Medicine) getting one.

        I love mine, I would be devastated if I could not have it – there is no way my body could handle the extra hormones.

        Fonda LaShay wrote on January 20th, 2012
      • This is incorrect.

        As a healthcare provider who does IUD insertion, I can tell you that the uterine size is not the determining factor. The cervix and any stenosis or inability to pass an IUD insertion tube through (the tube is slightly smaller than a pencil diameter) is what determines the difference between a woman who has never had a pregnancy and one who has been pregnant before.

        Amy L. wrote on January 20th, 2012
      • I have a copper IUD and no kids. No problems at all.

        Jenn wrote on January 22nd, 2012
    • I thought the copper IUD was unsafe for long term use due to build up in the body and the risk of copper toxicity?

      My doc and I discussed all my options and the main reason the for my decision is that the IUD is not recommended for women who have heavy flows. She said that many women get heavier flows and longer periods when they get an IUD.

      I scoured the web for information. My doctor and I discussed at length the different options and, the pill is really the only thing I can see for me even though I don’t think it’s ideal.

      We then discussed WHICH pill she would prescribe and why. For me, with my health, PCOS and other factors she prescribed the generic Alesse.

      We do what we have to do and what’s right for one person doesn’t always work for another.

      I wonder if there’s a good/healthy way to mitigate and keep hormonal balance while still on the pill.

      Sonya wrote on January 19th, 2012
      • I have not herad anything about the copper IUD being unsafe for long-term use. The fact that you can use a single one for up to 10 years seems to refute that.

        It is true that the copper IUD will cause heavier periods though. I’ve had one for 6 years now and experienced heavier periods initially (about the first year). For me, the IUD has been ideal… and like others have said, you don’t need to have already had kids to get one. I’ve never been pregnant.

        I really wish more doctors would tell their patients about the copper IUD as an option. Almost none of my family and friends had ever heard of it until I got it. All of them have been on the pill for 10 to 15 years at this point without ever even considering any other options.

        Nikki wrote on January 19th, 2012
        • I would like to offer a reminder that everyone’s body is infinitely different, exposed to different environments, and regardless of what doctors say is true for everyone, any individual might be an exception.

          To illustrate, as a teenager, I began a very irregular period at age 13. I never bled monthly, and often had six-week-long bouts of spotting with three months of nothing in between. I took oral contraceptives from age 15-19, which made my periods regular and my breasts a size bigger.

          When I quit taking the pill, I didn’t have a period for four years. (I also went from a B cup to A, probably in part caused by exercise bulemia from ages 20-24.) Then I had several anovulatory periods and a few “real” periods over a couple of years before I was diagnosed with celiac disease. Quit gluten and got a few more periods, but with little regularity and still lots of spotting.

          Never pregnant, I got a copper IUD about 5 years ago. My periods stayed erratic and I developed what my doctor called endometriosis. The worst menstrual pain I can imagine, I could do nothing but lie on the couch with pain killers and wish myself asleep to make the time go by. The bleeding was also extremely heavy. This was all new for me, having never had cramps or heavy bleeding before. Tried herbs and progesterone creams with some relief, but not enough.

          But after starting (and diligently, happily continuing) a primal-type diet last April, I started having periods about every 30-45 days, and ovulating, too. I think they call that “normal.” Since then, my periods involve very little pain and only about a day or two of significant (not overly heavy) bleeding. I feel so much better (and I still have the IUD).

          Lots of confounding factors to muddy the waters. But as with most things in life, I seem to be teasing out a mixture of contributors to my process of healing, many, many of which I have not mentioned here.

          While I think studies and averages can be of incredible importance to making health decisions, adding in others’ and my personal experiences leads me back to a fuller understanding of my unique and not-so-predictable individuality.

          Thank you to all whose comments have enriched me, and to Mark for bringing this community up-to-date on a hugely important and personal issue.

          hew wrote on January 19th, 2012
      • My Mirena IUD has pretty much rid me of the heavy flow I used to have.

        Heather wrote on January 19th, 2012
        • Many of my friends love the Nuva ring.

          moreporkplease wrote on January 19th, 2012
      • No risk of copper toxicity unless the user has Wilson’s disease which involves an impaired ability to eliminate copper from the body.

        rrustad wrote on January 19th, 2012
      • Some women who have a copper IUD benefit from a zinc supplement. The balance of the minerals is the key.

        Jen wrote on January 20th, 2012
      • I had the copper IUD, because I can’t tolerate birth control pills. It did make my already heavy cycle much heavier. I put up with it until it slipped out of place and stabbed my husband, if you know what I mean…it allowed us to wait to have our second until we were ready though. Condoms are how we ended up with our first. It seems like it’s all a trade-off.

        rabbit_trail wrote on January 21st, 2012
      • The Mirena IUD has a tiny amount of progestin in it and gives you 90% less menstrual bleeding and cramping after it’s settled into place over a few months. No estrogen. Maybe a better option for you than pills if you’re not prone to painful ovarian cysts, though the Alesse is most likely indeed the best choice amongst pills, given your history. Your PCOS should resolve on Paleo/primal, then any ovarian cysts will diminish and you might try a Mirena. Good luck!

        Jennifer wrote on July 14th, 2012
    • Thank you so much Mark for addressing this!

      I finally got off hormonal b/c about six months ago and went with the copper IUD instead. For those of you nervous about it, I have always been a very heavy bleeder with horrible cramps and back aches. The pill made these symptoms better but I was unhappy about taking hormones. Since transitioning, my periods have been regular and, after the first month, my periods are totally normal. I’m not pain free, and I do have heavier bleeding than with the pill, but it is by no means worse than before I started the pill, and I think it’s actually a bit better.
      Do your own research and make your own decisions, but going hormone free for me has been one of the best choices I have made for my body, besides going Primal.
      I feel less moody, less bloated, and have much more sex drive than before. I’m back to my normal self!

      Eryn wrote on January 19th, 2012
    • After a horrible experience on Yaz, including extreme mood swings and depression, I researched all the options and went with a copper IUD. After the first few months of readjustment to slightly heavier/longer periods, I’m extremely happy with it. If I follow a primal diet, the copper side effects are minimal.
      On a side note – the IUD WAS not recommended for women who haven’t given birth because the implantation used to be dangerous (higher risk of piercing and/or expulsion). Newer methods make insertion just as safe as for women with children and risk of expulsion is only minimally higher.

      Ashley S wrote on January 19th, 2012
    • Do NOT do Depo… I had the worst effects on that ever, including loss of libido, excess facial hair growth, dryness (down there), and poor weight management. Bad decision on my part. Lesson learned.

      Erin wrote on January 19th, 2012
      • I had the same problems! I do think when I quit last Sept., primal diet helped me get my period back sooner (was on it 2 years and off for 3 months before I saw a period). Typically it can take over a year. But then I started having a period every other week, so I had to start the pill to help take care of that. I wish I had never taken any of it…

        Emily wrote on January 20th, 2012
      • I had the same problems on Depo. I wouldn’t suggest it for anyone! I just hate that I was so young when I started it (at 17) and didn’t yet have that full understanding that you can harm your body, even if the doctor says it’s ok. Seven years on it, I finally did the math and had a wake up call.

