Birth Control Part 2: Understand Your Options

Coach Cate dives into the different types of hormonal birth control, how they work, and how do you know which option is right for you. You may be experiencing symptoms you don't even realize are connected. AND Coach Cate walks through how to advocate for yourself so you can make a choice that is best for you (not rushed, out of fear, or pressured). 

Transcript

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Hey, hey, welcome back to Healthy Period. I'm Coach Kate, and I'm so glad you're here today because this conversation is one that women deserve to have, and we definitely do not have it enough. Our last birth control episode was all about informed consent, understanding how the pill works, the research behind the risks and benefits, what the withdrawal bleed really is, and what the data says about things like depression, breast cancer risk, and nutrient depletion. But so many of you had reached out to me saying, all right, Kate, I get the bigger picture, but what about the different kinds of birth control? What do they do to my body specifically? What's happening to my hormones? And how do I know what's right for me? So today I want to take this conversation deeper. I want to talk about the different types of hormonal birth control, the hormonal story behind each one, what they do to your natural hormone production, how they affect the HPO access, gut health, and nutrient status, the symptoms women don't realize that may be connected, and how to advocate for yourself so you can make a choice that actually supports your goals in your long-term health. Now, a lot of people do think that I'm anti-birth control, and I am not. I am not anti-birth control. This episode is to not talk you out of birth control. This episode is pro-you, pro-informed women, pro choices based in clarity, not pressure, fear, or rushed appointments. Personally, the pill in hormonal birth control is not for me. But that doesn't mean that I need to put my sailboat in your picture. So I want you to be able to make the best decision for you based on the information, not based on what happens in a 10-minute appointment. So let's get into it. Before I break down each method, I want you to understand the foundation, the HPO axis, or the hypothalamic pituitary ovarian axis. This is the communication system between your brain and your ovaries. It controls ovulation, your menstrual cycle, and your natural production of estrogen, progesterone, testosterone, and FSH and LH. Most hormonal birth control methods work by disrupting or suppressing this axis. So what does that mean? Your brain stops sending signals required for ovulation. Your ovaries shut down or reduce natural hormone production. You do bleed monthly, but it's a withdrawal bleed, not a true period. And the hormones you get are synthetic, not bioidentical. So this disruption is the root of many of the side effects women experience. So I'm gonna break down each method very clear, very simple, and let's just dive into it. So option number one is what you all know as the pill or a combined oral contraceptive. This contains synthetic estrogen and progestin. So what does it do hormonally? It fully suppresses ovulation, it shuts down natural estrogen and progesterone production, it lowers free testosterone, which is how you feel low libido when you're on the pill, and it creates a monthly withdrawal bleed. So what you might not realize is that estrogen exposure from the pill is often higher than natural estrogen. Nutrient depletion is common. B vitamins, magnesium, zinc, your body can't absorb these things anymore. Research does link it to higher depression risk in teens and first-time users, and the pill can worsen insulin resistance in susceptible women. Okay, option number two: progestin-only pills, or you might know this as the mini pill, which contains only progestin. So what does it do? It thickens cervical mucus, it thins the uterine lining, may or may not stop ovulation, and it can create irregular or unpredictable bleeding. The mini pill is sensitive, so even if you take it three hours late, it does become less effective. Then you have the patch. So this is a transdermal estrogen and progestin. The big differences here are that it delivers a higher dose of estrogen through the skin. Hormones remain consistently elevated, and it may carry a slightly higher clot risk for some women. Then you probably heard of the vaginal ring. That's a local release of estrogen and progestin. So it still enters the bloodstream, it still suppresses ovulation, there's slightly lower systemic levels than the oral or the patch, but it has the same mechanism. We're shutting down our natural hormones. And then if you've heard of the Depo Provera shot, that's a high dose progestin injection. The hormonal impact of this is a very strong