Iowadays, fewer and fewer women rely on the pill.
This is the result of various recent studies and surveys, such as a recent evaluation by the Techniker Krankenkasse health insurance fund.
Many women discontinue the pill after only a short time due to severe side effects, or decide to stop taking it at some point after years of use. More and more women are also opting for a hormone-free alternative to contraception. Especially among younger women, this is increasingly the case.
Here is a current example from my daily practice: A patient in her mid-twenties comes to me for treatment. She has been taking the pill for over ten years. Whereby “the” pill does not apply in her case. Rather, she is already taking the seventh preparation. Due to strong side effects, she had to change her pill every 1-2 years on average. However, she still suffers from various side effects: Blemished skin with painful pimples and inflammations, abdominal pain, constant bleeding in between and headaches are part of her everyday life. After ten years on the pill, she finally decided to stop taking it. What remains at first, however, is her uncertainty: What other unnoticed effects might the long use of the pill have had? And you, too, may be wondering: What undesirable effects can it have?
Currently, almost half of adult, sexually active women and men still indicate the pill as their current contraceptive method. For many women, it is still a popular means of self-determined contraception and preventing pregnancy.
So the topic of the pill is still of enormous importance!
Of course, information about the pill may be especially important for you if you are currently using this method of contraception or have already used the pill for some time in your life. But this information can also be very interesting for other people. You probably know at least one woman who uses birth control pills and may be wondering what the effects are.
Like most people, you probably know:
The pill belongs to the hormonal contraceptives
Hormonal contraceptives consist of artificially produced sex hormones that resemble the body’s own hormones, but do not correspond exactly to them.
Depending on the contraceptive chosen, the exact composition of the artificial hormones and the form of administration may differ.
For example, the hormones can be taken orally (“birth control pill”), but there are also other forms, such as hormone patches, the three-month injection or hormonal contraceptive implants. The composition of the preparations can also differ from one another, depending on the hormones used and the respective dosage.
This leads us to an exciting question:
What are hormones?
Hormones are messenger substances that the body produces in special cells and releases into the body’s bloodstream. From there, they can then travel on to their destination.
Hormones are of great importance for all important bodily functions. They serve to communicate within the body and – to put it simply – tell a particular organ, for example, what it should be doing at any given time.
Hormone receptors are found on almost all cells in the body, including the brain. Hormones can dock onto these receptors and exert a variety of effects in the corresponding organs or body structures. Therefore, hormones can affect almost all of your body systems, including how the brain works and how you feel and perceive things. If you are interested in the topic of hormones in general, you can read about this in my blog article „When hormones go crazy“ in more detail.
In connection with the pill, however, we are now particularly interested in the sex hormones!
What role do the so-called sex hormones play?
Sex hormones are a subtype of hormones and predominantly influence the development of sexual characteristics and the control of sexual functions. Estrogens and progestins (progesterone) predominate in women, while in men it is the androgens (testosterone). However, sex hormones are taken up by all cells in the body that have the appropriate hormone receptors. Thus, sex hormones can also have a major impact on mood, behavior, and cognition, and can also affect your identity, goals, ideas, and preferences. The pill is also made up of hormones.
How does the pill actually work?
Most hormonal contraceptive pills contain a dose of artificial estrogen and a dose of an artificially produced progestin.
Hormonal contraceptive pills can prevent ovulation by keeping hormone levels in the body largely constant, thus preventing it from maturing eggs in the first place. They can suppress the natural fluctuations of female sex hormones in a woman’s cycle, inhibiting ovulation. In addition, they can also prevent the lining of the uterus from building up and make the mucus at the cervix more impermeable so that sperm cannot pass through as easily. All of this leads to a lack of pregnancy.
However, it is still largely unclear how the artificial sex hormones affect other cells in the body that also have matching hormone receptors. In particular, the effects on the human brain are increasingly the focus of current research.