        Ashley wrote on January 23rd, 2012
    • Except that an IUD can act as an abortifacient, and is therefore unacceptable to most women.

      Julie wrote on January 19th, 2012
      • ? most women

        mommymd wrote on January 20th, 2012
      • So do oral contraceptives if you want to get technical. And exactly… Most women?

        I was on oral bc since I was 16 and my period hadn’t started. I kind of feel like all my problems are the results of high steroid use when I was younger due to asthma. Lots of medical history I’m sure thousands of people would use to say medicine is bad. But I’m still here kicking and successful so I can’t complain at all. My doctor actually took me off oral bc and replaced it with the Mirena. I’m 24 and never been pregnant. He said that it would be more effective due to the hormones being more isolated to my reproductive organs rather than traveling my diabetic circulatory system. My boobs grew another cup (C to a D) and my libido maybe return to normal range ( use to be horny to super horny lol).

        Women just need to educate themselves and see how their individual bodies react as well. Women need to decide what is best for themselves.

        Amanda wrote on January 20th, 2012
      • Thank you for mentioning this. Many women do not realize that both the iud and hormonal contraception can work as abortafacients. If this is a moral concern for you and your partner, investigate the details. Mark, Thank you for all your great work.

        Karen wrote on January 21st, 2012
    • I’ve heard many women who are perfectly happy with the copper IUD which is really great. However I do want to tell you a little bit about what I went through after having it inserted. Just so you know it’s not all as dandy as the product website makes it seem. While having it in I experienced extremely bad bloating and stomach distention, I stopped ovulating and menstruating, I had horrible cravings, chronic fatigue, I gained 30 lbs, lost libido, my hair got thinner and brittle and I was diagnosed with copper toxicity. I kept on thinking the side effects would ware off but after 4 months I finally had it removed. Now almost everything is getting back to normal after a year of frustration but even 10 months since the removal I still don’t have my cycle back… On the bright side it never fell out or hurt… yay…

      Personally I’ll never mess with my hormones again. Now I use the lady comp, a simple little fertility monitor which I’m super happy with. No hormones, no drugs :)

      NatLeo wrote on January 19th, 2012
      • Hi NatLeo,

        I’m curious about your use of Lady Comp. I just looked it up, and plan, when I have time, to read up on clinical trials. I’m an IUD user but would prefer to use only natural birth control. I have very irregular periods and feel skeptical about how reliable natural methods might be for me. But I see you still don’t have your cycle, and use Lady Comp. How does it work for you if you don’t have cycles? How can it know if you’re fertile? Is it entirely based on your temperature? Do you use anything else, or just avoid the “green” days when you’re fertile? So skeptical, but hopeful : )

        hew wrote on January 20th, 2012
    • If you can tolerate it well, the copper IUD can be a great choice. Hormone free, lasts 10-12 years, nothing to remember to do. I had one and loved it, but my kiddo was conceived and carried with it perfectly placed, so I’m too superstitious to go back. Even 99.6% isn’t perfect protection. I plan to try the Mirena next, since it’s such a low hormone dose.

      ACOG’s official statement is that the IUD is fine for women of all ages, whether or not you have had children.

      Other Kate wrote on January 20th, 2012
  3. The minute I was old enough to ditch the pill and get sterilized, I did. I’ve never wanted children & never regretted it. Just wish I didn’t have to be on the pill at all. I was on it from ages 18-25.

    SusynK wrote on January 19th, 2012
    • Omg, same here lol.
      I never wanted kids either and was so thankful when I found my husband who didn’t want any either. Rescueing wildlife (and our dogs) is our mission in life, and so is world travelling.
      He then found out that he can’t even have any, he is infertile since he smashed his balls during motorcross…lol.
      So I haven’t had to take anything at all since getting married, which was 18 years ago :)

      I think this was a HUGE contributor to my overall health that I remained my entire life.

      Inge wrote on January 19th, 2012
  4. I almost died from a blood clot due to the pill when I was 25. The clot damaged the veins in my leg and I developed another clot about 10 years after the first one. So now I am on blood thinners for life. Every doctor pushed the pill on me and all pooh-poohed the risks, stating I was too young and didn’t smoke so no need to worry about clots and strokes. After my clot I heard many, many stories from nurses and hospital workers about women with clots in the hospital.

    Now, at 52, I am healthy. But very lucky to be alive. Caveat emptor.

    HillsideGina wrote on January 19th, 2012
    • Do you have Factor V Leiden? Did they check? This condition is a clotting disorder and one should never take the pill if they have it. (one copy of the gene is heterozygous, two copies is homozygous)

      Milemom wrote on January 19th, 2012
      • No. I didn’t have any underlying conditions. But after you have a DVT you are much more likely to have subsequent clots. So now I have an “acquired” condition.

        Also, doctors do not run diagnostic tests on women to determine whether they have conditions like Factor V Leiden and others before prescribing the pill.

        HillsideGina wrote on January 19th, 2012
        • That is really bothersome that more diagnostics are not performed on this issue. Both before and during, it should be mandatory, in order to determine the best course of action for women.

          Goodness though after reading all of this, I don’t think I’ll ever complain about a condom again. What a p.i.t.a…I conclude that as natural as possible is the best way to go, at least, in absence of detailed and ongoing diagnostics.

          Kenny wrote on January 20th, 2012
  5. I was literally thinking about this earlier today as I was awake (too early) with my toddler 😉

    Carrie S. wrote on January 19th, 2012
  6. Thanks to my upbringing (Cathoic, with a Mom who favoured the Billings Ovulation Method and a regular, problem free cycle) I never required oral birth control. I know that not all women favour this choice or are “lucky” enough with their cycles to be able to never take oral contraceptives. That said, there is never a day that goes by that I am not thankful that my body has been allowed to do what it needs to – naturally. Now here’s to hoping that menopause can also be met without medications . . . :)

    Mrs. Griffin wrote on January 19th, 2012
    • Ha! I was lousy at the billings method, my lovely 18 year old middle son is testament to that! But I agree if it is at all possible hormones are a tricky choice to make. I fund going on them the last time after my third son, that I went completely off the wall, moody, screaming, throwing plates… We ended up with a diaphragm, which took a bit of getting used to and some hilarious moments trying to insert it and having it ping off walls!
      Now at 50, recovering from metabolic syndrome, with the primal way of life, reading this reminds me of how little I was told of the options in my fertile years.

      Heather wrote on January 19th, 2012
  7. Very good post Mark. I especially appreciated you stating the absolute risks (eg cases per 1,000) instead of just the relative risk (eg 3-fold).

    If all the articles on this site did this it would make the risks and benefits we are interested in much easier to understand.

