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!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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346 thoughts on “The Pill: What You Need to Know About Oral Contraception”

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

    1. 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.

      1. 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!

      2. 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?

      3. 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. 🙂

    2. 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.

      1. 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.

        1. 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..

        2. 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.

      2. 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.

      3. 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.

    3. Hey, How come that didn’t happen to me? guess I should have started taking it before age 19

    4. 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!


      1. 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!

      2. 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.

        1. 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.

        2. 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.”

      3. 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.

      4. 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.

      5. 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.

    5. 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!

  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.

    1. The IUD is not recommended for women who have not given birth because it tends not to stay put.

      1. 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.

        1. 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.

        2. 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!

        3. 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

        4. 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.

        5. 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.

      2. 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.

        1. 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.

      3. My doctor told me I couldn’t get the IUD — because it can sometimes cause permanent infertility!

        1. That’s exceedingly rare now and usually the cause of poor insertion on the physician’s part.

        2. 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.

      4. 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. 🙂

      5. 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.

      6. 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.

    2. 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.

      1. 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.

        1. 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.

      2. My Mirena IUD has pretty much rid me of the heavy flow I used to have.

      3. No risk of copper toxicity unless the user has Wilson’s disease which involves an impaired ability to eliminate copper from the body.

      4. Some women who have a copper IUD benefit from a zinc supplement. The balance of the minerals is the key.

      5. 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.

      6. 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!

    3. 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!

    4. 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.

    5. 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.

      1. 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…

      2. 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.

    6. Except that an IUD can act as an abortifacient, and is therefore unacceptable to most women.

      1. 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.

      2. 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.

    7. 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 🙂

      1. 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 : )

    8. 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.

  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.

    1. 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.

  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.

    1. 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)

      1. 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.

        1. 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.

  5. I was literally thinking about this earlier today as I was awake (too early) with my toddler 😉

  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 . . . 🙂

    1. 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.

  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.

  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.

    1. 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.

    2. 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!

      1. 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…

  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 =/

    1. 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.

      1. 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!

        1. 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.

        2. 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!

  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.

    1. Yeah, that would be absolutely amazing if science was ever able to individualize medicine like that!

      1. 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.

    2. “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. 🙂

      1. Interesting, I guess the best option is to bite the bullet early then and pay for the extensive testing (and perhaps ongoing later testing).

    3. 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.

    4. 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.

    5. 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?

  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!

    1. 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.

    2. 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.

    3. 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.

  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.)

  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.

    1. 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!

    2. 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.

      1. 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.

      1. 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.

    3. 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…

    4. 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!

      1. “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.

        1. 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.

  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.

      1. Ditto. I LOVE my Paraguard. Insertion was NOT fun (I’ve never been pregnant) but otherwise this thing rocks!!

    1. 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!

  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.

    1. 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! 🙂

  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.

  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.

    1. I recommend the book “Taking Charge of Your Fertility.” Best of luck!!

  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.

    1. 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).

      1. 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.

      2. 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.

      3. 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.

    2. 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.

    3. 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.

      1. 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.

        1. 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….

        2. Just a note. Even if breast feeding you can become pregnant! Don’t rely on that alone. 🙂

        3. Agree with Beth. Regular breastfeeding is not a foolproof form of birth control – based on personal experience.

        4. 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!

    4. 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.

  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.

  20. 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.

    1. 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 😉

  21. 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!

    1. 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!

  22. 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?

  23. 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.

    1. 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.

      1. 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.

      2. 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.

    2. I totally agree with this comment. I got off the pill to discover a rather voracious sex drive. My husband, of course, was thrilled!

    3. 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.

    4. 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).

  24. 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.

  25. 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!

    1. 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).

    2. 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!

  26. 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.

  27. 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.

    1. I’m sorry to hear about your sister. Unfortunately, many times the first sign of a blood clot is death from a pulmonary embolism.

  28. 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

  29. 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!!

    1. 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.

  30. 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).

  31. 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!

  32. 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.

  33. 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.

  34. 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.

  35. 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.

  36. 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

  37. 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.

  38. Haha…it sounds like a quite a large proportion of the primal “community” plans on driving itself to extinction within its first generation.

    1. C.M. Kornbluth wrote a sci-fi story about this sort of thing…the title is “The Marching Morons”. Not at all politically correct, but its still a great story.

  39. I was on Alesse for quite some time, and as soon as I went primal, I was spotting between periods.

    My doctor suggested I switch to a higher dose pill. I tried it for a while, but decided I didn’t want to be on the pill anymore.

    Now I use something called LadyComp, and it’s more natural form of birth control. Nothing to take except for my (oral) temperature every morning.

    I didn’t mind taking the pill, but even on the low dosage ones, I was always exhausted the week before my period (and sad). Now that I’m no longer on the pill, my mind and body aren’t all over the place!

  40. I took the pill (not sure which one, but it was a Canadian concoction) for six weeks during which time I turned into a “pill” myself. I felt horrible, and behaved horribly. I quickly sought another way. Many of my friends suggest “Fertility Awareness Method” (FAM) and I bought into it.

    My husband and I shared the duty of tracking my cycles for 4.5 years before we began to try for a family. I confess that there was some nervousness that the reason why FAM worked for us was perhaps because I was simply not fertile. However, just last year in July we conceived (after trying for two months) and I’m now just into my third trimester – due in April! So, FAM worked for us! 🙂

    P.S. I’m not talking about “Rhythm Method” – I’m talking about charting both temperatures and cervical fluid. FYI.

    1. Gilliebean – I love that your hubby shared the duty of tracking your cycles. On a practical level, how did this work? Did he take/record your temp and you take your fluid, or some other delineation of duties? I ask because we’re about to start naturally tracking for fertility awareness and I’d love to know how to share the load, and hubby is happy to help. It also is a unique bonding experience for us. Thanks!

      1. For me, hubby takes my temp every morning when the alarm rings (important to take temp at same time every morning as much as you can help it, to see the pattern clearly). He records it on my chart, which is on my bedside table. I check my own cervical fluid and record that each day. It’s nice to have the teamwork… bond-strengthening, I would say. 🙂

  41. I went off Nuvaring 14 months ago because I hated what the hormones did to me. I had been on it for 3 years since I met and then married my husband. Eventually I realised It had ruined my sex drive, made me want to eat all the time (or maybe it was my CW diet) and it zapped me of my creativity (I’m an artist by trade).
    I started using the ‘OvaCue Fertility Monitor’ instead for birth control and haven’t gotten pregnant yet (for about 14 months). I do have to use condoms for one week of my cycle (or abstain, or get creative!) and it is a good idea to log your cycle separately for backup.
    It is not promoted for birth control use, but it tells you when you are fertile. It is way easier than the whole thermometer thing. Plus when I do want to get pregnant it will be just has handy. It is not a cheap device, but I used to spend $50 a month on birth control, so it is definitely cost effective over time. It takes at least 3 months of use to become accurate, especially if you go off hormonal birth control.
    I highly recommend it if you are enjoying sex daily and don’t like taking hormones.

    1. Wow, that is scary. I noticed the lack of sex drive, but the things you talk about are unacceptable. I preferred the patch over the ring, but doc said I’m too heavy for it to work right and my fat already makes too much estrogen.

      I think it’s time to talk about getting my uterus cauterized anyway, that should take care of the horrible bleeding issues.

      1. for Kelekona and anyone else who has damaged uterus/cervix and bleeding from that, supplementing with vitamin C may help. Please research it for yourselves. Vitamin C is also a very strong anti-toxin. Thomas E. Levy is a medical doctor and supporter of vitamin C. You can find good info at too.

        1. Oh, I’ve had horrible bleeding all of my post-puberty life, and only about 2-3 years of BC relieving it.

          I don’t know when I contracted PCOS, (don’t even know if I have PCOS because they aren’t recommending tests since I don’t want to concieve) but I think I grew the beard young and the arm-hair might have been from microwaving food in non-safe plastics.

        2. I know I’ve posted it before for others but this thread is very long, you should read about iodine and Dr. Jorge Flechas, he treats patients using iodine and I know there are interviews of him giving amazing info about the conditions that iodine reverses/cures. He says iodine deficiency is shown by cysts developing on ovaries, breasts, uterus, thyroid. hope this helps

  42. When I went in to get a prescription for the pill, I was told NONE of the potential health repercussions. Just “here you go!”

    What made me go off of the pill was the information about its role as a potential cause of early abortions – as a pro-lifer, that was totally unacceptable to me (not looking to start an abortion debate, just mentioning this). Secondarily, I was horrified when I read about the health problems that it can cause.

    One issue that I didn’t see mentioned above was the research that’s come out recently about effects to the environment – because the urine of women on the pill is tainted with the hormones from the pill, it goes directly back into the water system and is having negative effects on various species of wildlife.

    One additional thing I noticed – when I went off the pill, I just felt better – like my body relaxed. It was hard to describe, but I definitely felt better.

    It just makes sense that pouring artificial and unnatural hormones into our bodies on a regular basis would have negative repercussions. Thanks for this article!

  43. There is avery good solution for horny hetero couples who do not want to make babies: Non-penetrative sex. Use hands, mouths, friction etc. Most women orgasm through clitoris stimulation anyway.

  44. I took it a long time ago, so my comments aren’t relevant to the newer formulations.

    I was skinny until I turned 27, when I went on the pill for three years. I had several undesirable side effects. And I gained a lot of weight very quickly. I have had trouble with my weight ever since. I don’t blame the rapid weight gain entirely on the pill, but I am sure it was the major trigger.

    Since that experience, I have stayed far away from female hormonal drugs, including the natural ones.

  45. This reminds me how grateful I am for menopause!
    When my periods first stopped I would cruise the feminine hygeine aisle at the grocery store emitting evil little chuckles and great sighs of relief!
    I fortunately traveled the “pause” with ease and thanks to being primal am healthy enough to really enjoy my freedom.
    Great article, Mark.

  46. I’ve been primal for two months and have been off oral contraceptives for the same amount of time. I’m feeling amazing and the benefits of this lifestyle are too numerous to list (okay, okay: weight loss, increased muscle tone, acne issues completely resolved, brighter skin, dramatically improved moods and energy, better focus, zero cravings for S.A.D. fare, better sex drive, much more confident, etc). I don’t know if this is because of going off the Pill or primal, but I like to think it is a combination.

    My long term boyfriend and I practice a mix of (lazy) cycle planning, condoms, withdrawal, and other creative and *fun* methods. We discussed my health concerns and agreed that the risk of an unplanned (but not unwanted) baby outweigh the potential harm that long term oral contraceptive use was doing to my body. I understand my situation makes this plausible and would probably reconsider if I were not in a committed relationship.

    Also, I mostly started the Pill because of really painful periods. My formerly debilitating cramps and PCOS symptoms have completely disappeared. My last two periods have barely registered. Much heavier than usual, but shorter and pain free (I do feel pressure and I am aware I am on my period, but it isn’t painful).

    Good luck, Grokettes.

    And Mark, thank you so much for recognizing exclusively female health concerns. It gets a little old to have your symptoms written off as “depression” or some ill defined female hysteria.

  47. I was on the pill as a young woman, and didn’t have much trouble with it. I liked the double protection of condom and pill at that time. I really wanted to avoid pregnancy! Then, when I was about 24, I switched to watching my cycle, and was in a long-term relationship and then we got engaged…after kid #3, my husband went to get snipped and all is well! Now, I like having normal cyclical hormones much better, and think the pill might be harmful for me as a 38 year old. But for the younger set, it might be the easiest.

  48. Hated being on those things! Like other have said, PMS-y all the time, messed up libido, weight gain, etc. Until I went on Yasmin. Yeah, one of the ones you see on the “wanna sue” commercials. I actually felt balanced on that one. HOWEVER, I now have thyroid issues and it absolutely destroyed my gallbladder. Fun stuff (not).

