Gut Knowing: How the Pill Fails Us
Most young women are offered the pill early in their hormonal career. Our healthcare fails at promoting health because it’s focus is on managing disease. Periods are not pathological. In fact, they tell protect us from some diseases and help us stay healthy by giving us reliable cues every month!
If birth control is given to a young woman for acne then it fails to address the underlying cause. Usually impaired detoxification or reactivity in the gut contribute to skin issues. Often it’s both. Treatment that masks symptoms without sorting out cause can create more problems. In this case the pill will worsen the underlying cause if the gut is involved.
This is an example of how the pill can undermine long-term health. There are certainly times that the pill is a good option as a short-term intervention but this is rarely how it is used. Many women I see in clinic have been on the pill for ten or twenty years.
Feeling Sexy?
Put the gut component aside for a moment. Most women are on the pill or another hormonal contraceptive because they want to enjoy heterosexual pleasure without the fear of pregnancy. Rarely is informed consent part of this decision. Being told that there is an increase in blood clots is usually where education stops.
The pill can increase sex hormone binding globulin (SHBG). This acts like a sponge for hormones like free testosterone. Low testosterone can lower sexual desire, shrink your clitoris and decrease lubrication. At this time we have no way to turn this off even after a woman has come off the pill. Lower libido and painful sex is not what we were looking for.
If that not enough, add in mood issues and altering who you are attracted to. I spoke with a group of teens last year. Not one of them knew how the pill actually works. Several reported being diagnosed with a mood disorder shortly after starting the pill. For three of these young women this meant being prescribed an anti-psychotic medication.
My Gut Hurts!
The pill undermines gut health by altering the microbiome. This can result in fungal overgrowth and chronic yeast infections. Fatigue and brain fog often follow. What rarely gets talks about is that the pill also can increase your chances of developing irritable bowel disease (IBD) like Crohn’s.
An altered microbiome may also contribute to developing endometriosis. We understand that immune and gut function play a role in the development and treatment of endometriosis. Lower abdominal pain can be due to inflammation in the gut. It can also be gynecological but often it is both. Short-term use of a hormonal IUD can be helpful with endometriosis.
In my twenties, I developed gut symptoms that were debilitating. If you’ve heard my story you may know I could barely function. My functional medicine doctor told me I was on my way to developing IBD. And I have been diagnosed with endometriosis. But all of this is resolved now. It too patience, a few simple interventions and a lot of self-love which is arguably the most important part.
Perimenopause
Reverse puberty can begin in a woman’s late 30’s. It is a time when we need nuanced treatments but rarely is this available. Usually the pill is offered followed by an anti-depressant. The pill paves over all of our natural hormone signals which have many benefits. We can maintain the cardio protective qualities of estrogen safely using bio-identical hormones when indicated.
Ensuring that estrogens are being metabolized down the right pathways is important. This can be checked by running thorough labs. Often a gentle dose of herbs along with vitamin C is enough to promote endogenous progesterone. Nudging the body into balance is much smarter but it takes someone doing precision medicine because unfortunately women’s bodies aren’t given the attention they deserve yet within in the conventional medical model.
Informed Consent
Women need to know what hormonal contraception is doing. Pill bleeds are not a menstrual cycle. You are likely to go through menopause earlier if you are on the pill for an extended time. This means you won’t benefit from ovulating which is cardio protective and helps maintain muscle mass. One of the most important ways to keep your bones strong and live a long life is by building muscle.
In 2019 immigrant & women of colour were given hysterectomies without consent at a medical establishment in the US. This confirms that bias in medicine happens today in a overt and painful ways. We cannot ignore it. Canada has it’s own track record that bleeds into 2018. Using a trauma informed and body-based approach, we can begin to unwind the root causes of these assaults and stop the harm.
Informed consent is our right. When a patient tells me she’s been offered a hysterectomy when the underlying cause hasn’t been addressed I take the time to dig deeper. There is an underlying cause for fibroids, endometriosis, heavy cycles and lower abdominal pain. I inform her of other, less invasive options to explore while treating her as a whole person.
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