    Tim wrote on January 19th, 2012
  8. I tried taking it a few years ago but went off it as it made me nauseaus and completely shut off my emotions. I tried to go on it again recently, but a different kind and thought id give it the three months the doctor reccomends for it to fully settle in my system, but it still didn’t agree with me. I was crying over everything (like those Hallmark commercials),it messed up my cycle, I got really depressed and the veins in my legs became very noticeable very quickly…so i went off it after a few weeks…to me that wasnt worth seeing how it would be after 3 months if I was feeling great before I started. I know people react to the pill differently so hopefully not too many get to experience that lol.

    Ashley wrote on January 19th, 2012
    • I have been on and off the pill for nearly 20 years. Each time it gave me headaches and made me feel nauseous. I ended up feeling not myself for the time I was on it. I hated being on the pill. (And over the years, I tried all sorts of different combinations and with no noticeable difference in side effects.)

      Best thing I did was ditch the pill and listen to my body and pay close attention to its nuances. It’s remarkable how much I learned about myself by just closely observing myself throughout the month.

      Happycyclegirl wrote on January 19th, 2012
    • I never thought about the veins in my legs being shown due to the birth control. I just went and looked and the veins are completely gone now! I never would have guessed that the stupid pill was the cause of that!

      Darcy wrote on January 19th, 2012
      • awesome! what a nice surprise :)

        Kenny wrote on January 20th, 2012
      • I had an endocrinologist who didn’t like me because I hated taking the pill — granted, I had PCOS and needed some kind of treatment, but I was a teenager and wasn’t sure whether I trusted grown-ups or not. I remember once I asked about the veins showing and he said it was because I didn’t exercise enough, and made some rude comment about my physical condition.

        Now I know why he was so touchy about it…

        tangle wrote on January 23rd, 2012
  9. What about women who take the oral contraceptive in order to keep our hormones in check due to endocrine disorders such as PCOS? Guess I’m screwed either way =/

    Jessie wrote on January 19th, 2012
    • Jessie… there are some natural options out there that work a lot better. The pill only treats one aspect of hormone balance, but there are supplements and herbs that address a wider variety of the causes and symptoms. The primal diet that mark suggests helps a lot, but some other herbs (Maca, Red Raspberry Leaf, Natural Progesterone Cream and others) can really help too.

      Katie wrote on January 20th, 2012
      • I was wanting to ask the same question. I have a hormanal imbalance that I am almost certain was caused from being on BC for nearly 10 years starting at age 15. When I stopped I gained a ton of weight verrrry quickly, I had crazy acne all of a sudden and bizarre hair growh that I never had before. I started getting regular headaches and the list goes on and on. After meeting with a couple doctors and countinually monitering my imbalance the only suggestion they had was for me to go back on the Pill to try and get things back in order. (I tried for 6 months for it to balance itself eating strictly Paleo/Primal). All of the above symptons stoppped immediatly, my breats got larger again instantly and I feel nasuas every morning. Feeling lost and frustrated because obvioulsy I can’t be on bc my whole life and my hubby and I are anxious to start our family, but I have been so nervous to get pregnant with all these crazy things going on inside my body.

        Mark I am so thankful for you writting this blog because I have been so curious. Athough in my situation I still feel a little lost and confused…Would love feedback if anyone can relate!

        MLARA wrote on January 20th, 2012
        • try reading everything you can find about iodine. There’s a Dr. Jorge Flechas who specializes in using iodine as treatment for his patients. You can probably find some interviews with him online. Also be sure to check all the personal items you use such as shampoo, conditioner, lotions, etc for parabens (they act as estrogen) and contribute to problems. Tea tree oil and other things can have estrogenic effects too. I hope this helps.

          Wenona wrote on January 21st, 2012
        • I’ve been using a product called Estrobalance for about a month now and I feel so much better! I too was having hormonal balance issues with anxiety, depression etc. and my natural food store lady recommended this product and I felt better after the first day! Its supposed to rid your body of excess estrogen. You can check it out online, good luck!

          Amy wrote on January 24th, 2012
  10. On the other hand, there are those of us for whom the Pill has a stabilizing effect and finally lets us feel normal, for instance in cases of (even mild) PCOS.

    I’ll happily stay on my Pill for as long as possible, especially given that “au naturel” I have the opposite of the listed issues: low blood pressure, excessive androgens/testosterone, moodiness, irritability, depression, risk for endometrial cancer, etc.

    My wishes in terms of future research would be more personalized medicine, making it possible to tailor specific hormones and their combinations to specific women, based on *their individual* hormonal make-up. At the moment, a lot of it is just educated guesswork based on population statistics. “Try this pill and let’s see what happens” is not the ideal state, and particularly ineffective for those people who are in some ways non-standard, or merely outside the average.

    Ella wrote on January 19th, 2012
    • Yeah, that would be absolutely amazing if science was ever able to individualize medicine like that!

      Abby J. (formerly C.) wrote on January 19th, 2012
      • Absolutely!! I never felt better than when I was on the pill but really wanted to go au natural when I went primal but I’ve been miserable and have more of the awful side effects of PCOS than I did when I was on the pill.

        I would so like the option for personalized hormonal balancing for health and birth control.

        Sonya wrote on January 19th, 2012
    • “more personalized medicine”

      But there are many doctors who will do this. Just march into your endo and pay for the tests – then let him presecribe. It’s a cash service: if you’ll pay the $800 for the tests, then you can get the correct prescription, which shouldn’t cost your more than a couple thou a year. So you can solve your problems for probably less than $3K. Which isn’t a lot if you think about your quality of life. :)

      moreporkplease wrote on January 19th, 2012
      • Interesting, I guess the best option is to bite the bullet early then and pay for the extensive testing (and perhaps ongoing later testing).

        Kenny wrote on January 20th, 2012
    • I agree. I have been on the pill on and off for about 27 years. I have had HORRENDOUS periods and life threatening depression when not on the pill. When I was in my late 20’s, I was told I was infertile and stopped taking the pill. I was pregnant 3 months later. When I tried natural family planning, I was pregnant within 4 months.

      I would love to try to go off of the pill, now that I am living a different lifestyle, but the depressive issues scare me. I do not have the depths of depression I did before going back on the pill.

      I am conflicted to say the least.

      Victoria wrote on January 19th, 2012
    • Getting off the pill was one of the best choices I made. Actually, it’s how I found out I had PCOS in the first place! Avoiding grains and sugars and eating plenty of good fats has taken care of the PCOS symptoms and I was able to regulate my cycle (although it isn’t like clockwork and it’s a bit longer than the average). Over two years of eating right and exercising allowed me to conceive within 6 months (after initially being told that I would likely need medical intervention).

      I will NEVER take hormonal contraception again! It’s a mask that makes it difficult to naturally manage hormonal balance when you have PCOS. Also, before taking the pill for 5 years, my cycle was like clockwork and I had no issues, so I can’t help but be suspicious of hormonal contraception.