  49. Your sentence, “There’s a reason some 100 million women around the globe turn to the Pill” leaves out a major part of US Healthcare. . . many insurance companys and doctors refuse to perform any permanent sterilization on women who request it, unless they’ve a) already had children or b) are over 35/40 years of age. Thus, as a result, many women are forced to turn to long term birth control measures when they’d rather just be sterilized.

    Men, on the other hand, are never questioned repeatedly when they ask for a vasectomy.

  50. Gosh, Ive been on the pill for 33 years with a year off for each of my pregnancies. Ive also had a trial of 6 months or so to see how I did off it. Ive never had a problem with anything while being on it. My doctor tells me he wonders if this is why I still look far younger than my age. I don’t know… All I know is that I feel much better when Im on it! The incredibly small amount of time off it made me feel awful. CRABBY, horribly heavy periods and bloating.

  51. Mark, thank you for stepping into this issue (and doing it rather well at that!).

    Im one of those women that has BIG problems with hormonal birth control. I have been on HIGH dose hormones in the past and my body is ultra resistant to hormonal control. I still ovulated, still had a regular period on top of the withdrawal bleeds when on the pill. Increased hormone levels made me insane. I have had a Paragard IUD (non hormonal one) for 5 years now and I am VERY happy with it. I am nulliparous (Have not given birth), 35, and very happy with my current birth control.

    1. Yvette,
      Was your doctor on board with offering you Paragard? I had an appointment for a consult today, and they just called to tell me that they won’t offer Paragard because it is non-hormonal. I’m trying to figure out whether I should fight for it or find a more understanding doctor. Thanks!

  52. Mark, you were very gentle with this…probably too gentle. You know darn well that the most primal thing any woman can do is to know and understand her fertility signs (regularity doesn’t have as much to do with it.) If you were talking about anything except the possibility of conception, you I think you’d give it a flat out thumbs down.
    sterilization also has physiological effects on the body (for both men and women)

  53. Great post! Do you have any information on the male pill, and its potential affects on men?

  54. I recommend all women read ”Taking Charge of Your Fertility” by Toni Weschler. Great information on how your body works, how your cycle and a great tool for women looking to use all natural birth control.

  55. 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.”


    One of the many things that concern me about the Pill is the spread of sexually transmitted disease as a result of unprotected sex. Personally I think that has been a hidden consequence with massive implications for women’s health and we are still not admitting it as a society.

  56. I have been on the pill for about 9 years (scary) and I’ve definitely noticed changes… Mood swings, thinning hair, irregular periods, etc. These side-effects could be linked to anything though. Luckily, I take vitamins, eat well, and work out as often as possible.

    Mark – Do you think any damage (or risks) can be reversed by getting off of the pill?

  57. Thank you Mark! I’d always suspected that going on the Pill had contributed to my Crohn’s relapse, and now I have a study to back it up… This was really helpful and encouraging, as I just got off the Pill three weeks ago for fear of what it was doing to my body.

  58. When I was younger, before menopause, I always tracked my cycle with a basal thermometer. It was pretty easy. Then I used condoms when I was fertile. It worked fine.

  59. I tried birth control pills briefly in the early seventies, but they made me nauseous and caused weight gain and fatigue. Then I tried a diaphragm with spermicide. The spermicide caused spotting. Finally I went to the method of tracking my fertility, as mentioned above. It’s interesting as well as practical. You start noticing other things about your body that coincide with where you are in your cycle: moods, interest in sex, etc.

  60. I’m on the other side of the birth control issue now and dealing with menopause. After a couple of years of hot flashes, night sweats, low libido, and dryness in all the wrong places, I finally started using a low-dose estrogen patch. I’m not a better living through chemistry kind of woman and I tried every natural remedy known to woman-kind first. But being able to sleep through the night regularly for the first time in several years was well worth it. I’ve tried going off of it a couple of times, but the hot flashes come roaring back with a vengence and then it takes about a month to get back to where they stop again. I’ve already been going through this for seven years, and I’m hoping I’ll make it through to the other side soon, but I have friends who’ve been having hot flashes for 10 years or more. I see my doctor regularly and since I’m not having any adverse side effects on the patch, for me being able to sleep is well worth it.

  61. I developed chronic depression and didn’t realize it was because of the pill. That’s because none of the many doctors I saw thought to mention anything. And that’s because that half of them are unaware of the side effects themselves! it is ridiculous.

    I also had low or no libido from it and just believed I was not a sexual person. Starting the pill at 18 didn’t give me any chance at all to get to know my body. Anyway, I wouldn’t touch the stuff now with a barge pole and regret the 8 years I spent on it.

  62. I went on Yaz when I was fifteen and then switched to the patch last May. However, the patch gave me horrible rashes wherever it was and so when my husband and I decided to go Primal we decided to ditch all forms of medication including the birth control. I noticed that since then my sex drive has improved partly from the raised energy levels of eating primally and partly from stopping all these unnatural medicines being put into my body. We now are going to have my tubes tied next winter and if we want to have children we will adopt as there are plenty of kids out there who need a good home. I know this option isn’t for everyone but I personally would never recommend the pill or anything hormone form of birth control to anyone because it just doesn’t make a person feel good.

  63. I wanted to add that not only is lowered testosterone a side effect of taking the pill, but there is evidence that hormonal birth control can result in a permanent decrease in testosterone production, even after you stop taking it. Eeeek! The best birth control ever – no sex drive?

  64. I was on the pill for several months in the mid ’70s when the pill had higher doses of hormones. As many others have reported here, it made me crazy! LOL! Mood swings, irritability, etc. etc. Stopped it and never looked back.

    My doctor had prescribed it because I’d had hormone imbalances resulting in irregular periods and serious issues from ovarian cysts. After stopping the pill my periods were more irregular than ever, although I didn’t have any ovarian cysts until many years later in peri menopause when I had one minor cyst.

    I had difficulty with fertility until after the first child and an “accidental” foray into a lifestyle very close to Paleo. Raised my own organic garden, grass feed beef, pastured chickens, etc. for several years. Had two more children during that period with no difficulties conceiving. Had a tubal ligation after the third child.

  65. I was on the pill for 10 years, and had very few problems other than sort of losing touch with my emotions. So I got off the pill, but now had to choose a new method and I went with the copper IUD. It’s been fantastic! It’s a thing I don’t have to think about, good for 10 years, reduces my bleeding, and I’m pretty confident that it works and I won’t be getting pregnant.

    It hurts a bit going in or coming out, but it’s overall worth it. This is my second one, and will hopefully take me up to menopause, when I really won’t have to worry about getting pregnant.

    Birth control options aren’t well talked about, so thank you for addressing this. The Pill seems to be pretty much the known option, and if you want something else, it seems to be … unusual somehow. I don’t know. I had some difficulty finding information on other choices.

  66. Thank you, Mark, for this great article.

    I’ve seen it mentioned above, but wanted to join the chorus. People who think that natural family planning is the rhythm method really need to take a look at sympto-thermal methods of NFP. It’s so much more advanced and so much more accurate.

    Yes, it requires consistency and dedication and may not be for people who are not in a committed relationship. And yes, it does require periodic abstinence, although not nearly as much as previous “editions” of NFP did. But it also keeps you chemical hormone free and improves communication with your partner.

    “Emergency contraception” and such are even worse than regular chemical birth control to me, because of the massive doses of hormones involved.

  67. Fabulous, diplomatic post Mark; such a huge topic for women (and potentially the prostate’s of men) everywhere!

    But I think I have a certain degree of lee-way as a gal who was prescribed the pill at 15 solely to help with cramps to say – that sh*t is messed up. Would add further expletives if I could.

    I understand that it’s hugely liberating and can absolutely be prescribed in a right place/right time scenario, but the lack of information for impressionable young thangs who just want a ‘quick fix’ for teen acne, hormonal upheaval and contraception is deplorable!

    I quit the pill at the beginning of last year after around 7 years and as a result have been plagued by acne, absent periods and the uncomfortable knowledge that my doctor did not give me the down-low, low-down. Nutrient depletion, infertility and higher disease risk is swept under the shag-pile carpet, and it takes a lot of healing and hormonal recalibration to get back in the womanly zone! Just my 5 cents. I’m sure other readers can relate!

  68. to all the woman wondering what to use if you don’t want to use the pill. Do they still have the sponge? That was a great form of birth control. I don’t need it anymore (hysterectomy) so I don’t know if it is still available.

  69. Thanks Mark for this post! I’d like to mention a natural alternative to the pill. I’m a huge fan of the book “Taking Charge of Your Fertility” by Toni Wechler. It provides a very clear and thorough explanation of the Fertility Awareness Method (FAM). The book details how you can use different signals from your body to either avoid pregnancy or to conceive — you either avoid sex (or use condoms) when you’re fertile or that’s when you go for it!

    Also, I should note that this is NOT AT ALL the same thing as the rhythm method. You use your basal (waking) body temperature and your cervical mucus to judge when you’re fertile, and give adequate cushions on either side. I used it for years to avoid pregnancy, and then eventually to conceive with my husband. When followed correctly, it has been shown in clinical studies to be as effective as the pill (and has actually been recommended in countries where women need birth control but don’t have the means to get it).

    Anyways, reading the book teaches you so much about your body, I think it should be required reading for every woman.

  70. Thank you Mark; great read. I was on the pill for a couple of years but never once felt “right.” In retrospect, I believe the medication contributed to my endocrine issues (hashimotos, adrenal exhaustion — although obviously my horrible lifestyle and diet were major contributing factors). I totally understand the convenience and the pressure women feel, and would never counsel anyone not to be on the pill. However … if your body doesn’t feel right … listen.

  71. I must be proof of the opposite regarding the Pill’s prevention of endometriosis. Taking the Pill was like pouring gasoline on the fire. I had some cramping that naproxen couldn’t touch, so I asked my doc for something better, he said the Pill! It’s harmless! And naïve me thought, “ok!” I know endo doesn’t start overnight but things were manageable pre-Pill and now I’m disabled for 2-3 days out of every 3-4 weeks because of the intense pain.

    Just 3 cycles on the Pill and things have never gone back to the way they were pre-Pill. I had severe symptoms after just one cycle and complained to my doctor, but he told me to stay with it for the 3 months and things should settle down. It’s been 6 years and I’m still battling the awful cramps, heaviness, etc.

    I have had to completely remove entire food groups (I’m talking beyond the basic paleo diet) just to lower the volume (but note totally mute the pain). I will never touch hormones like that again.

    1. I had similar issues, not caused by the pill, just had problem periods. I finally had a hysterectomy. It has been wonderful, not having to worry about planning around a very erratic schedule and taking way too much pain medication. If you don’t want children or you already have them it is an option.

      1. I agree. I always had hormonal “issues”, couldn’t take the pill, trouble conceiving, etc. Had a tubal ligation after the third child. My problem periods increased and eventually the cramps were like a very painful period almost everyday of the month. Quality of life was in the toilet!

        Five years after the tubal, I was diagnosed with a form of endo called adenomyosis and had a hysterectomy at that time. 25 years later, I have had NO regrets about the hysterectomy. I got my life back. My OB/GYN said that adenomyosis is the primary reason for having a hysterectomy these days and that most women with the diagnosis feel like I do about quality of life, etc.

      2. That’s what I ended up having to do. I don’t know if that was the right solution, but I do know that I felt better than ever after getting rid of all the “period” problems. My only regret was that I didn’t do it sooner – like many years sooner. That was when I was over 45 years old 9n 1989. I’m now 67 years old and have never regretted it and like I said — why the hell did I wait so long?

        Sometimes you just gotta know when to fold—

        1. Well, that was how I felt, too – “why the hell did I wait so long!” – even though I was only 36. In fact, what eventually prompted the decision was a scary pap test that led to a cervical biopsy that showed advanced pre-canerous changes. Enough! LOL!

  72. I’ve read in a couple Paleo diet books that the pill also contributes to Leaky Gut Syndrome and can have a hazardous effect on autoimmune diseases.I was on the pill but after reading that I stopped taking it that very night since i have an autoimmune disease. But it seems like there aren’t too many options for birth control that don’t mess with your body’s hormones. anyone have any suggestions? Thanks!