Known side effects of the pill
However, depending on their composition, hormonal contraceptives can also trigger various risks and undesirable effects. The same pill can also cause completely different side effects in different women. What applies to one does not necessarily apply to the other!
Widely known are, for example, the increased risk of thrombosis with some preparations, the possible risk of weight gain and the possibly increased risk of mood swings and depressive moods, as well as the occurrence of headaches, breast pain or digestive problems. Almost every woman who uses the pill has heard of these side effects, and many men have too. You yourself are probably also familiar with some side effects and have heard about them or even had your own experience with them.
Effects of the pill on experience, thinking, feeling and acting
But there are also possible effects of the pill that most women are far less aware of and some of which have only been researched in more detail in recent years or are even currently still being researched. These are mainly effects that you cannot necessarily observe directly on your body (such as pimples, abdominal pain or constant bleeding, which my patient noticed). It’s about effects that might influence how you experience certain things, how you think, how you feel, and even how you act in certain situations.
Effects on the female brain
There is evidence from several recent studies that the pill could permanently change structures in the brain. This could have a major impact on how women think, feel and act. It has been found that various brain regions in women who take the pill may differ significantly in size from those women who do not take hormones. It is not yet certain what effects this has in detail. However, it is suspected that there may well be serious effects on the memory as well as the cognitive performance of hormonally contraceptive women.
Effects on the stress response
The pill can also cause a crucial part of the human stress response to be absent or attenuated. For example, it can often happen that the release of cortisol under stress is absent or reduced when taking the pill. However, the personal perception of stress remains the same. The release of cortisol is enormously important in telling the body that emotionally very significant things are happening that should be held in memory and is part of the normal and healthy response to various forms of stress. Cortisol also performs important functions in the body and is an important factor in performance in stressful situations. However, if cortisol is not now being released when stress levels are elevated, this can make us less able to cope with stress. And in today’s often stressful times, this could have a really detrimental effect in the long term.
Masculinizing effect of the pill
Since many of the progestins used in the pill are made from testosterone, some of them can unfortunately also dock onto testosterone receptors in the female body and lead to side effects such as pimples, increased hair growth and weight gain. The pill can therefore have a “masculinizing” effect under certain circumstances. There are considerations that the brain and thus our thinking and feeling, as well as behavior, could also be influenced by this process.
Pill and depression
Several studies have repeatedly found a connection between taking the pill and the increased occurrence of depression among users. It is still unclear exactly how this connection comes about. However, several mechanisms are suspected as to how taking the pill could lead to the occurrence of depression. The extent of these individual factors, however, is still being researched. It is suspected that the pill can trigger a serious vitamin B6 deficiency and thus lead to a change in tryptophan-serotonin metabolism. In addition, it could lead to an unfavorable shift in kynurenine metabolism. Both are also increasingly observed in patients with depression who do not use hormonal contraception and could generally represent a risk factor for the development of affective disorders in hormonally contraceptive women.
Choice of partner and relationship
Hormonal contraceptive pills may also have an impact on partner choice and relationship satisfaction in some circumstances. It is known that heterosexual women may be more attracted to different types of men at different stages of their cycle than at other stages of their cycle, which may be important for partner choice. When taking the pill, however, women may generally be more attracted to and have more relationships with only one type of man compared to women who do not use hormonal contraception. However, these preferences could change noticeably once the pill is discontinued. This may have a significant impact on relationship satisfaction.
There are also indications that the pill could have serious effects on the oxytocin signaling pathway. Oxytocin is known as the “cuddle hormone” that plays an important role in emotional bonding, maternal care, and sexual arousal. This could have an impact on building partnership bonds and, on top of that, have a negative impact on libido, i.e. lowering the desire for sexual intercourse. This could significantly affect the level of perceived closeness and the perceived quality of a relationship.