      I would consider using a copper IUD perhaps after my childbearing years, but it’ll be condoms until then (as long as I’m not trying to conceive or pregnant). Fortunately, my partner is fine with that. He knows that me getting off the pill and making lifestyle changes has allowed us to conceive naturally.

      Viv wrote on January 19th, 2012
    • agreed, pharma should be working on better diagnostics options before trying to make more “possible” fixes to replace the last generation of “possible” fixes. However, do they have the incentive?

      Kenny wrote on January 20th, 2012
  11. I’ve been on the pill since I was a teenager, over a decade now. I’ve never had negative side effects, and enjoy the benefits (short and light period, little cramping, no babies) and convenience. Yet, now that I am Primal, I worry a lot about the long-term risks. I’ve seen mixed research regarding cancer risk, but it’s scary nonetheless. For now, the convenience and not wanting to get knocked up is winning out!

    Amy wrote on January 19th, 2012
    • I was on the pill for 6 years and never had any side effects whatsoever. It was when I went off, that I suffered from severe acne and stomach issues for over a year as my body and hormones re-adjusted.

      I went off of it after going Primal for those same fears about cancer and just generally of putting something so unnatural into my body.

      Anya wrote on January 19th, 2012
    • Just went off the pill in October after being on it for 18 years! That’s over half my life!
      The pill was prescribed back in HS due to heavy cramping. Senior year a laparoscopy discovered endometriosis.
      I never questioned any of this until going primal. (I’ve started questioning a lot of health/nutrition choices recently.) I spoke to my doctor about why I’m on the pill and told her I’d like to try going without now that I’ve changed my lifestyle. She said it was worth a shot and told me to call her if it’s not working.
      So far so good. Here’s hoping.

      Beth wrote on January 19th, 2012
    • I too was on the pill for over twenty years straight, never going off. All Doctors over the years said it was beneficial to stay on the pill. Well, now with Leaky Gut and a “rash’ of problems… Finally after seeing someone in Chinese Medicine, who was concerned with my whole body, not just a symptom, my body is straightening out. A year ago I started with an elimination diet and it’s now basically Paleo. Hormones are still out of whack, but I’m on my way. I would highly recommend finding a non-hormonal birth control.

      Christine wrote on January 19th, 2012
  12. I was on the pill for about 5 years, and it gave me migraines, about 1 every 3 or 4 months. I didn’t realized the pill was the cause until I stopped taking them and never got a migraine again. I went back on the pill after my second daughter, but opted for the mini-pill, thinking it might curb the migraines, but all it did was give me my period every 2 weeks (sucks!) and totally deprive me of my sex drive (double sucks!) so I went off the pill. We successfully used the “pull and pray” method for 3 1/2 years until my husband got a vasectemy. (This was husbands choice as he hates using condems.)

    Meesha wrote on January 19th, 2012
  13. I am surprised the total primal option – periodic abstinence / natural family planning – has not been really mentioned. I have used it successfully for 25 years, both to avoid and have kids (I have three, all planned). It’s method effectiveness is as good as the pill, and practical effectiveness is as good as your motivation. Anyone who can make the primal lifestyle work should have no problem with natural family planning.

    Damien Gray wrote on January 19th, 2012
    • I am really happy to learn that this method worked for you. I have a friend with three children who swears by it. However, in my case, it didn’t work so well as we ended up with an unwanted pregnancy that caused us a great deal of distress. My husband has since got a vasectomy. Though we worried about the risks of that procedure, it is the most wonderful thing to not have to stress about conceiving anymore. It makes sex a LOT more enjoyable!

      Sabrina wrote on January 19th, 2012
    • Damien,
      As one who used the natural family planning method while Primal and got pregnant, I would suggest otherwise. It’s a wonderful option that I practiced for a few years successfully, but it’s not foolproof by any stretch – especially for some women. Now that my husband and I are assuredly done building our family, I would never depend on that method – especially as perimenopause (with its random cycle shifts) looms on the horizon at some undetermined time.

      Jen wrote on January 19th, 2012
      • One more thing…the periodic abstinence part of that method is a real pain considering most women’s libido peaks around ovulation! Who wants to give up the best time, so to speak?? The method usually ends up becoming a part-time condom routine, which is less than 100% effective.

        Jen wrote on January 19th, 2012
    • Abstinence=no fun!

      Amy wrote on January 19th, 2012
      • not true! 25 years married 5 planned children, and I have soooooo much great data to talk menopause with my obgyn. And there is quite a bit to be learned about “natural family planning” Billings, Sympto Thermal(my choice) and now the Marquette model are all different and can fit even the fussiest of life styles and cycles. And if you are motivated to do it, the days of abstinence are very very few. I’ve taking hormones a couple of times to handle irregularities after pregnancy or in perimenopause. The best success has been with compounding pharmacies, where they can truly fit what a woman needs. BTW, studies show that estrogren is protective against Basal cell carcinoma – although not other skin cancers. So while this thread is about contraception, it is really necessary to look at hormones as medicine/HRT as well. I’ve had much more success with dietary changes than with using hormones. And our fish will be much happier if we women could stop peeing estrogen into their habitat.

        Christine wrote on January 19th, 2012
    • I know someone will respond. But extended breastfeeding and old fashioned “pulling out” works for us. 2 kids, nursed each for just over 2 years. Got pregnant the day we tried both times (14 days after period). Was on the pill 10 years, been off for 7 years… first pregnancy attempt was 2 months after stopping. I know this isn’t a guaranteed method…

      nicole wrote on January 20th, 2012
    • Yes, I would love to see a follow up post about Natural Family Planning. I just read the excellent book “Taking Charge of Your Fertility” and plan to use this method from now on. I wish I had known this was even an option when I got married 5 years ago. I also feel that if I had known the day I ovulated when I got pregnant, I would have been able to avoid a probably unnecessary labor induction with my son. This is the only method that can be used for pregnancy avoidance and pregnancy achievement! It’s also a powerful diagnostic tool for a woman (and her partner) to understand her body and the way it works. Please consider a follow-up or a link love on this topic!

      Allison wrote on January 20th, 2012
      • “Taking Charge of Your Fertility.” WOW!!! I cannot recommend this book enough, especially for the Primal community. The information is fantastic and I guarantee most women will be amazed about how uniformed they’ve been. At least I was.

        *Note: this is not the old-fashioned Rhythm Method, it’s charting your daily temperature and cervical fluid (aka discharge) so you’re aware of when you’re fertile/infertile.

        If you’re disciplined enough, which many in this community are, you’ll find this method of preventing pregnancy (or conceiving) to be truly Primal, and an eye-opening way to being in-tune with your body & cycle. I recommend reading the book to see if its an option for you.

        travelgirl wrote on January 21st, 2012
        • I agree completely! Huge huge thumbs up for this book (Taking Charge of Your Fertility)… I’ve been charting for a few months now, and got used to it pretty quickly. At first I was frustrated because I couldn’t see a pattern, but that was because I ingored the fact that I needed to set an alarm to take my temp at the same time each morning (as much as possible). This is my second month doing that and it has been so amazing to see my body’s pattern and workings. Really awesome to get in touch with that.