  73. I have been researching The Lady Comp ( lately. Does anyone have any experience with it? 99.3% effective with no side effects.

  74. I haven’t seen anyone mention the Creighton method of NFP. I realize it would mostly be Catholics who are familiar with it, but I am curious as to whether people have found it easier and more effective than the common NFP methods. Anyone use Creighton?

  75. The pill has always been a sexist issue, despite being touted as liberating and empowering for women.

    How about a pill to make men temporarily stop producing semen? Wouldn’t that be easier than changing a woman’s entire hormone production?!

    The fact that this has never been considered or invested in shows the obvious sexism in the birth control industry.

    That said: I was put on the pill at age 17 and then went off at 22 after struggling with depression, anxiety and acne. Going off the pill, learning my REAL, NATURAL cycles and of course cutting out grains and sugars from my diet have brought me to a place where I am healthier now than I ever was at 18 or 19 years old.

    When you get off the pill, learn your cycle, actually FEEL yourself ovulate, and respect your woman-ness for what it is, rather than oppress it you will be far more empowered that you ever were on the pill.

  76. Mark, I have been a fan of yours for quite some time now, not only because you have totally changed my outlook on life, but because you keep it real. Thank you for being brave and reporting on subjects that really are important to women like myself. I have long questioned the complex issue that is oral contraceptives, but have often been dismissed by doctors who are all too keen to shove a prescription in your hands. Thank you for providing some perspective, and keep on keeping on!

  77. Don’t forget that hormonal birth control decimates your intestinal microflora which causes havoc in your body and cause issues for your future children. I wish someone had told me that.

  78. Thanks for the article, and thanks to all the readers for sharing their experience! I’ve been wanting to go off Nuvaring for some time, and get off hormones for good, but didn’t realize there was a non-hormone device available (paraguard). I saw a neurologist 6 months ago about ocular migraines I was getting more and more frequently, and she said the one thing I should do is go off Nuvaring, that she has seen many neurological problems arise from its use. After reading all of this, I’m calling my Dr. tomorrow.

  79. This is really interesting, especially as Kelly the Kitchen Kop wrote about this recently.

    In the comments at the post, “Dangers of the Birth Control Pill“, a reader named Sharon replied to another commenter who questioned the safety of tubal ligations:

    “Having your tubes tied can cause serious hormonal disruptions in your body. It will increase fibroids, cause an enlarged uterus, heavy monthly bleeding, and the need for a hysterectomy. I did not know this before it was done. If I had known we would not have decided to do this.”
    Some food for thought for those thinking of doing that. This post is not a judgment on your decision. Just be aware of this information and share it with others so they can be informed about all the risks before moving forward. Do not use this information to beat yourself up over what you didn’t know until now!

    1. Anita,

      Thanks for the caveat about not “beating” ourselves up :-). A good reminder.

      Most of us – maybe all of us – have tried to become informed, to make sound decisions, and all while under some degree of duress.

      Especially before the advent of the Internet as a public source of information and support, we were often at a loss as to where to turn for sound advice. We wanted to trust our doctors’ advice – but look how unhelpful that often proves to be. So, we do the best that we can at the time and sometimes if we had it to do over we would do it the same way again.

      Anyway, what you are referring to is PTLS – Post Tubal Ligation Syndrome. There are now discussion groups, message boards, website, etc. on this topic. From what I read, it seems that how women respond to the ligation – as well as to the reversal process – is similar to how women respond to hormonal interventions – lots of variation in response from good to bad.

      In my own case, I suspected at the time – mid/late 80’s – that my symptoms were at least in part related to my TL, but of course that possibility was denied by several doctors. I had even asked about what effects that ligation might have on my body before making the decision (early ’80’s). Again, multiple doctors poo-pooed my concerns & questions – some of which are now the basis for the major hypotheses about what causes PTLS.

      And, I gotta tell you that at age 59 I am pretty fed up with patronizing, head-patting, dismissive, disrespectful, and down right dishonest doctors! And, that refers to most of the medical doctors that I have seen over my lifetime – and all that even given that I am a highly educated (former) research scientist myself. Even the “good ones” are misinformed on at least some topics, IMO.

      Now I fully avail myself of multiple informational resources and am fully armed to the teeth as my own advocate. And I STILL find that medicine is a Grand Experiment. What works for many others may or may not work for me and vice versa.

      My daughter chose the Paragard IUD over a TL, and I am glad that she did. But how will we feel if she ends up one of the small number of women who have a perforated uterus or sepsis or any other serious side effect?

      The bottom line is that there are NO guarantees in life. EVERYTHING we choose to do as well as choose not to do carries some degree of risk. The best that we can hope for is to play the odds in our favor and to minimize the overall risk.

      As the old saying goes, the only thing certain is life is death and taxes. I like Mark’s “new” saying best – “Live Long – Drop Dead!” If I manage to achieve that – and also to maximize my quality of life along the way – then I think that is success! So far, on the balance I am succeeding.

  80. Right. After reading this article and every comment I am more confused than ever. It seems that everyone reacts differently to various forms of birth control, what works best for one does not work for others and there are simply too many moving parts to diagnose and prescribe the ‘right’ solution.

    My situation? I am in a committed relationship with my partner, have been primal for almost 2 years, have moved from condoms to the morning after pill once (oops), to the pill (no issues on the pill, other than I stopped menstruating for a few months, also likely due to increased training program and low body fat), to Implanon as I wanted a set-and-forget type solution while we went traveling for 12 months. I see children in my future though definitely not for the next few years at least, and I need a solution. Implanon was a great practical solution at first, though disastrous for my emotional and mental well-being, (weight gain, irregular heavy cycles, still some acne and I am in tears all the time and am completely aware that I am not myself, so much so that it frightens me and my poor partner as well).

    We’ve made the decision to remove the Implanon but honestly, I have no idea what we are going to do now. I’m leaning towards going on a low-dose pill. What I think people need to see on this subject is to have some of this data collected, a survey where the results may help point people in similar circumstances in the right direction. In other words, thanks for the post and the comments but… what now?

    I am sick of experimenting with my body and I know there are women and their partners who want to help, properly help, to at least limit the experimentation to a case of what is ‘most likely’ going to work for each person based on their circumstances. I frankly don’t care how successful some claim natural methods to be, it’s still freaks me out and as primal as I am, I want to find the most successful medical solution with the least impact on my health, so that I can continue to enjoy sex and not be fearful of falling pregnant (among other side affects).

    I know one thing for sure and that is that I cannot trust my doctor! Mark, please help us crowd-source the solution!

    1. lyndal, as several others have said, I recommend you read the book “Taking Charge of Your Fertility.” Even if you decide not to go with a natural method, I think you might find the information very empowering. You will certainly better understand how your body works! 🙂

      1. Good point, thanks. Anything that will help understand such a complicated thing is an advantage!

      1. I will do a bit of research on this (or the equivalent brand in AU) as previously I’d only heard of Mirena. Anyone had any issues with your partner being able to feel it? There seem to be some mixed responses on that subject.

  81. If grains were introduced 10,000 years ago and mankind has not yet adapted, what of “the pill”. Certainly it is not part of a “primal blueprint”. This comment is not based on a moral issue. It’s just not nice to mess with mother nature. Touchy topic for sure. Nice PC blog.

  82. I took the pill for several years, but stopped because I believe that it gave me depression. I also gained weight while on the pill, suffered from mood swings, and had bad gastrointestinal issues. Me and the pill just weren’t meant to be. When I came off of it I immediately noticed an improvement in my mood and gut issues. I’ve been hearing of a male ‘pill’ with less side effects but I don’t think it’s available yet. Still in the works. What are your thoughts if something like this becomes available???

  83. From a Male’s point, (pardon the future pun)I hope they’ve improved the Copper IUD since I was dating. That pesky cord that’s attached, kept stabbing “John Thomas” in the face (not pleasant). On seperate occasions, (with different girlfriends) we visited the Doctor and he showed me the cord in situ. After the first “hug” with any future girlfriend, I could tell her if she had an IUD or not.

    1. poking of the peen is usually because the strings are not curled up around the cervix. Ive had a Paragard (the non hormonal IUD) for 5 years and the ex said he was poked once and that was fairly soon after insertion of the IUD. The strings do soften up after a time and will curl up towards the cervix and the ends of the string will be at the cervix and not facing downward to stab. I have warned partners since that I do have an IUD and if they happen to feel something that feels like fishing line when they are poking around at my cervix to not be alarmed.

        1. and also ‘wrap around the cervix’…I am SO not sold on IUDs…

  84. This is such a hot button issue for me. I went on the pill at 16 because I already had very painful, irregular periods. I started at 10 years old, so my ovaries are quite exhausted. I spent 14 years on birth control, everything from ortho tricyclen, mini pills, seasonique/seasonale, taking it continuously to not have a period. to taking a low dose pill to just have the bare minimum. I always have a menstrual migraine, pill or not, but the pill made it SO MUCH WORSE. I had a terrible time and had to keep switching, but I would be damned if I got pregnant before I wanted to. I turned 30 and wanted to get pregnant so I went off the pill. we tried for 2 years, the first year I knew something was wrong, but my doc refused to check anything. When she did do bloodwork and an ultrasound, she categorically denied that I had PCOS and put me on clomid. I did 4 months of that before going to a specialist. In 5 minutes she diagnosed me with PCOS. Aside from hormonal issues and PCOS, when they did a laparoscopy, they found that my tubes are mangled, making conception without IVF nearly impossible (5%). So all that birth control for nothing, and my hormones are so screwed! Also, endometriosis runs in my family, all the women had hysterectomies in their 40s or died of uterine/endometrial cancer, so I’ve been on the watch for it. When they went in for the lap, my doc said she saw endo, BUT LEFT IT IN. Great.

    Fast forward 3 years, we adoped a beautiful daughter, I’ve been paleo for 8 months, and the only thing that hasn’t resolved itself is the endo. I went to my OB (new) and she first gave me low dose pills to try, but they increased both my blood sugar and blood pressure so dramatically that I couldn’t take them. I started paleo around then and really wanted to give it a chance. This December, after 6 months of really clean eating the 7 days of in bed, on pain killers, crying, going to urgent care or the ER and I was just done. I went to have Mirena put in because others I know have had success with it. Worst. Decision. Ever. I had pain immediately and it never went away. I lasted 12 days with it in, even went to the ER to make sure my uterus wasn’t perforated, but my body was rejecting it with one long constant contraction. So I had it taken out, but my doc basically thought I was crazy and said I couldn’t be in that much pain. She reluctantly took it out and handed me more b/c samples to take. She said no more pain killers, but I could do Depo or Lupron to put me into chemical menopause. Seriously???? She wouldn’t even discuss surgical options to see the severity of my endo or if I had adhesions, and refused to help my pain without hormonal intervention. I spent the next 2 weeks in bed on whatever I could take, rationing pain meds and hoping that my cycle would end and I would be able to start fresh and be without pain for just even a few days.

    Anyway, I have a very jaded outlook on hormonal treatments. After doing fertility drugs and having a horrible time, I will never do anything to alter my hormones dramatically again. Food got me into this mess, and using hormonal methods to fix it is just covering up the problem. Food is definitely the way to control this, because hormonal suppression when it gets to the point of Depo or Lupron is something that can really screw up your body. Unfortunately, my pain has gotten to a level now that I cannot handle it anymore, and am going to an endometrial specialist tomorrow to discuss excision. I’m just generally pissed that my doctor would so casually offer depo provera or lupron without discussing what I know to be dramatic and long lasting side effects. It is not casual treatment. Granted, neither is surgery, but at least with surgery you get the caveats. She was literally in the room with the syringe as if I would just say “oh yeah, i’m in the worst pain of my life, do what you want with that.” For me, hormonal treatment of that level just messes with so many other parts of your body, and your life, it’s not worth it.