Safety of the pill
Many gynecologists emphasize that the pill is a safe and well-researched contraceptive and that the amount of artificial sex hormones added is quite small. In principle, this can be agreed with if a woman were to take the pill even for a comparatively small period of time. However, if one considers how many women have been taking the pill since a young age and in some cases have been doing so permanently for decades, the picture looks different. After all, the amount of sex hormones supplied is so enormous that the female body is successfully prevented from becoming pregnant for decades. The fact that this amount of artificial sex hormones over such a long period of time can then also bring about other undesirable changes in the body should not surprise anyone.
Getting to the bottom of unclear symptoms
Perhaps you are unsure whether you could be affected by these or other effects of the pill or have the impression that this applies to you. If so, I can help you find out! Are you currently taking the pill? If so, it may be helpful to think about how you felt before you started taking the pill and how you have felt since. Do you notice any differences in your cognitive performance or libido? How do you deal with stress? Do you notice differences that you couldn’t explain before? How is your digestive system doing? Do other people report back to you that they notice changes in you? Then it could definitely be helpful to look into this topic more intensively!
There are definitely many other interesting effects of the pill that are beyond the scope of this article.
In my practice we can get to the bottom of your individual symptoms and find out the cause! Of course, I also include your current contraceptive method as a possible cause or possible influencing factor in my detailed anamnesis and diagnostics.
But even if you do not use hormonal contraception, a measurement of the sex hormones or hormones in general can provide information and clues for a variety of diseases, but also for possible treatment approaches. For example, many people benefit greatly from therapy with bioidentical hormones. I can also offer you sound advice on the subject of (hormonal) contraception and alternatives to hormonal contraceptive methods. In addition, a gentle elimination of the pill with naturopathic remedies can often prevent possible symptoms during the upcoming hormonal change.
Would you also like to learn more about the effects of the pill or about your hormones? Do you have questions about alternative contraceptive methods or suffer from unclear symptoms? Or are you toying with the idea of discontinuing the pill and would like someone to provide you with expert support in this decision and the subsequent process? Then feel free to schedule a free online video appointment to get your questions answered or contact me by email at email@example.com or by phone at 089 32 80 88 97.
I look forward to hearing from you!
Your Sebastian Weber
Curtin, Anne & Johnston, Carol (2022). Vitamin B6 Supplementation Reduces Symptoms of Depression in College Women Taking Oral Contraceptives: A Randomized, Double-Blind Crossover Trial, Journal of Dietary Supplements.
Hill, Sarah (2020). Wie uns die Pille verändert. München: Heyne Verlag.
Meier, Timothy et. al (2018). Kynurenic acid is reduced in females and oral contraceptive users: Implications for depression, Brain, Behavior, and Immunity.
Molloy, Anne (2015). Tryptophan Catabolism and Vitamin B-6 Status Are Affected by Gender and Lifestyle Factors in Healthy Young Adults, The Journal of Nutrition.
Morelli, Isabel (2020). Kleine Pille Grosse Folgen. Grünwald: Komplett Media.
Urbanska, Ewa et al. (2012). New insight into the antidepressants action: modulation of kynurenine pathway by increasing the kynurenic acid/3-hydroxykynurenine ratio, Journal of Neural Transmission.
TK-Daten: Immer weniger Frauen nehmen die Pille (2021). Ärzteblatt.
Verfügbar unter: https://www.aerzteblatt.de/nachrichten/128438/TK-Daten-Immer-weniger-Frauen-nehmen-die-Pille [10.02.2022].
Neue BZgA-Studiendaten: Verhütungsverhalten Erwachsener (2019). Bundeszentrale für gesundheitliche Aufklärung.
Verfügbar unter: https://www.bzga.de/aktuelles/2019-09-19-neue-bzga-studiendaten-verhuetungsverhalten-erwachsener/ [10.02.2022].
Important note: The treatment methods mentioned in my blogs originate from empirical medicine. The majority of these established, medical therapy methods have not yet been sufficiently scientifically validated according to the principles of evidence-based medicine (orthodox medicine). In particular, randomized, controlled studies or comprehensive meta-analyses do not yet exist. A success of the empirical medical therapy forms cannot be guaranteed in every treatment case.