          If I had known about this book and method three years ago, I would have never gotten on the pill. I dealt with stomach issues my first year on the pill, then eczema came the second year and hasn’t left yet. I’ve been eating “primal” for the past couple of months, and if I need to get extreme to beat the eczema, I’m going to put myself on the GAPS diet.

          RSL wrote on January 24th, 2012
  14. Thank you for such a balanced and thoughtful consideration of the risks of the Pill! It’s hard to find a discussion that isn’t the obvious lie of “everything is fine, these aren’t the droids you’re looking for, move along” or the other extreme of “hormones are always bad and nobody should take them”.

    I took the Pill for about 3 years before I read any serious discussion of the risks. I thought that I had tolerated it well, but when I decided to go off of it I was surprised at how much things changed. I could feel my emotions again – for a month or so, it was a bit of constant PMS, but it really helped me moved forward in life. Plus, my sex drive came back!

    For a year or so my partner and I depended on cycle tracking and condoms, and it was a little nerve-wracking, but better. Then I got a copper IUD (free with insurance!) and I LOVE it. I considered the Mirena but I couldn’t buy the company’s information about “hormones are localized, but your period might stop and ovarian cysts and acne are common side effects”. The insertion sucked, but now I’m protected for 10 years. Totally worth it.

    Gretchen wrote on January 19th, 2012
    • Totally agreed, Gretchen. Yeah for Paraguard!!

      Jen wrote on January 19th, 2012
      • Ditto. I LOVE my Paraguard. Insertion was NOT fun (I’ve never been pregnant) but otherwise this thing rocks!!

        AustinGirl wrote on January 19th, 2012
    • Agree! Insertion and the next few days were less than pleasant, but well worth the peace of mind and the return to my natural self (mood, body, drive) after years of being on the pill. Why don’t more doctors mention this option? I only found out about it from another Primal person this year!

      Eryn wrote on January 19th, 2012
  15. I was on the pill from ages 16-27.

    I ditched it about six months ago in favor of a natural family planning method (I am in a committed relationship where we plan to have kids, just not quite yet, so we are okay with the risk — it is working out great so far). I never had any problems with the pill. The ONLY thing would be slight spotting mid-cycle over the last few years. And actually, I think a lot of the spotting happened whenever I drastically changed diet and/or exercise, so there was other hormonal stuff going on.

    I expected/hoped to see some sort of difference after stopping the pill, as per anecdotal evidence (e.g., weight loss, improved energy, mood or sex drive), but I feel pretty much exactly the same. Periods are basically the same too (minor cramps at worse, moderate bleeding, no biggie overall). The good news is that my cycle is perfectly regular (almost 28 days to a T, the first month off the pill). I credit primal in part for that.

    I guess the point is that I had/have no major complaints about the pill and no anecdotal evidence to back up any problems resulting from using it. Any issues that I may have or have had would be below the radar. My mom took the pill for a few years, then had four kids no problem, and hasn’t had any problems associated with it that I know of.

    Michelle wrote on January 19th, 2012
    • I’m in the same boat as you. I was using the NuvaRing until recently, but when the time to renew my prescription came around, I just decided to skip it in favor of condoms-only since we plan to have kids, just maybe not quite yet.

      No real improvements in weight, mood, sex drive, etc. either. Blood pressure came down a bit, but went back up with stress. Whee! :)

      Christine M. wrote on January 19th, 2012
  16. Great article Mark (examplary of what I find so great about this site) and a much needed conversation for couples, doctors friends etc. to have.

    It always made sense to me (and I have has a sense of) the differences in female libidos when a woman is basically tricking her body into thinking it is pregnant with the pill or not.

    No free lunch (or, uh, the other thing) as you say.

    Anders wrote on January 19th, 2012
  17. This blog post is so timely as I am at the end of my 5 year stint on my IUD and feeling very confused about what birth control to use. I really want to give my body a chance to be natural, especially as I’m trying to get healthy by being primal and exercising regularly now.

    This article confirmed for me what I was already thinking … I don’t really want to go on the pill. Now the hard part comes deciding what else I can do.

    Jacey wrote on January 19th, 2012
  18. For the primal who don’t mind a lot of work, are dedicated and able to refrain from being stupid, the book “Taking Charge of Your Fertility” describes a natural method of birth control that is much more accurate than the “rhythm method”. I know many women who have used it successfully, but it takes a certain type of personality so don’t try it if you’re not committed to actually doing it.

    When I was a teen and got my period and started getting awful cramps, I started taking the pill to make my cramps less painful (had to go to PP and get it secretly because my Catholic parents didn’t want me on it!). Worked ok, but I didn’t want to take it long term. Now that primal/paleo has gotten rid of my cramps naturally, I have no reason to mess with that stuff. When I tried the Ring it made me cry and be completely depressed every day. Not very sexy.

    The ironic thing about birth control is so many women I know lose their libidos while on it that it’s a total catch 22.

    The weird part about hormones and their effects on our mood is trying to remember that it is hormones and not that everything suddenly sucks. When I kept crying every day it took me several days to realize, this isn’t me, it’s the hormones.

    Stephanie wrote on January 19th, 2012
    • I was just going to mention this book! Taking Charge of Your Fertility is a fabulous resource. When I had major side effects from the bill, Weschler’s book helped me figure out what direction I did want to go in with birth control.

      The book is about understanding how your body works, and is perfectly primal-compatible.

      Love this topic, Mark. Kudos for rising to the challenge and tackling this one (so eloquently, too).

      Anne wrote on January 19th, 2012
      • Yes, this.

        I find that once you get in the “swing” of charting, it really isn’t so much work at all. It just becomes part of your daily routine. Wake up. Take my temp (and laze in bed a couple extra minutes while the thermometer does its thing). Get up, get dressed, etc.

        It’s also extremely helpful when you DO want to have kids, as you already know what’s going on with your cycle.

        hm wrote on January 19th, 2012
      • When I started studying herbology, we were introduced to a book similar to the one you mentioned and my husband and I had great success using this method, to get pregnant and prevent pregnancy. Now, that I am getting close to perimenopuase, when things are a little wonky, we use VCF, which can be purchased everywhere and are non-hormonal. Thanks, Mark for broaching this subject.

        Lori wrote on January 19th, 2012
      • I read this book and it changed my life. When I had been on the pill, I didn’t get to experience the “highs” of being super-attracted to the opposite sex during the time of ovulation (duh, that’s when you are supposed to want it) — MUCH more fun to be OFF the pill. One problem is, if you are not interested in getting pregnant, then obviously during ovulation is NOT when you want to be doing it. However, Fertility Awareness Method (FAM) really, really works. I am in tune with my body’s rhythms now, and much more clear-headed.