  85. Is there nothing you don’t address? I have been following your blog for years and have only commented twice, when I was especially impressed that you read my mind. You cover so many important health topic that most people wouldn’t even bother to touch. I am now an IUD user and believer at being on an oral contraceptive for 14 years. I have seen serious longterm implications from my oral contraceptives. I, too, would not take it off the table as it is one of the only truly reliable forms of birth control, but it is so important to make an informed decision

  86. I feel like the lack of information related to thyroid function and the pill is the biggest problem with prescriptions. I started on the pill to treat a condition that really should have been dealt with by addressing the thyroid directly. Instead, I probably ended up further causing reduced thyroid function during the year I was on the pill. I’m off now and waiting to see what the changes are. Do your research ladies. Your body isn’t some kind of experimental lab to throw chemicals at.

  87. Thank you for this post. I have never commented on your site before, though read gratefully. I just want to offer this: I am one of the statistics you refer to. I am a breast cancer survivor whose only risk factor was taking the pill in my pre-marriage years. It was actually my GP who suggested the pill (for difficult periods, etc) and I stupidly didn’t look further. When I was diagnosed with cancer, my oncologist said, “There is such a high risk of breast cancer in women who have used oral contraceptives. It’s most everyone I see.” If you’re on the pill, get off it. I say this with the conviction that everyone on this site tells people to get off sugar or grains. Like with them, you may not see obvious or immediate symptoms (or you may) but it is harming you. You may say that you’re OK with a ‘cancer risk’ but, trust me, once you have cancer you will not be OK with it. I say this out of concern and care for every woman out there, not out of judgement.

    1. Hi Lauren, my story is very similar to yours. I’m also a breast cancer survivor. At my first oncology appointment I was asked first about any family history (none) then second, had I taken the oral contraceptive pill? When I replied yes, she gave me a kind of resigned nod and commented how common a history of contraceptive pill use is amongst those diagnosed later with bc.

      I only took it for about 5yrs and that was 20yrs ago, but I sure regret it and the chaos it created with my hormones.
      I second your urging for women to strongly reconsider their pill use. As well as checking and maintaining vitamin D and iodine levels.

      Best wishes to you Lauren and thank you Mark for opening discussion on such an important topic

  88. I don’t know if it’s been mentioned yet (I don’t have the time to read through 4 pages of comments):

    The Fertility Awareness Method (FAM) as described by Toni Weschler in her book ‘Taking Charge of Your Fertility’ is a fantastic way to naturally monitor your own fertility.

    It can be used for birth control as well as pregnancy achievement, and it is NOT the ‘Rhythm method’. It is as reliable and effective as hormonal contraception, but has no side effects.

    I was on the pill/nuvaring for 10 years, and would highly recommend FAM as a means of natural birth control.

  89. This post is so timely – I was searching through it last week to see what the take on hormonal contraceptives was.
    I’ve been on and off the pill most of my life. I’ve suffered from Chronic Fatigue Syndrome for about 3 years now and was beginning to see some real result eating Primally – and off the Pill – in the last 6 months.

    I recently had the mirena fitted to control heavy bleeding and lower back pain which started up again after the birth of my second child (also about 3 years back) Since I’ve had it fitted I’ve got the same foggy, drugged up tiredness back again. It’s not listed as a side effect – but I’m starting to be unable to ignore the fact I only make progress with the CFS when I’m off all medication.

    Now I’m in 2 minds whether to endure the 6 months everyone says I should do to let side effects settle down, or find something else.
    Oh – and if my libido was low with the Pill , it’s now a flat as a pancake. On that score my husband thinks the Mirena is a very effective contraceptive!

  90. Oh…. how inconveniently well timed, Mark you’ve annoyed me, I didn’t want to look at this! I’m going to share a quick summary in case it helps someone (and then I guess I’ll go help myself). I am 27 and I have never had children. I started taking the combined pill just after I turned 16 (thanks mum!) and although I already had some little boobs I was only just beginning to truly bloom into womanhood so I cannot say if my hourglass figure is due to the pill or nature (vanity problem here: what happens when I stop? Love my shape and I don’t want to lose my nice boobs!!). I should point out that I had anorexia type illness prior to taking the pill so that is another confounding factor. The pill did take care of my terrible acne which made me the target of bullies in school, and the crippling (I mean crippling, on the floor gasping) monthly cramps so these are positives. I have struggled with depression / anxiety and lots of milia (fatty spots on face) a few times due to particular brands not suiting me. Most recently (early 2011) my normal pill that I’d been taking for years was in short supply due to production problems and the substitute made me go MENTAL. I was signed off work for a fortnight so I could climb out of the emotional dungeon I fell into. So basically only one ratio of hormones in the world allows me to feel normal. Secondly, the pill has caused cervical erosion which causes symptoms such as bleeding after sex. In 2008 I had to have my cervix cauterised, which was a bit grim, but about 6 months later the intermittent bleeding started again. Now it’s fairly constant causing slightly to very bloodstained discharge daily (sincere apologies to the squeamish) but I have no idea if the ‘damage is done’ or if coming off the pill will stop it. I also have controlled IBS so I wonder what will happen with that if I come off.
    I will also throw in there that during the odd short month where I have been pill free my cellulite vanished.
    Oh, and my libido has virtually vanished but I don’t really know what will happen if it came back since my partner has a uncommonly low sex drive. So in summary, the combined pill can cause even more problems than Mark covered above, but it did help in some areas. I have no idea what to do.

    1. Charlotte,
      I am so relieved to read this. Last year, I also got to experience the joy of silver nitrate cauterization for the exact same reasons. I never imagined the pill as a possible cause because I’ve been on it since my teens. It’s such a relief to know I’m not the only one who has experienced that.

      1. Oh Randi I think it is so common but no one talks about it! You can PM me any time if you want to talk about it. Recovering from the procedure is pretty grotty. My mum had to come off the pill before she had me due to erosion and that was in the 80’s I guess. I was terrified at first, I thought something terrible was wrong. I wish a Dr had told me about this before I started taking it. In fact, if I remember correctly, he just sighed and wrote me a presciption, signed it and said ‘try this’. End of appointment.

        1. I’d love to learn more about what you’ve been through. I’ve been to several doctors and been tested for everything. Not one doctor ever even mentioned that the pill could contribute to this. They keep telling me nothing is technically wrong, but obviously something is. The bleeding is horrible and even came back a few months after cauterization. How do I send a pm?

        2. Oops sorry Randi, didn’t think that one through. If you go to Forum; Community; Members List and then tab through the alphabet, my user name is ‘Nibbler’ and you can leave me a message on my page x

  91. Charlotte I’m in the exact same boat as u! I’m 35, went on pill at 17 (with NO probs, all benefits) had the odd 12-18mths off it during baby making/preg/breastfeeding time 2kids. Started primal (slowly but surely) about a yr ago. Came off antidepressants last July and since then have noticed how my body has now gone v different – I’m v emotional, sore breasts, exhausted, v moody before period, even had a few spots too! It’s like my body was in my teens prior to the pill…. I wonder if its cos since goin Primal, my body is now hormonally adapted so now the pill gives me like “anti-symptoms”?! Like my body has reversed somewhat?! I also take into consideration that my body has changed naturally over 18yrs (really that long?!) and I’ve had 2kids which prob changes ur hormones too? It’s also massively affected my libido too 🙁

    But like u, I’m scared of coming off and facing mths of possibly horrible physical/mental symptoms while my body adapts and the uncertainty all that time if not knowing if it is actually adapting or is there for good – aagghh! I had this a bit in the few mths after I’d finished bf my last baby and its what prompted me to go back on pill even tho I wasn’t entirely happy to do so but when dealing with a baby/young toddler I didn’t have the strength to “try it out”….

    I think I prob will give it a go but do worry about being v hormonal when I’m also currently feeling a bit depressed too – or maybe coming off will cure both….eventually?!

    H x

    1. Well Helen I have been reading about this all day… I have just spoken to my partner and he says we should try condoms for a bit instead. I’ve made an appointment with my GP to see what other options I have. So maybe this time next week I could be hormone free… God this is liberating!!
      I always believed that children change your hormones although I’ve never had any myself. I think if you understand your body and your moods, and your partner is going to be gentle with you and support you when you come off, it’s worth a go, surely? You can always try something else if you feel a bit funny. Good luck, I’d love to hear how you get on. x

  92. Incredible that this article popped up just days after a discussion with my parents about whether I should go on the pill or not!

    I’m 20 and suffered body confidence and weight/eating issues during my teens, totally put off the pill because I was scared I’d gain weight. Now I’m Primal and don’t look back – I feel incredible!

    I suspect I have PCOS – all the symptoms are there, including extremely painful and irregular periods. This sparked the conversation with Mum and Dad after two days rolling around in agony. I still refuse to take the pill. I try to avoid any medication – even paracetamol, despite the agony. Why would I want to disrupt my body when there’s clearly something it’s already trying to handle? I’m hoping that the more I commit to the Primal lifestyle and the healthier my body becomes, my periods will become better and more manageable. I’d rather use condoms than risk damaging my body!

  93. Well, I don’t do the pill, but I am on the Depo Provera Injection, and it is hormonal. I gained a lot of weight after I started doing it, but that was the only side effect I really noticed.

    My grandmother told me (at 17) when I wanted to start spending the weekends at my BFs house I had to be on the pill but the doctor reccomended the shot and the only thing she told me is “it’s the most effective form on the market and if you get the injection now you’ll be safe right away you can even have sexual intercourse tonight” she never mentioned any risks or anything. So I just did it. My (now husband) and I don’t ever want kids but in my state you have to be a certian age or have a certian number of children already before they will steralize you so I guess I will just keep on the shot for now. FYI I’m 24 this year and I’ve been on it since I was 17.

    1. I really recommend the copper IUD! See some earlier comments about it, lots of women have chimed in. 🙂

  94. Mark,
    Thank you so much for this article. I have been on and off(mostly on) HBC for the past 28 years. I went off last week due to BP issues and my older sisters having breast cancer. It’s not worth the risk. Every woman needs to know the risk factors of any BC method and many times doctors do not know it or are in with a pharmacuetical company to push the latest pill. Women need to become detectives just to become informed and make the right choices for them.
    I’m curious to see what happens to my BP and LDL levels after being off HBC.
    Again.. many thanks for the article and all the great information you keep putting out there. Primal Blueprint is the greatest thing that has ever happened to me.

  95. I hate having my period. We have our one and only child, and that’s it for us, so I see no pint in suffering through the monthly woes. I take Seasonal, and as soon as I can find a doctor in Canada who knows if that ‘once a year period’ pill is available, I am getting it. I hate the periods this much. They are pointless and messy.

  96. To the ladies posting above who are afraid that coming off the pill will eliminate the benefits they’ve seen:

    I had menorhaggia; buckets of blood and crippling pains every month. Coming off the pill and being paleo/primal has solved that. My periods are SO much lighter, pain-free, and barely noticeable now. I understand your fear but I would urge you to give your body some time off BCP to regulate and see how your body works now. No doubt it has changed as your diet has changed.

  97. I think birth control was an amazing invention. I am thankful I grew up during a time where it was inexpensive and readily available.
    I was on the pill or some form of hormonal birth control for six years. Looking back on it now, I had incredibly mood swings. Highs and lows like you wouldn’t believe. Although I wouldn’t go back and not take birth control, it is interesting to look back on the effects that are very likely related to the birth control. I was young, didn’t know any different and really really didn’t want a baby but really, really wanted to have sex. I married my husband 4 years ago and birth control hasn’t entered my body. My moods are much smoother (ep. after eating paleo) and my lovely husband was smart enough to get a vasectomy. Of course if you want kids this shouldn’t be the route for you but, if you don’t want kids I highly recommend it! Talk to your doctor if you think you are feeling funny on your birth control. It might not just be you. There are so many options and one might work very well for you and another might make you feel horrific. You have options, don’t settle.

  98. Anything that doctors shove at me as if it’s totally harmless sets of my alarm bells. The fact that “breast cancer” isn’t even mentioned by gynecologists as a possible side effect of the pill is a scandal. People are figuring out on their own that there is a link between birth control pills and breast cancer. I know three women who got very dangerous breast cancers in their 30s, and all three were on the pill. Upon their diagnoses, each one was told to go off it immediately. That fact alone should give pause to gynecologist’s, but it doesn’t.