        Elsie wrote on January 27th, 2012
    • Agreed. If you’re a woman who is already making the effort to live a healthy Primal lifestyle, Weschler’s book is a MUST READ!(Her anecdote regarding a fictitious male implant is worth the read alone!)

      I’ve found the method effective and empowering, along with the Ovacue fertility monitor.

      The idea that one can take pills or insert a hormonal device that disrupt the body’s reproductive process WITHOUT long-term effects is illogical at the very least.

      PLEASE, ladies, get this book at your local library. Our bodies are not our enemies, but when we choose to tinker with them, they have no choice but to rebel and/or weaken.

      Annie wrote on January 19th, 2012
    • Yes! This is THE book, excellent and informative reading for women and girls too. All the things no one ever bothered to explain and should have. The medical community sucks at this. So paternalistic.

      Anna wrote on January 19th, 2012
      • The issue here is that quite a few women can ovulate in response to being around male pheromones – this can cause a burst of LH (lutenizing hormone). So if you go away for a sexy week long vacay and cuddle a lot on days 1 & 2, some women will find themselves preggers on day 6. Most women’s bodies after all want to get preggers and evolution has made sure it can happen when the opportunity to be in steady close contact with a fertile male occurs – unless you are already regularly breastfeeding.

        moreporkplease wrote on January 19th, 2012
        • You really, really need to read “Taking Charge of Your Fertility” to understand why what you have written is absolutely ridiculous nonsense.

          Women are fertile for a max of 48 hours per cycle. Technically speaking this means there are about 7 days where sex could lead to pregnancy. Of course it depends how confident you are about reading your signs as to how many days you need to abstain or use a barrier.

          Things like stress could delay ovulation but your cycle will not stop and start randomly depending on the company you are keeping. If you learn how to temp, observe cervical mucous and check the position of your cervix you’re in control.

          Ladycomp is an excellent gadget – convenient way to temp and gives advice on safe or not safe days – great for a double check against your own charts.

          Fertility Awareness is soooo misunderstood. There are even many who say they used the method and were let down by it who never understood it in the first place….

          darko wrote on January 19th, 2012
        • Just a note. Even if breast feeding you can become pregnant! Don’t rely on that alone. :)

          Beth Swan wrote on January 19th, 2012
        • Agree with Beth. Regular breastfeeding is not a foolproof form of birth control – based on personal experience.

          rrustad wrote on January 19th, 2012
        • However, breastfeeding can be effective birth control under certain conditions. LAM (Lactational Amenorrhea Method) means that for the first six months after birth, if the mother is breastfeeding on demand at least every 4 hours during the day and 6 hours at night, and the mother has not had a period yet, then this will be about 98-99% effective in preventing pregnancy. Just as effective as the pill!

          Allison wrote on January 20th, 2012
    • Stephanie, I so agree with you about the book, but also your warnings. If you (or your partner) are sometimes prone to “being stupid,” this fantastic method may not be for you. :) We learned this the…ahem…family way. Thanks for mentioning the book though.

      Danielle wrote on January 20th, 2012
  19. I started taking the pill when I was 18 years old, and just 6 months later, began having incredible pain in my vulvar area. After 2 years of visiting doctors who told me it was all in my head, or to just have a glass of wine, or that it would be better after I had a baby, I was diagnosed with vulvar vestibulitis, a condition that affects between 8-12% of women and results in pain and inflammation in the vulva. At best, you can’t have sex. At worst, you can’t wear pants. I went through numerous therapies, including strange anti-oxalate diets, steroid injections, capsacin injections, and a surgery, but it was only after seeing a specialist who realized that my hormones were out of whack because I had taken the pill that I got any better. After hormone replacement therapy to increase both my estrogen and testosterone, I have been pain-free for 6 years. As a result, I can never take hormonal contraception, but it’s a small price to pay.

    Anon wrote on January 19th, 2012
  20. I’m curious what you make of this study from 2009:

    I have never taken the Pill and never will. For me the risks are not worth the convenience.

    Danielle wrote on January 19th, 2012
  21. I was on Depo-provera for 4 years, and the pill for a year with no problems. Since going paleo I tried the pill again for 2 months and it made me CRAZY. I got depressed, moody and cried all the time. I couldn’t meditate either. I stopped it and immediately felt better. Maybe my body is more sensitive now, or maybe the recent pill was just a bad type for me.

    Elise wrote on January 19th, 2012
    • I hear you on that. I was on Depo for 2 years, then Mirena for 4 and then had to discontinue use for other reasons, so I went back to Depo. I was only on that for 2 years when I started experiencing the side effects of acne, depression, mood swings, irritability and general flat affect. Going primal seemed to have made it worse, so I just got off it. Now Im experiencing the readjustment period which is no fun either! I hope this clears up sooner than later. Now I just want the Mirena back, but I may just wait and let my body readjust hormonally first… see what its like to have “feelings” again 😉

      Hilary wrote on January 19th, 2012
  22. I got snipped with no children at the age of 30. I paid my $10 copay and saved 500K and never looked back. Aside from the Low Carb Paleo diet it’s the only time I got more than my monies worth!

    Grokitmus Primal wrote on January 19th, 2012
    • I did the same at 32, no kids (hub to be and I were agreed on that). As time went on and my period cramps got worse and worse and cycles grew shorter and shorter, docs kept telling me to go on birth control pills to control this. It just seemed foolish to me to have had the surgery to prevent fertility and then take the damn pills anyway b/c I had major pain/cramping issues….As much as I wish I could say going Primal has resolved my problems in that area, it really hasn’t made any difference that I can see. However, as I’m 51 at this point, I figure I can wait it out!

      Beth wrote on January 19th, 2012
    • Right on! :)

      Inge wrote on January 19th, 2012
  23. I’ve been on the pill since I was 14, and I am now 41. There was a time period of one year where I was off the pill and had the “Depo” shot…which was horrible.. I have never experienced any side effects that I know of from the pill. It’s a very low dosage of microgesterin and I’m honestly afraid of what might happen if I stop taking it. (weight gain etc). I have been Primal since August of 2011, so maybe it’s time to really go All Natural?

    Monika wrote on January 19th, 2012
  24. There’s another side effect of The Pill that doctors do not often mention or even know about, and that is lowered sex drive. I’m not sure if there have been studies or not, but I do know from my own experience and from the experience of *many* others, that taking the pill can majorly lower sex drive. I took the pill for 12 years, 15-27, and the entire time I was on it I never thought I was experiencing side effects at all. A few years ago I decided to go hormone-free, especially after hearing lots of other people talk about sex drive issues w/ the pill, and I’m so happy I did. I’ve had a copper IUD for the past 3 years and I feel so much more in tune with my body’s natural cycle, plus my sex drive sky rocketed.

    sarah wrote on January 19th, 2012
    • I had to go off birth control when I developed gallstones. (and, now can never take estrogen of any kind without getting my gallbladder removed.). I had a high sex drive to begin with, but it skyrocketed after going off the pill.