  99. I got on birth control at age 14 due to excruciating menstrual cramps. I stayed on birth control until about a year and a half ago (age 24). I wanted to give my body a break and also try and get some libido back. I was hoping that since I was older maybe my cramps would not be as bad. NOPE…they are horrendous again. Also, my PMS is raging for an entire week before my period. It is only getting worse. I have tried EVERY herbal/home remedy to try and fix this (Krill oil, Magnesium, ect.) but I cannot. I must be one of those women who need the pill to help balance a screwed an already screwed up system. 🙁 I have two samples of Loestrin24 sitting on my counter that I will try in about 2 weeks. Just hope it all works out again so I don’t have to miss work and life anymore.

  100. When I was 16 (nearly 20 years ago) my doctor put me on the pill to decrease acne. It was horrible. Not only did the acne persist, but I gained 10 pounds and became depressed.

    Throughout my 20s I used the copper IUD until it started to weird me out that I had a foreign object in my body.

    Now I use FAM so I know when I’m fertile. We just use a condom on those days. It’s been my favorite form of contraception so far!

    Actually, now we’re trying to get pregnant, so we just ditched the condoms. 🙂

  101. Hey Ya’ll,

    I just wanted to throw it out there, my wife and I as well as a number of couples we know have use NFP (natural family planning) as a way hold off on having children after being married (we had no money, big debt, tiny apartment, etc).

    I can tell you from our experience and that of our friends, in addition to being both completely natural and very effective (when used right, as in any method), it seemed to put us in better touch with our bodies rather than working against them or circumventing them.

    It also was great for our relationship. Rather than simply taking a pill and being done with it, we had to continually discuss our goals and priorities. I had to really learn to listen to my wife and her concerns about having a baby before we were more secure.

    One thing I love about the Primal Blueprint way of thinking, is that I have cut things out of my life that were artificial and toxic. As a result, I feel so much more in touch with my natural processes and balance. It is now not just a diet but a lifestyle of maintaining that balance. In the same way, it has been great to learn with my wife how to work with her natural cycles of fertility and infertility rather than using artificial means.

    Thanks for all the great info Mark. Grok on ya’ll!


  102. I was lucky enough to have a gyno that told me “You don’t need the Pill”. A conversation would have been better, and I was unaware of the risks and side-effects. That is, until I got to college and heard the tales of woe and weight-gain. Dilligent use of condoms has gotten me through 10 years of sexy times. I’ll have my tubes tied when I’m done reproducing.


  103. I’ve never taken the pill. I started my menses around 14, and it’s been pretty regular–every 28 days since. I’ve been careful, never been pregnant and I don’t regret my choice. However, my GYN has urged me over the years to consider taking the pill to lower my risk of ovarian cancer. To me, with a family history of endometrial, and breast cancers (post menopausal/paternal side)–it was never worth the risk. Granted, ovarian cancer is usually deadly, since most of the symptoms–if there are any–are mild or mimic GI or other issues, and by the time it’s found, it’s too late. Nonetheless, I get pelvic exams routinely, and I’m getting a pelvic ultrasound today, which helps to keep close watch on those dear ovaries. Of course, limited or no dairy and a primal lifestyle (I’m a newbie-sort-of) will likely help. Lucky for me, I stopped drinking milk when I was 14.

  104. I recently went off the pill after being on it 7 years. I used it due to insomnia & acne, symptoms I developed beginning in my late 20s probably from dieting and eating low fat. While I was happy to get rid of my acne (I searched and tried to find the cause of it and never was able to– that is how broken the U.S. health & wellness culture is), the mood swings and increase in body fat got on my nerves after a few years. My diet has been semi primal since 2000 so I didn’t gain like a ton of weight on it & also worked out some mid 2000s but I got peri symptoms on it anyway, have been getting up to pee at night since 2008. The sad thing is, I need help hormonally. That’s just my situation being very small, petite & ectomorphic with breast tissue- I thrive on estrogen. Am currently using a higher cholesterol diet, exercise & a small amount of otc bhrt to treat. But most women aren’t so lucky- they don’t understand that a low cholesterol diet & lack of exercise is sending them in to early peri. So when the symptoms show up they read a book, go on a forum, and end up on the pill. It’s really pretty sad.

  105. Thank you so much for posting this! I have been looking forward to your opinion on hormonal birth control for some time. It’s been quite the conundrum as my boyfriend and i absolutely do not want children right now, but I hate thinking that I’m pumping some sort of hormone in my body tha could cause cancer (part of the reason I went to Mirena).

  106. you should also mention what happens when you go off the pill–what very few dctors will ever discuss with women: messed up hormones and lack of period. Issues because the lack of period can contibute to bone loss, massive hormonal mood shifts and general uncertainty regarding ones body.
    For me it was the devil drug and not one I will ever recommend to my daughters or their friends

    1. What was your experience coming off it, if you don’t mind sharing? This is what makes me kind of nervous despite clear evidence that I need to at least try it!

      1. Charlotte, when I went off it, my cycles took a while to normalize, but my crazy mood swings that I was having from being on the pill, went away immediately. I was happier from the first week. I think it all depends on your body’s relationship with the pill in the first place.

      2. Just wanted to say, I was depressed while on the pill, but not knowing any better, I thought I was just a really negative person and tried to accept myself. After going off the pill, it was like a cloud had lifted. Emotionally I felt so “normal” again, so balanced, in a way that is hard to describe. You just have to try it.

        I don’t know if you suffer from this or anything else. I also got my libido back (after decades thinking it was just normal to feel kind of blah about sex). I have a feeling it never really got fully back to what it could have been though. I was so young when I started, now I will never quite know.

  107. Coming off the Pill ruined my life. I gained so much weight sooo fast. Im talking 30 plus pounds. No change in diet or exercise.
    The cramping was unbearable and the bleeding was tremendously heavy. 2 periods a month.
    I have a progesterone deficiency so without the pill I’m an overweight estrogen dominant mess.

  108. I am so thrilled to see this!

    I’ve been primal for only 3 weeks, but during that time I went off the pill for only the second time in 11 years.

    For me, the pill was a godsend to help control my PCOS. However, I’ve always wanted to find a way to be ‘normal’ without the pill. I’ve been asymptomatic of PCOS since losing a substantial amount of weight a few years ago. I’m now 37 and hoping that having children is still in my future.

    One month off and I got my period right on the dot on 28 days! Let’s hope it stays that way.

    I do know that, if my PCOS symptoms start to reappear, that I will most likely get back on the pill, but I appreciate all the information that you have offered here, thank you!

  109. My 20 year old daughter just suffered a massive pulmonary embolism which led to her organs being deprived of enough oxygen to result in multiple organ damage. Her heart and liver sustained damage and she went into acute kidney failure. After a couple of weeks on dialysis she recovered kidney function but it was discovered that she was allergic to heparin and that she has heparin induced thrombocytopenia. The doctors think the blood clots may be because she was on the pill but say they can’t determine that for sure. Her recovery will be long, I’m just grateful it didn’t cost her her life. Thanks for the very good article, Mark. It is such an important decision for women and the thinking that the rare side effects can’t happen to them can’t be the deciding factor. The risks are real and happen to real people.

  110. When I was seventeen I went on a campaign to learn as much as I could about my various contraception options. I was frustrated, again and again, by the blank looks and subsequent pushing of cheerful pamphlets I got from medical professionals. Nobody could tell me anything useful. I was asking, “so this stuff makes my body think I’m pregnant and therefore renders me temporarily infertile? What does that actually mean, biochemically, in the context of my body? What else will happen?”

    I was told there were no side effects that wouldn’t “even out” eventually. I wasn’t convinced but I took the DepoProvera shot after a lot of consideration, as a kind of self-experimentation.

    Worst three months of my life. I remember very little of it, besides a lot of bleeding and a lot of crying on the floor.

    Anyway, I’m 21 years old now and haven’t tried anything since. Still not pregnant. Guess what? Condoms work! Then a woman I nanny for was kind enough to explain how my fertility cycle ACTUALLY WORKS, which I realized nobody had bothered to tell me about, not even in Grade 12 Biology. It was always this vague mystery, oh I guess there’s an egg and some ovaries and whatever. What, you mean I’m not gonna have a baby every time I have unprotected sex? What, you mean it’s not entirely random and unpredictable? It almost felt as though all the planned parenthood courses, youth clinics and puberty books were discouraged from revealing the reality: That women have been having unprotected sex for hundreds of thousands of years, and many of them knew how to avoid unwanted pregnancies until that information was lost or suppressed. That, if you understand how your own body works, you are empowered to make your own choices.

    I also read somewhere to do with GAPS that the Pill wipes out your gut bacteria, leaving you more susceptible to illness, less fertile, and more likely to bear children with abnormal gut flora, leading to GAPS (Gut and Psychology Syndrome) conditions such as autism, ADD/ADHD, allergies, asthma, etc. Hmm… I need to research this further, but given the timing of the “unveiling” of the Pill and the recent (and ever-climbing) explosion in rates of diagnosed children (one in 10 has a GAPS related diagnosis)…I’m not entirely unconvinced. <— here's some info on the natural fertility awareness method. There's lots of info out there if you know what to look for.

    Oh, and sex is positively more amazing when you know your body inside and out. Just saying.

  111. The trouble with the pill – is you really need to know what your OWN hormone levels are like before adding in more. Some people don’t produce enough progesterone and then if they take a pill high is oestrogen – it will throw you out of kilter. I suffered bad PMS and was crazy and depressed half of every month – took me a loong time to cotton on to it being the B.C. pills. Much calmer coming off them. Hard to find alternatives though. Copper IUD can cause woman trouble too…you really have to be prepared to listen closely to your own body’s needs. 🙂

  112. To anyone curious about the copper IUD, it has no hormones – it works by creating a hostile environment for sperm. while there is a chance for copper toxicity (not to mention the chance you may have a copper allergy), i found it is the best method for me. if I stay (mostly) primal with my diet and/or supplement with zinc when I slip up, I’ve been able to avoid a lot of the reported side effects. I’d recommend anyone interested visit this site: which contains the experiences of women worldwide who have an IUD.
    After the nightmare of hormonal birth control, this is the most effective non hormonal method for me barring sterilization (which doctors won’t do yet because of my age).

    1. IUDs should be banned. It’s a foreign device in a womans body. Though true copper toxicities are rare, mineral imbalances are prevalent especially those that copper must create a balance with – namely iron, molybdenum, zinc, & manganese. Additionally, those copper IUDs influence the copper bile salts that are made in the liver & stored in the gallbladder. So gallbladder problems are not uncommon. I once saw a woman who had an IUD in and then her gallbladder removed 6 months later – not a coincidence.
      Low back pain, hip problems, and other pelvic and low extremities problems are also common with an IUD. I won’t treat a woman with an IUD until it’s removed; it’s a guarantee it’s causing some, if not all of her problems. One of the very few times I won’t see someone until they deal with an issue beforehand. Of course the hormonal IUDs even worse than the copper ones.

      1. I’ve never heard anything about the copper IUD and gallbladder problems. Could you provide a source of more information, please?

        Also, I’m really surprised to see that an IUD makes the list of reasons to refuse to see someone. I researched them pretty extensively before I got mine and everything I found indicated that they were relatively harmless, especially compared to the risks of other forms of birth control or an unintended pregnancy. I’d be interested to see the research that shows otherwise.

        1. I’m not sure what has been done in regards to research, but like all drug research (and an IUD should be considered as such) there is always plenty of research to substantiate benefits and risks (or lack thereof). My “source” is my own professional experience over 14 years with treating women with hormonal problems,as well as many other health issues. Not once have I seen a woman not have a problem with her IUD. No, you probably won’t see in the literature a link between the copper and gallbladder problem. Even the patient I saw won’t be classified as a link between the two. Copper, though, as a strong affinity with estrogen, and that is why more women than men have gallbladder problems – due to this estrogen/copper relationship. More estrogen = more copper accumulation.
          BTW – an IUD is the only thing on “the list” that I won’t see a woman until she removes it. The reason is because if they’re seeing me for some health concern, the IUD is going to play a part. It just always will since it’s constantly irritating the uterine tissue. It’s like putting a little stone under your foot and even if you don’t feel it there after some time, it’s going to change your posture, gait, muscle balance, etc.

  113. I wish I would’ve been informed about the gastrointestinal effects of the pill years ago. I started taking the pill when I was 21 years old within about 2 months I had gained 10 pounds. I seemed to never really full or satiated. I also had crazy mood swings, worse than any natural hormonal mood swings I had ever experienced. I went to the doctor and explained my symptoms, her suggestion was a different brand of pill. Fast forward 6 months, I was 35 pounds heavier, depressed, and began having extreme acid reflux and bloating after every meal. I was an avid runner before the pill, but my GERD was so painful I couldn’t even bend over to tie my shoes without stomach acid rushing up my esophagus. I had never had anything like this before, I always though heartburn was just an ‘old people thing’. I went to the doctor for my stomach problems and was put on Prilosec. I kept taking both medications and still had chronic GERD, one time I even went to ER because I had stomach acid coming out of my nose! The diagnosis that time was to start taking 2 Prilosec a day instead of the usual 1. Over the next 2 years I had dozens of blood tests, co-pays, expensive medications, and even an ultrasound of my gallbladder, and I gained 20 more pounds. I was between a rock and a hard place, eating made me fat and gave me heartburn and not eating gave me more heartburn! My last straw was when the doctor wanted to do an endoscopy (a $1200 procedure NOT covered by my insurance due to my young age) and when I told the Dr I have anxiety about going under anesthesia his only response was ‘Don’t worry, I’ll give you some Valium!”. That was the moment I gave up on my doctors completely. I researched the side effects of Prilosec and the Pill and immediately stopped taking both of them. It took a little over a year to heal my GERD and I’m still trying to lose the weight I gained during that time. I had to take TONS of probiotics, I did a Candida cleanse for 4 weeks, and had 5 colonics over the course of that year. Those things combined with primal eating cured my GERD. I haven’t had any symptoms in almost 9 months now and I finally feel like a normal person again. I wish I would’ve known then how dangerous the Pill can be for some people, and I wish that my doctors would have been more willing to consider the pill was the cause of the problems. It was almost as though they didn’t want to admit that there could be side effects like I was experiencing at the time.

  114. I was on the pill for 3 years, then off, then on for 3 more years. Both times it made me irrational, with mood swings, lost sex drive, and lost physical energy. It also reduced my pms and the length of my periods, but that’s not really worth it. When I got off the pill, my doctor told me I had PCOS, and the only way to “fix” it was to go back on it. I noticed there are a few similar stories about PCOS on this thread….

    Medical studies have shown that the pill reduces women’s ability to build muscle and reduces sex drive. The way it regulates hormones causes our testosterone to get unbalanced, and screws with our natural production of hormones, which for women is a delicate balance. I’m sure this is why PCOS happens afterwards.

    The pill may have been a great political invention at the time, but we don’t need it for political freedom anymore, so it’s time to look at what it’s doing to millions of women around the wold today, medically and psychologically. I know I will never take it again.

    1. I know I’m replying to a three year old thread, but your comment really struck me. I first went on the pill at 21, and I had zero hormonal problems before then. Perfectly clear skin all my life, annoying PMS, but not unbearable, and very regular periods. I decided to go off the pill at 26, when a long-term relationship ended, and suddenly I had PCOS. My hormones were a mess, my skin was incredibly oily, I had hirsutism, oily dandruff, cystic acne and gained 20 pounds.

      Every doctor told me I would have developed PCOS anyway, and the pill had actually kept it at bay for all those years. But reading so many similar stories here, I have to wonder if the pill is what caused this hormonal imbalance.

      I’m now 35, and doctors have put me back on various forms of bcp over the years, each time with worse effects. The most recent time I became violently ill and stopped it after 3 days. Reading through the stories in this post has convinced me never to try it again. I may have to deal with the after effects of being on the pill for years, but I believe I can balance my hormones with proper diet, exercise and sleep.

  115. Oh, and for anyone out there reading this and thinking the pill might help you grow boobs… didn’t make a damn difference on me, and I started taking it at 19.

    1. Me neither, taking it at 18. I’m smallish, and the thought of hormone-induced boobs doesn’t appeal to me anyway.

  116. I am 26 and was diagnosed with a mild form of endometriosis when I was 21, and that is the reason I’m on birth control (pain and illness during my period were so extreme I was missing 2 days of school/work every month). Being fully Primal for a few months, I’d like to get off the pill, but I worry that the pain and sickness will come back. Can anyone offer any incite?

  117. What is your thought on the Nuva ring? Is it any better than the pill? What do you think of IUDs?

    1. My daughter takes this… it was recommended for her (she started at 16) because it is fairly low maintenance and doesn’t impact them the same way the birth control shots do.

  118. There is also a device called the baby-comp/lady comp. It was the option we choose so I could get off the pill since I had been on them since I was 16. basically you take your temperature every morning and it tells you when you are most fertile so you can either avoid having sex those days or use some sort of contrceptive or can help you have a baby. Has worked great for us!

    1. Also called the rhythm method…. My friend is catholic and this is what her priest counseled for her and her husband.

  119. I was taking prenatal vitamins (they had them at the shleter I’m staying at) but stopped because one of the staff told me they have a bit of estrogen in them and it doesn’t have to be printed on the label.

  120. Thanks for the timeliness of this post!

    I’ve been trying to get directive from my Endocrinologist, DO, and GYN about coming off of the pill for 8 months with no real directive.

    I decided yesterday to stop on my own. I am hopeful that with being off of the pill, that I will have better digestive function, less inflammation, and better overall health. Hopefully I can get to that point before I start having withdrawal hormone rage, lol

    1. Change doctors. No directive from your endo? How lame. The others, well I’ve come not to expect much from them anymore.

  121. What about Endometriosis? I have been on the pill for the last 8 years to control my Endometriosis, which has worked quite well.
    I have thought about trying an IUD and talked with my doctor, but after reading about the side effects, I decided against it. But it seems the commenters on this forum have had mostly good luck with the Copper and Mirena IUD’s.
    Any other options for those of us who don’t want to live with full blown Endometriosis?

    1. I mentioned this in reply to someone else’s post, but it’s relevant to your question/problem too. Please read about iodine and look for Dr. Jorge Flechas interviews/info. good luck 🙂

  122. Hi all!

    i wrote this article a couple of years ago on BCP-

    it goes into some more detail on the topic. besides being used for contraceptives, they’re being over prescribed for women with Polycystic Ovary Syndrome (PCOS) as a treatment (there is no “cure”).

    I’ve been recommending that friends try this diet as well as look at Body Ecology and WAPF and just use condoms instead of BCP

  123. Wow, I think this is the most passionate comments section I’ve seen on MDA. I’m in menopause now, but tried oral contraception three separate times, several years apart, and each time became a weeping, depressed mess within a week or two, not to mention gaining at least ten pounds in one cycle. I never stayed on long because I liked my body too well to put it through that, and found the Paragard IUD to be a great option– though I wish I’d actually had the ol’ tubes tied instead, as now the Paragard (my fourth and final IUD) is embedded in my cervix and too risky to yank out. Ten years might be a tad too long to leave a foreign object in the human body.
    Mark, I’d love to see you address the NEXT phase of life: menopause and its endless hot flashes.

  124. does anyone have good/bad things to say about depo? I’ve been on it for a long time, the only side effect i’ve noticed is decreased libido. I’m generally happy with it, as I used to get really bad cramps/heavy bleeding, now rarely even spot.

  125. for anyone having heavier periods, you should read about and consider trying apple cider vinegar. I’ve heard it helps lighten period flow, but not sure it would work if the cause is an IUD. Just something to consider.

  126. Hi, Thanks for this article Mark. I was on birth control, and I think that it hid a lot of inflammation symptoms I was experiencing. My skin went haywire, but since going primal, it got a lot better. I feel better, and much more “primal” in my urges than I felt before. I also think that this paper explained a lot of what I was feeling:
    Basically, this paper states that “contraceptive methods which alter a woman’s natural hormonal cycles may have an underappreciated impact on choice of partners for both women and men and, possibly, reproductive success.” (Since this site is about evolutionary eating, I thought evolutionary fertility/partner selection might also be relevant.)

    in sum, Ladies: Being on birth control might be hiding some serious problems!!! (with your body, or your partner selection)

  127. my mother had an IUD back in the 70’s and still got pregnant. I was on the pill for about 5 years, initially for an ovarian cyst. I saw it on ultrasound, literally looked like a 3rd ovary, same size and shape. Then I liked the regular, short, light periods. I don’t recall having bad mood swings or any other effects besides the “positive” ones. Maybe gaining weight, retaining water, but that could have been caused by my decision to start eating what I wanted w/o trying to be careful. At the end of the 5 years, I just sort of started skipping days when I was supposed to take them. And decided to stop all the way. That was about 6 years ago and I can’t remember anything other than not having my period for a while, which I didn’t mind at all. Now I’m completely against taking any hormones, whether by pill or shot or implant, etc…maybe very rarely some natural progesterone, definitely not synthetic. If you look at the chemical diagram of estrogen and testosterone and synthetic estrogen, testosterone is closer to estrogen than the synthetic estrogen…that’s kind of scary to me. We should try to work with our bodies instead of forcing them to do things.

  128. I was on the pill (low-dose) from 19-25. I went off the pill a few months before attempting to become pregant and the first time we tried I got prego!
    I tried to take the pill while breastfeeding and, nope, that ain’t happening again; I lost my milk 🙁 Once I stop breastfeeding I may go back on. I didn’t notice any side-effects while taking it for 6 years and I haven’t noticed anything differnt since I’ve been off of it.
    I do agree that pills that make you only have one or two cycles a year are just plain dangerous. I haven’t heard any of my friends who tried them speak nice things about them (except they flush down the toilet extremely well).
    It’s a personal decision and when it comes to something like not bringing another baby into your life I really don’t care if someone deems it “primal” or not. I’ve read some people (on a natural parenting page) insisting that if you know your cycles you’re fine! Yeah, that’s why a lot of those women made a side-note listing child number 3 as that “wonderful little surprise”. I don’t need a surpris like that, thanks. Flowers or money will suffice.

  129. Have the Mirena, absolutely love it… it is the first birth control I have done that I can absolutely forget about, that doesn’t change my personality or give me physical side effects.

    It is very important to remember that we are all unique physically and emotionally, that is why there are so many different kinds. I have tried many versions of the pill (pregnant twice..) the shot (made me depressed) and the Mirena.

    Of course, I have no intention of having more children and am within the last two decades of menopause so it makes perfect sense for me. Plus I don’t get periods at all any more which I LOVE.

  130. I’ve been on low-dose bc for 8 years now, and it’s definitely made my migraines worse, caused freaky weight gain, and mood-swings, but considered worth it all to avoid pregnancy. I don’t want to be on bc anymore, and don’t want an IUD foreign object either – I may be close enough to peri-menopause to not have to worry but my gyno won’t discuss this with me for whatever reason. So after putting my annual off for 6 mos to avoid the incompetency (not just her but also last 3 gynos refusing to discuss or entertain other options), I guess I’ll just have to switch gynos once again. Why isn’t there a list of docs that are willing to discuss options and test for fertilityor hormone levels? Geez!

  131. My thanks for this post and all of you who commented.
    After 2 surgeries to remedy the excruiating pain of endometriosis ive been on microgynon for 3 years (that or hysterectomy at 27 i was told by the surgeon).
    Id like to stop it, but worried the endo will flair up again. I cant bare the thought of surgery every few years to clear it all out.

  132. Thanks for this Mark! I have used Fertility Awareness (there are other factors to chart besides temperature, but for the most part I can tell when I’m ovulating just by how I FEEL!) with great success. I’ve been off the pill for 4 years and am still pregnancy free!