      Currently, I am using Mirena, and I love it. I think the tiny amount of localized progesterone isn’t a big issue, and I would rather have that than a baby (at the moment.). I will most likely practice some sort of fertility awareness to space my children.

      AmandaLP wrote on January 19th, 2012
      • My sister had to have her gallbladder removed because of complications from Yaz. I was appalled when to learn there was a class action lawsuit in the works BECAUSE of that complication.

        Myself, I took the Pill for exactly 3 weeks, a few months before my first wedding. I put on 8 pounds and was a nervous wreck. Of course the mood swings were probably due to marrying the wrong guy, but the weight gain wasn’t! Neither was the nausea at 3:30 p.m. every day, precisely 8 hours after I took a pill as part of my morning routine.

        My 80-year-old GP failed to mention that the Pill he gave me was the oldest one still on the market, and contained about 60 times more hormones than the newer ones–I had to find that out for myself, on the web.

        I ditched the Pill before I got married, and relied on counting & condoms. Since my ex was dreadfully unhealthy and never wanted to have sex, it wasn’t much of a problem.

        Husband 2.0 got a vasectomy as his wedding gift to me.

        taihuibabe wrote on January 19th, 2012
      • Yes, I also had my gallbladder removed after 15 years on the pill and only after I learned about the class action suit against Yaz and Yasmin and that the pill increases the risk of developing gallstones. People on OC are 1.5 times as likely as people who don’t take OC to develop gall bladder disease.

        Julie wrote on January 19th, 2012
    • I totally agree with this comment. I got off the pill to discover a rather voracious sex drive. My husband, of course, was thrilled!

      Sabrina wrote on January 19th, 2012
    • Thank you for bringing this up! It is a hugely common side effect and can be so damaging to marriages, especially new ones! Sexual desire for women is complicated enough without mucking around with hormones.

      Taryl wrote on January 19th, 2012
    • I had the opposite experience. Was on BCP for 10 years, age 19-29, and had very strong sex drive during that time. Went off BCP and libido crashed to the floor – totally nonexistent. Never had any problems on pill, but mood and hormones have been erratic ever since going off. Testosterone is so low it’s below the lab’s measurable range. Eating Primally for a year hasn’t helped. Would love to hear if anyone has insight or suggestions. I am terrified of BHRT, since I suspect hormonal alteration (BCP) got me into this mess (even though it showed no adverse effects at the time).

      Anonymoose wrote on January 20th, 2012
  25. Well written, Mark. I was on oral birth control on and off, trying different types to see what would work with my cycle (2 periods in one month for several months at a time is not fun), from ages 18-23. I stopped just last summer after going Primal. My cycle regulated immediately (it was always on time though) and got lighter with fewer PMS symptoms. To me, being careful with condoms is worth the effort to feel good.

    Tasha wrote on January 19th, 2012
  26. I used the pill on and off, initially because I really wasn’t into throwing up and passing out once a month, and later for family planning. I went off it at 40 because we were thinking a third would be nice if nature agreed. It was just about then that I was diagnosed with a branch retinal vein occlusion (out to the side, so it didn’t have an effect on my vision – my optometrist caught it at my annual). Further work pinned the cause down to having a clotting factor disorder, Factor V Leiden combined with being on the pill. If there is a history of DVT or clot-caused strokes in the family, especially at a younger age, or during pregnancy, I’d personally recommend that any woman considering the pill get tested for this first.

    We’re currently debating whether to put my younger daughter on the pill for hormonal/emotional issues, probably related to her weight issues and her “atypical congenital adrenal hyperplasia”, which puts her at much greater risk of PCOS. I’m tired of having screaming matches which *always* coincide with her period. I’m trying to primalize the family, but we’re just starting the switch and it’s hard to convince a 14yo that she needs to give up all her standard high carb goodies, especially when she is a fussy eater to begin with. We have an appointment with the endocrinologist up at Children’s in Hartford next month to go over her latest test results, and if they recommend some nasty drugs I may have a better chance of convincing her to try eating better first!

    Nancy wrote on January 19th, 2012
    • Oh wow, I have three boys, so have never experienced the female hormone cascade in anyone else except myself. I just need to say, I hope this is resolved for you and your daughter, and hang in there (hug).

      Heather wrote on January 19th, 2012
    • sounds like me at age 16; i was really tough to deal with. i also was having periods only every three or so months. the pill completely normalized my mood swings and cycle, and i’m still on it to this day (Yaz). i’m a bit freaked out by all of this talk of gallbladder issues with Yaz, not so much about bloodclots as i’m young and don’t have a family history. i’m still wondering if i might have PCOS. i’m going to a birth control specialist to see what my options are soon. i also have been a slave to carbs and following paleo has gotten rid of my up and down energy levels.

      i know the pill isn’t primal, but i’d at least consider putting your daughter on it and talking about all the risks with her doctor. it might be worth the risk if it is the right pill for her. obviously getting kids to stop eating carbs is really hard, but that combined with the pill might make your and your daughter’s lives a lot easier; it made me feel like a normal human being. good luck!

      alemonmoonsky wrote on January 21st, 2012
  27. YES. So happy to finally see a post on this. Thanks for this informative insight, Mark!

    Becca wrote on January 19th, 2012
  28. I was on the pill for two years and then on the mini pill for a year. It made me have these bizarre crying spells, messed up my digestive system, caused yeast overgrowth and made me feel bloated (though I was very thin). I nursed my first child for a year while on the mini pill and I worry about the effects that it may have had on him (he has Aspergers). My doctor never counseled me on any risks to my health at the time. Knowing what I now now about the side effects, I would have opted for another method.

    Sabrina wrote on January 19th, 2012
  29. Thanks, Mark, for the balanced article.

    It’s important to note that blood clots can be very serious. My sister died at age 35 from a heart damaged by Yaz-induced blood clots. Since then, my parents have met many women who have had clots while on Yaz, which contains drospirenone, and we met more when we attended an FDA review of the drug. Some of these women suffered serious damage, like losing the ability to walk. Sometimes, we just met the family, because the woman herself was killed.

    My sister suffered from other side effects of Yaz in the months before her death. Unfortunately, she did not recognize them for what they were because the drug information brochure she received at the pharmacy was not the full brochure and so omitted many side effects; also, an endocrinologist she saw speculated that her complaints were symptoms of PCOS. Ironically, the recommended treatment was “stay on Yaz”.

    Obviously birth-control pills, even the more dangerous ones such as Yaz, don’t cause suffering or death in most women. But I’d encourage everyone considering or taking the pill to learn what the side effects are and then pay attention to how their bodies react to the pill. Don’t depend on a doctor or a pharmacist to monitor you or to make the right diagnosis if you do have problems.

    Glenn Ammons wrote on January 19th, 2012
    • I’m sorry to hear about your sister. Unfortunately, many times the first sign of a blood clot is death from a pulmonary embolism.

      HillsideGina wrote on January 19th, 2012
  30. what about the problem in our drinking water, more compounds that are not natural, the sewer system can not remove these, the pill, bp medicine, heart, and viagra a bad combination for nature, look at the data, scary for our future and children

    seabee wrote on January 19th, 2012
  31. Thank you for planting a foot into the mess that is known as being female!! Great post…Would love for you to cover other topics. I tried going on the pill when I was 21 and it made me crazy. I was weepy and anxious the whole time. I got off of it and tried to just keep track of my cycle and BAM! 6 months later my husband and I were pregnant. I’m 25 now and we’ve been trying for about 1 1/2 years to get pregnant with baby number 2. Just recently I caved and took Provera a couple times to induce my period and I’m on my second round of Clomid to help me ovulate….Part of me doesn’t like taking this stuff but the other half wants another baby so bad! I’m not going to take Provera or Clomid in my next cycle, because I want to give my otherwise healthy body another chance. :) I’d love for you to do a post for women who WANT TO GET PREGNANT and what their options are to promote fertility. If you covered both natural and conventional remedies, along with risks and side affects, that would be great!!

    Oh and I’m under the impression that the Pill contributes to a little or a lot of extra added body fat. Depends on the girl. I knew one young woman who was smoking hot, went on the pill and literally ballooned out in a matter of weeks. Kinda scary.

    Great post, Mark! Thank you!!

    Ashley North wrote on January 19th, 2012
    • Ashley, you might look into FertilityCare/NaproTechnology, which is the Catholic equivalent of fertility treatment. Instead of attempting to force pregnancy month after month of chemical treatments or IVF, they attempt to diagnose the cause and treat the symptoms to restore full health. After that, most patients are able to get pregnant naturally. Using them requires learning the Creighton Method of NFP which will allow a woman to avoid future pill use.

      Here is their page on infertility:

      Some types of infertility require surgery, but at least they are addressing the cause instead of treating the symptoms and billing you hundreds or thousands of dollars per cycle.

      If you search for various types of infertility like endometriosis, PCOS and other common infertility situations along with the Hilgers name, or search blogspot for Dr. Thomas Hilgers, you’ll find some success stories.

      Eric wrote on January 19th, 2012
      • Thanks, Eric! I’ll check it out. :)

        Ashley North wrote on January 20th, 2012
  32. Thank you, Mark! Very fair article. As several other commenters have proposed, I too recommend the fertility awareness method (as taught in Taking Charge of Your Fertility).

    Sami wrote on January 19th, 2012
  33. I was on the pill from 18-21 and from 23-33. Fine until about 30, except I started spotting earlier than the period was supposed to start for a couple of years. Flash forward to 22 day periods that were heavy as hell. The doctors tried me on all sorts of pills, no help. Finally, I had LOTS of acupuncture, went off the pill, and a year later have five-day periods. Two days are bad, but it’s so much better than it was!!! I also feel better emotionally than I have in ages, lost weight right away, and the libido went way up… NEVER putting that stuff in my body again!

    jess wrote on January 19th, 2012
  34. Interesting. I’m in the “it balances out and I’ve had no problems” camp myself – I’m willing to take some cancer risks and shrug it off with the diminished risks on the other side, I’ve never had any pill side effects, off the pill I can never predict my cycle (resulting in some RESOUNDING disasters), and I like being able to control when & where I get to be inconvenienced by menstruation. (Not something I enjoy – especially not when camping or traveling.) Kudos for paying attention to that in the article and leaving non-judgmental room in it for girls like me to make a decision like mine.

    Bananabonobo wrote on January 19th, 2012
  35. Well I’m 42 and have been on the pill since age 17 (25 years). I guess I must tolerate it well because I’ve never noticed any side effects. Before the pill I used to have horrible, painful periods which had instantly gotten better. I have no family history of breast cancer, or any type for that matter, I exercise pretty regularly, my blood work has always been fine and I don’t have high blood pressure. For me it mostly comes down to convenience, my husband and I travel a lot, hike a fair amount, bike ride, etc… It’s just easier to be able to really plan ahead. We do not have children and don’t plan to and I’m sure my husband would be willing to get a vasectomy, but I’m the one who doesn’t want to go back to the sporadic, heavy, painful old self.

    Tammy wrote on January 19th, 2012
  36. My husband was sterilized a few months ago. My God, it feels great to be off birth control.

    I had so many side effects from hormonal contraceptives, from mood swings and *extreme* breast tenderness to weight gain, exhaustion and (ironically?) lack of libido.

    I swear I’ve tried everything on the market — each new prescription gave me a different set of adverse reactions, but they were always there.

    The best (least severe side effects) option for me was Nuvaring, so anybody out there looking for something that might help, it helped me.

    That being said, being hormone-free is where it’s at for me.

    Christine wrote on January 19th, 2012
  37. I have Implanon now and once spring semester is over, I am getting the sucker out!

    Upon thinking more critically about birth control, I came to the conclusion that it doesn’t make a whole lot of sense to prescribe a specific dosage to a ton of women with different hormonal levels/needs. It’d be like prescribing the same amount of insulin to all type 1 diabetics. I think this is why there is such variation in the symptoms (and severity of symptoms) experienced by women – because there is such variation in women! Sure you can experiment with different hormonal (and even non hormonal) birth control methods but that is a lot of trial and error on the body and I don’t know anyone willing to spend that kind of time and money to find an ideal prescription birth control.

    Emily Mekeel wrote on January 19th, 2012
  38. Went on 3 different pills between the ages of 19 and 22…never again! Each time, it killed my libido, made me moody and over-sensitive, and want to eat the entire contents of my fridge daily.

    I stopped having periods after 2 months of paleo (relatively common on low carb, something to do with leptin and thyroid hormones…) but when it returns I’ll be going with the IUD or IUS

    celticcavegirl wrote on January 19th, 2012
  39. I went on the Pill to normalize my periods. At the time I worked a night shift, and I was skipping periods; my body just didn’t like the change.

    Over the years, though, the Pill stopped working as it should. I went on the continuous cycle version, and that never worked — I bled even more than when I was on the standard 28-day pack.

    Finally, around July, I took myself off the Pill completely. My husband and I use a combination of female contraceptives (nanox9) and condoms, plus I track my cycle. On “hot” days of the month (when I’m fertile) we either don’t have sex or he uses a condom. So far, no babies.

    That’s interesting about the CRP elevation. The last time I had my CRP tested I was still on the Pill, and alarmed when it came back at 2.0. Now I wonder if it isn’t related.

    One final note: since going Primaleo, my periods have stopped being painful. I don’t cramp. I do get a sort of “run down” feeling on the first and second day of my menses, but it’s nothing that can’t be cured with a simple steak dinner. This is one of those “wouldn’t believe it if it weren’t happening to me” side effects, but I’m living proof that it does, indeed, happen.

    Steph wrote on January 19th, 2012

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