    The best part about learning Fertility Awareness is that unlike hormonal birth control, it actually makes it EASIER to get pregnant when that’s what I want.

  133. I’m a bit late to the party here but from a purely paleo perspective there is the advantage of fewer overall periods by practicing continuous contraception (you don’t take the sugar pills and have around 4 periods per year).

    Ladygrok would have probably been pregnant every 4 years or so and had long stretches of amenorrhea brought on by breast feeding. That’s a very different experience than starting puberty at 12 and getting a period a month until menopause. I’m very interested in exactly how “natural” this is and if it’s doing women any harm.

    Also – many thanks for the citation re: pap smears and the pill. I’ve been looking for this for quite some time, and even asked 2 doctors, and no one has ever been able to give me a good answer on why I’m required to get an annual pap smear while on the pill when my risk factors fall to zero (HPV negative, history of negative smears, HPV jab, and no sex in the last year).

    Seriously, dude, kudos. This is an issue I feel strongly about and this is the first blog within the paleo/natural health community to really give it a fair shake with real science. I love the pill and will continue to take it but doctors don’t give women all of the info before prescribing and, in my experience, tend to downplay the negative side effects that many experience.

  134. Fertility isn’t a disease so it’s no surprise that treating it with drugs can cause problems.

    I also recommend Taking Charge of Your Fertility but to also use charting with a fertility monitor. Using both together gives an extremely high success rate, with either achieving or avoiding pregnancy, your choice.

    Persona, only available in the UK (and maybe Canada?), is the best fertility comp on the market. It works by measuring hormone levels in morning urine, via test strips, 8 days per month. What you want to do with that information is your business. (And the same test strips for the ClearBlue Fertility monitor can be used, so once you get the Persona, you will be able to buy a steady supply of test strips in the US.)

    But someone please tell me why Persona can’t be sold in the US? It’s 100% non-invasive. Could it be because then a good percentage of their customers might stop buying chemical bc? Hmmmm….

  135. After having children, I’ve opted for the copper IUD and love it, except for the long cycles. But that is a small price to pay considering the Pill (pre kids) messed up my system so much that my doctor diagnosed me with the non-insulin resistant form of PCOS when I went off of it. I blamed the drugs (the Pill) for messing me up, and after a year with NO cycles due to my jacked up hormones, resorted to drugs to fix the problem. Thankfully they did the trick and I was able to have 2 children. Now my body seems to be back in normal year! 🙂 Personally, I am going to steer clear of the Pill now, and am encouraging my little sister to do the same. I’ve had lots of friends use it with no problem, but if you don’t know how your body is going to react, it is not worth risking your fertility, if that is something you value.

  136. So the pill is made from horse urine-yes. Do I really need to say more. Plus you are lied to about the metabolic pathway it uses. It does not prevent pregnancy. You do become pregnant on the bill but it causes your body to trash fertilized eggs down in the form of your period and you never know the difference. Women who are on the pill probably have had dozens of abortions and then when they go off, they wonder why they can’t get pregnant? Don’t believe me, ask a pharmacist- oh yeah I am one.

    1. Ok-I do know how to spell. I was just so mad that I forgot how to type.

      The pill has destroyed “the family” to promote sex for pleasure without morality and in-turn, destroying the family will destroy communities (too many single moms need government welfare) and when communities fail and too many people depend on government, societies will fail. Oh wait-does that sound like something we are seeing?

      1. For all those people who say their Dr’s told them to go on the pill for some bogus medical reason-RUN!

        The urgent medical reason probably had more to do with some vacation your doctor was trying to earn from some pharma rep. There is no medical issue on the planet that is caused by a deficiency is horse urine! If you have irregular periods, change your diet first.

        1. My last comment and then I am putting this to rest. You women on this site are FAR to special and worth way more than to be a monthly customer to some drug company. I sound like a crazy lady in these posts because I was lied too and it makes me so mad to know that you are all still being lied to.

          You don’t need to pay for some birth control. That is what these companies want you to think. Your body is only fertile 24 hours a month and if you check out NFP (free!!!) you will learn how to gauge this. Please-don’t let someone else control your hormones.

  137. I’ve been on various BCP since I was 19 (almost 20 years ago). Took a few years off to have my two daughters. Had I known the side effects, I never would have started hormonal contraceptives. After our second child was born, I was done having kids, my husband got a vasecotomy and I quit taking the pill. Immediately, I had acne worse than any teenager. Deep, horrible, scarring acne that responded to nothing. Within three months, my hair started falling out in huge handfuls. I lost so much of the hair on my head that I looked like a chemo patient. So yeah, the sex drive came back, then I looked like a freak and no longer wanted to have sex. No doctor could find a reason for the mysterious acne and hair loss. I was expected to just deal with it. Suspecting it was hormone-related with stopping the pill, I was patient, suffered through it and waited for things to return to normal. I live a very healthy lifestyle, eat well, exercise daily etc. but this went on for TWO YEARS without showing any sign of stopping. Finally I gave up. I was so depressed, I felt like a shadow of my old self, embarrased to go out, meeting new people was excruciating. So I asked my doctor to put me back on the pill, as an experiment. RESULT: face and neck acne cleared up within a week, perfect skin. The hair loss gradually slowed down over about three months, now after 5 months, the hair had stopped falling out and looks to be growing back. The catch is, I have to stay on hormones…
    So my point is, do your homework, ask questions, be careful before you or yuor daughter start down this path. You can’t undo it. No doctor ever warned the 19-year-old me that this could ever happen.

  138. I was on Nexium for gastrointenstinal issues that I am pretty sure were linked to the pill (YAZ), which I stopped taking prior to taking Nexium. Nexium was pretty hard on my body too. I ended up anaemic (hair loss and lethargy) and went off Nexium after 2 months and sought the advice of a naturopath and later accupuncture with a TCM doctor, their help has been incredible! I still have some gastro issues but can at least function without daily pain.

  139. As a woman with PCOS, metabolic syndrome, and early onset of high blood pressure, hypoglycemia, etc (started at the age of 21!) I am stoked to see Mark weigh in on this topic. Part of the “treatment” for PCOS is hormonal birth control. I cannot stress how much birth control contributed to my ailing health. Spiraling depression, exacerbation of existing health problems, and massive weight gain… they told me it was the PCOS. Only after I nixed the birth control entirely (I have a female partner so it’s not necessary) did I see some improvement and going primal allowed me to cease all “treatment” meds for PCOS. And I lost 25 lbs. Oh and my depression is gone. Did I mention my health problems resolved themselves?

    Conditions like PCOS and Metabolic Syndrome are further crippled by the inadequate guesswork of conventional medicine and the SAD lifestyle many of us have been led to believe is the cure.

    For women out there with hormonal issues I think hormonal birth control can be a dangerous dangerous thing. Proceed with EXTREME caution and try going primal first.

  140. Very informative, thanks Mark.

    For years I had side effects from the pill and it wasn’t until I started to use the Nuvaring that I found the contraceptive for me. It’s a super low dose and I can’t recommend it highly enough.

    There’s plenty of options out there for women and it’s important for women to know they have these choices and it’s not one size fits all.

  141. I love all the comments here — it just goes to show how different we all are!

    I’m on birth control, Implanon to be precise — it’s a sub-dermal Progestin-only implant. I originally went on it for birth control, and discovered that it corrected my life-long struggle with intense, debilitating depression. When I have the Implanon, I don’t get depressed.

    I’ve had it out once, and within a few months the depression came back with a vengeance, coupled with crippling social anxiety. I hadn’t properly clued in to the cause and effect at the time, and so I battled with the depression for 6 months before I figured it out.

    I was living in Japan when the depression came back, and they don’t have Implanon there, so I went on the Pill for awhile. My depression went away, but my period was heavy and irregular. Still, the depression being gone was good enough, so I stuck with it.

    Later, I moved back to Australia for other reasons, and decided to try going off the Pill for awhile. Within a couple of months, the depression started creeping back up on me. So, I went and got the Implanon again. Bang, I’m totally fine again, and have been since. And Implanon also regulates my period, and completely frees me from PMS and period pain, which I suffer a great deal when I’m not on Implanon.

    I know there are other health risks involved with hormonal birth control, but quite frankly, being freed from the crippling depression that stole at least 10 years of my life from me, and being able to live a “normal” life now, means a lot more to me than the possibility that I might get sick from something later on.

    It’s a risk I’m more than willing to take, but that’s a choice I made for myself. I couldn’t make it for someone else.

    (And yes, I was on Primal for quite some time when I tried going off the Pill for awhile. Unfortunately improving my diet hasn’t seemed to fix my susceptibility to depression.)

  142. Some of the stomach issues associated with the pill are related to the fact that they include lacstose in the formulation. If you are lactose intolerant this could be causing problem and you may want to try taking lactaid pills and acidopolis. Also primrose oil helps some women with reducing the bloating.

  143. I was 28-years-old when I was sidelined by a pulmonary embolism. I had no family history of clots, did not smoke, and while I was overweight, I was active and not considered at “high risk.” Oh – but then I started taking an oral contraceptive for the first time in several years. A month and a half later – BAM! – I’m in the ER, hours away from death, with seven blood clots in my lungs.

    I have to take an aspirin every night for the rest of my life as a blood thinner. And if I ever get another blood clot, I will be on dangerous, tricky blood thinners until I die.

    And my doctor did not mention a thing about this risk, saying that because I didn’t smoke I wouldn’t get blood clots. And I stupidly believed her. That was the last time I take a doctor’s advice without doing my own research.

    (Oh – and that’s why I’m going paleo, despite my doctor saying that the only way to lose weight and get healthy is with lots of grains and no fat. Suuuuurrrreeee).

  144. Thank you for a very balanced article. I’m so glad you didn’t dismiss the oral contraceptive out-of-hand. Having endured four decades of the monthly inconvenience (latterly fortnightly nightmare) of menstruation, and having recently discovered the benefits of taking a progesterone-only pill (no menstruation), I can safely say that there isn’t much you could say which would persuade me not to take it!

  145. Just wanted to recommend NFP/Creighton Method. Super easy once trained. Super cheap. No chemicals and works 98% when used correctly. Works amazingly for preventing or achieving pregnancy. Once primal you can see a huge difference in your chart. I took my chart to my OB who is Creighton trained and pin pointed my issues. Now that I know them hoping the diet will correct them. (PCOS, endometriosis, hypothyrodism, and progesterone deficiency) Been 95% primal since Feb. 2012. Doing ok waiting for that 1 year mark to see the huge difference. Had surgery in Dec. 2011 (ovarian drilling for the PCOS and lasar for the endo also confirmed low progesterone. Hoping for that primal miracle! 🙂

  146. I have to agree to sharing concerns about the pill. I’ve been on birth control for most of the last ten years. Its only now as I’m getting married and thinking of starting a family that I’ve realized something: I’ve been experiencing seven of the eight bullet points (plus others!) in “other side effects”, and they are most likely tied to my birth control.

    With a recent increase in side effects, I stopped my pill two weeks ago. With the first day off, it was a drastic improvement. Now if only I can wean off the nexium…

    My big concern is this: When we go to our doctors, and we have a new issue, why isn’t the first step to see if its a possible side effect of current medication? That thinking could have saved me thousands of dollars in medication and procedures.

  147. I just want to put out a word of warning about hormonal methods of birth control. I’ve been on OrthCyclen/Spritec/Mononessa for a decade on and off. I’ve found it to be helpful with adult acne, but it could be causing my very painful monthly menstrual migraines. I’m a little scared to go off it and see what happens, but I’m going to give it a shot.

    More importantly, I had the Mirena for over 2 years. After six months I started developing acne. By the one year point, it was deep, cystic acne that was painful and horrible. My dermatologist was NOT able to successfully treat it, even with peels, topical ointments, and oral antibiotics. I told him I thought it was the Mirena and he told me that it wouldn’t cause acne. I decided to move forward with having it removed around the two year point and went back on the pill. My acne had completely cleared within 3 months (but now I’m a bit afraid to go off the pill). Please be carefull when considering the Mirena. Also, it was always poking my boyfriend, even after I got the wires trimmed. He hated it because it caused some serious penis pain.

  148. Hi have been on the pill for the last 14years and what to be off them for good this time (2nd try two years later) because I want to try for kids on 2 years. Last time was horrible – bad acne, depression (made worse by acne), thyroid issues causing be to lose weight and have heart palpitations, tirdness and insomnia. I thought all of these problems were something else but after reading many simalar reactions to going of the pill I realised thats what it was from because it all started after stopping the pill and went away again when I went back on it. I didn’t know any of the about the pill until now but it’s really scary (especially the link to PCOS, which my younger sister has and struggled gettting pregnant). I which I was told about this when I went on the pill, but even now most doctors (esp here in NZ) won’t acknowledges the risks of a hormonal contraceptive and try to tell you it’s something else.

    Also the comment about the lower scores on measures of sexual satisfaction and partner attraction” and “experienced increasing sexual dissatisfaction during the relationship.” is so true when I think back and even now in my current relationship. It’s great to know it could all linked to something and hopefully fingers crossed it improves once I come of the pill (straight away would be nice).

    I hope ALOT improves after I come off the pill, including weight management, moods, libido and fertility of course coz the side affects I have read are all not good being on it or the period in between when your body is getting back to normal.


    hoping my partner is understanding. Although I think he thinks I am reading into it all too much and just jumping on a band wagon, but he doesn’t know my body or quite understand really not does he realise the implications it could have. He thinks I am worried over nothing.

    nothing in life is ever easy is it!!

  149. Hi,

    I am really scared an not sure what to do. I have taken the pill for 7 years and it has served me and my partner well. I am comfortable with it. How much longer can i carry on taking it? Am I already at risk of getting cancer? I was planning on stopping it today but I am hearing two different sides that it’s very very bad for you and that’s it’s ok to a certain point. I need an answer please as I am scared.



    1. Don’t be scared – there’ll always be people giving you opposite opinions, some for, some against and some positively scaremongering. I would go and see your doctor or nurse and discuss it with her/him. There might be better options for you, or you might be fine with the pill you’re on. It all depends on your age, your current state of health, the type of pill you’re taking and the other options available to you. In my opinion, the pill, either combined or progestogen only, are good options for some women, but of course you have to sensibly weigh up the risks and benefits.

  150. I have been off the pill for a few years and have felt great since. However recently had an abnormal period and the doctor insisted I go on bc again to make it normal. 4 days later I started having gallbladder attacks for a week straight. I’ve been off the pill again for the last 2 days and my gallbladder symptoms have decreased by 95%. I’ll never touch the stuff again.

  151. I also use a copper IUD. I’ve only taken birth control for about six months and I felt horrible. I think, in my case it was not because of the side effects of the pill, but just the feeling that there was no natural hormonal cycle. I just felt so aweful, never felt anything more unnatural before.
    I use a frameless copper IUD named ‘Gynefix’. It is said to prevent increased cramps and heavy bleeding that is usually a side effect of other copper IUD’s. I must say, during the first 4 months after insertion, the bleeding was heavier, but this stabilized after half a year. Now I’m just really happy with copper IUD. I have indeed heard of coppor toxicity when using a copper IUD but I think with a good diet it’s rare. As I’ve read somewhere in these posts, zinc supplements may be good in that case. Anyhow, I think copper IUD’s are a far better choice than hormonal contraceptives.

  152. Great article and discussion! Wow, there’s a lot to learn from everyone’s different experiences.

    I went on the pill at 22. I asked my doctor about it and she didn’t give me one word about risks or implications, after reading this article that now makes me rather concerned. The severity of my periods did subside and my breasts grew in size. I was on the pill for 2.5 years. Then, at the same time I went primal I decided to stop taking the pill because I want my body to be completely natural. My breasts have shrunk (talk about a sign of cause and effect) and my period symptoms have incredibly decreased (even more so than when I was on the pill). I’m a firm believer in the Primal Blueprint now based on the undeniable symptoms my body has exhibited.

  153. I think BC is to blame for my cyst. Without my cyst I would have never been diagnosed with Endometriosis though. I fought against going back on BC for years after my diagnosis and finally gave in and am finishing my 3rd month of the mini pill. It’s frustrating because it’s not well known yet so the resources are limited. And until I read this article my doctor never said the mini pill increases my risk of cysts especially if I’ve already had one… which I have. My other issue being that I’m constantly spotting or full on bleeding which is starting to really interfier with my relationship and is rather obnoxious.I was under the impression that by going on BC my cramps would be relieved. I’m not looking for a mirical but I’ve been in more pain this past month than most months without BC. So from my experience you bleed none stop you DO gain weight, I’m also breaking out horribly all over my chest (which is not usual for me) and the pain is still very much there if not worse.

    I could be just an exception. But I am very anti-bc and even the minipill is a nightmare.

  154. I am keen for info/opinions/experiences from other ladies (or men with experience/knowledge) for my issues as I’m really frustrated at the moment.

    I was on Micronor (mini-pill, progesterone only) for a year and did not bleed at all (it was pretty awesome/convenient but probably not very healthy). In the last few months my body has decided to make up for lost time by giving me a whole bunch of periods, usually with about a week in between the end of one and the start of the next. I don’t get much/any symptoms, only some pimples and slight anxiety/lethargy at the start, however needless to say it is annoying and inconvenient. I went to Family Planning and switched to the only other kind of progesterone-only mini pill, Microlut. That seemed to work at first (cutting off a period a day or two in) however quickly returned to the irritating week on, week off pattern. I figured I should give it a month or so to see if it settles, but I’m not liking my chances.

    I can’t take the full Pill or Nuva ring or any other oestrogen-based contraceptive because I used to get migraines with aura/numbness and doctors therefore won’t prescribe oestrogen as it means I am at an increased risk of having a stroke (even if it is still fairly low chance and I haven’t had any of said migraines for over a year.)

    The injection lowers bone density and my bones are problematic as it is, also I hate needles.

    I tried Implanon for several months way back when but had continuous bleeding/spotting. Considering trying it again seeing as it seems my hormones have changed in the last year.

    When I went to Family Planning they suggested that an IUD might be the way to go. They apparently fit them to women who have not been pregnant on a regular basis these days with fairly good results. However any time I have asked anyone about these everyone goes STAY AWAAAAAY IUDs ARE EEEEEVIL and also there is a risk of perforating the uterus or something?!? urgh. The copper one apparently likely to cause a lot of breakthrough bleeding/spotting. the idea of not having hormones appeals to me. The Mirena hormone one can stop periods completely apparently or just have breakthrough bleeding.

    At this stage I would be happy to just have normal periods.

    I’m considering these options, pending discussion with Family Planning or maybe a gyno:
    – Give my body a month or two off synthetic hormones completely and see what it’s like (it’d be the first time since I was about 16) and then try going back on the mini pill or Implanon…
    – Try a double dosage of the mini pill, or Implanon AND mini pill (they tried that back when I first had it, didn’t work then, but things may have changed)
    – Last resort, try the IUD I guess?

    Diet wise, I don’t think there’s much that would be negatively affecting my hormones. I eat soy very rarely, caffeine maybe once a week or less, and hardly any dairy, processed sugars or carbohydrates, or chemicals. Alcohol similarly rarely. Good quality meat. etc.

    Anyone got thoughts/suggestions/input?

  155. Good article. Used pill only 2 x 2 years, two decades apart, glad it existed as an option, even gladder chemical hormones of pill lowered over the years, and that the “progesterone only” pill, the Mini Pill, was pulled off market after realization by mid 1990s it was linked to breast cancer. Not a fan of copper 7 iud, causes problems including heavy bleeds. Dutch cap conjunct with spermicide is fair alternative,only 96 percent effective as contraceptive, but better for health reasons.

  156. There is a lot of talk here about the copper, non-hormonal IUD…. non-hormonal sounds good and all, but from what I have read about how it works, it actually works by causing constant inflammation. Inflammation is bad y’all. It basically makes your womb have an immune reaction that causes your cells to attack sperm and ova. Just want to put that out there so it can be considered as well.

  157. Hi everyone. I have been particularly concerned with this issue. I am 20 years old and have been on the pill since I was barely 12 years old (6th grade), NOT because of sexual activity but because of horrendous periods and PMS. I would transform into super witch for a week, then bleed heavily for 9 to 10 days. The pill regulated my flow and my attitude problems. However I do have breast cancer in my family history, digestive issues, and hormonal issues in general. Lots of genetic factors mixed with the added risks of taking the pill for as long as I have already. I have also been in a committed relationship for two years now, adding the family planning aspect to why I take the pill. It is a mind boggling issue for me. I have considered herbal contraceptives but many of those increase risk of miscarriage by a considerable amount. Long story short, I have been racking my brains for a better way for a long time and have no idea what. I know I have some serious hormonal imbalances that I am currently controlling with artificial hormones and I want to figure out how to naturally regulate/correct those imbalances and maintain some other sort of birth control that is acceptable for me, and us as a couple. Suggestions???

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  159. I enjoyed reading this as I just took myself off of the Microgestin today. I am 48 years old with terrible premenstrual and menstrual issues as I hit perimenopause. So I thought I would try this, though the summer about four years ago that I tried Lo Loestrin, I spent the whole summer feeling physically numb and very depressed.

    So, three weeks into this trial of Microgestin the same thing starts to happen and I’m in tears feeling suicidal and completely disconnected from my body. I decided, in the end, that I will deal with my few days of extreme depression and severe cramps, heavy bleeding instead.

    I was taking Now Women’s Menopause Support more regularly at one point and that might have helped somewhat. I got off schedule with it due to travel, however.

    I also plan to try and stick to a more primal diet than I have been lately and see if that helps and ramp up my yoga and meditation practice.

    I have bipolar disorder and so this was probably never a good idea for me but I got desperate again and tired of prolonged PMS and never knowing when I was going to get my period.

    I would rather feel everything the way I was than feel totally numb like I started to recently and very very down.

    As well, I have a PFO (small hole in the heart with an atrial septal aneurysm with bilateral shunting) and this already increases my risk for stroke, so the whole thing was making me nervous anyway. But as I said, I was feeling desperate. Many people don’t even know if they have a PFO and it is quite common – like 1 in 5 people are born with that hole not closing up in the first year of life.

    Mine was found via an echocardiogram looking at something else.

    Anyway, thank you again for this article because I really did not know abut these extra add ons to formulations and read somewhere else that they increase oxidation.

  160. I think it’s important to note that the pill can be absolutely life-saving for some women- I just advocate more balanced coverage. I find everything about the Pill seems to be either highlight the true but negative (above) or the true and positive (no unplanned pregnancy).

    For me, even as an athlete in high school on a whole foods based diets completely lacking in sugar (high protein, high fat), the endocrinological fluctuations that came with my natural cycle had far too big an impact on my mental health for me to remain functional. Like clockwork, every two days before a period started, I would be suicidally depressed- and even though I knew it was just biochemistry- I was either catatonic, crying, or pondering checking out early.

    Being on Seasonique now has been a god send. I don’t have periods. And I don’t have the monthly two-day impulse to honestly kill myself. Sometimes you have to realize primal living also means dying of childbirth at 19, and deciding to take a more modern alternative.

  161. This was an interesting article, and I appreciate the care the author took in giving this message.

    I’ve been on birth control almost continuously for about a decade. I’m using it to help manage endometriosis. At this point I have a slew of other issues, and am considering trying to stop the pill, but even just thinking about it is very scary: my endometriosis is debilitating without the pill.

    The other option seems to be taking other options that put my body into menopause. I’m thinking of going ahead and getting surgery number 3 and maybe stopping the pill just before then, to see if all of the other work I’ve been doing (diet and lifestyle changes, supplements, pelvic physical therapy) will help with the overall pain post-op and off the pill.

    But another part of me wonders if all that is worth it. If maybe the side effects of the pill are the lesser of the two evils, since at least I can sort of function now .