suppression of ovulation. It can shut down estrogen production significantly. It can reduce bone density with long-term use. We do need estrogen for good bone density. And it does have a long delay in fertility returning, sometimes 12, even 18 months. So many women experience mood changes, weight changes, or irregular bleeding on this one. And then you have the hormonal IUDs. That is a local progestin release inside of the uterus. So we're told it only works locally. But what's actually true is that even though, yes, the main action is in the uterus, progestin does enter the bloodstream. Ovulation is suppressed in up to 60% of users with the higher dose IUDs, and it can cause systemic side effects, acne, mood changes, low libido. You might notice that if you are on the IUD, your period becomes lighter or it disappears, which some women love, but it's due to a thin uterine lining, not hormonal balance. Then you have the implant, which is a progestin rod in the upper arm. How does this work? It's a strong ovulation suppression. It's a continuous release of synthetic hormone. It has a high rate of irregular bleeding, by the way, and it can lower natural testosterone. So mood swings and spotting are common reasons why women do remove it. So now that we know the details of the different types of birth control, let's dive into the deeper impacts on the body. And I want to start with gut health because your gut and your hormones are deeply connected. Birth control can influence gut health through microbiome disruption, decreased bacterial diversity, increased intestinal permeability, or we call this leaky gut, inflammation affecting hormone clearance, changes in bioacids and digestion, and increased risk of IBS-like symptoms. So some symptoms you might experience are bloating, constipation or loose stools, food sensitivities, nausea, or cramping unrelated to your period. Many women have no idea this is from hormonal contraception. And then you have the HPO axis suppression. So when you stop birth control, your brain and your ovaries need to relearn how to connect and how to communicate. This leads to irregular cycles, no ovulation for months, acne, hair loss, mood swings, painful or heavy periods, delayed return of fertility, or post-pill PCOS-like symptoms, which we call post-birth control syndrome in my world. It's not your real hormones being crazy, it's your body just recalibrating. And then you have nutrient depletion. This is huge because most women don't realize that all of their symptoms can come back to this one phenomenon. We're just depleted in nutrients, no matter how clean you eat, right? So common depletions include B6 and B12, folate, magnesium, zinc, vitamin C, vitamin E, selenium, omega-3 fatty acids. These nutrients matter and they matter for mood, energy, thyroid function, healthy cycles, detox pathways, gut integrity, skin health. So if you're experiencing symptoms like anxiety, fatigue, low libido, headaches, and acne, they often improve once your nutrient status is replenished. And then you have the thyroid and metabolic effects. So birth control can increase thyroid binding proteins, make thyroid hormone appear normal on labs when cells are starving. It can worsen insulin resistance, and it can increase blood sugar dysregulation. So some of these symptoms look like fatigue, weight changes, brain fog, cold hands and feet, irregular cycles off of the pill. Alright. So now you're thinking, how do I know if birth control is right for me? Hormonal birth control can make sense when you need reliable contraception, you're managing endometriosis pain short term, you're preparing for surgery and want suppression, you've weighed the risks versus the benefits, you feel emotionally stable and symptom-free on the birth control, and you understand how it works and you're choosing it intentionally. But it may not be the best fit when you're using it to fix symptoms like acne or painful periods, you've struggled with depression or anxiety, you have a history of blood clots, you notice worsening mood on hormonal methods, you want to understand and support your natural cycle, you're experiencing gut issues, nutrient deficiencies, or thyroid symptoms. No woman should be on birth control because she felt rushed, pressured, or dismissed. So here are some questions to ask your doctor to be a better advocate for yourself. What side effects are common with this method? What should I expect when I stop? How will this impact my mood, libido, or metabolism? What labs should we monitor while I'm on it? That is huge. That is one of my favorite ones. What labs should we monitor while I'm on it? Are there non-hormonal options for managing my symptoms? Can we address the root causes? So if you feel dismissed, that doesn't answer my question. Can you clarify this for me? I need more information before I make a decision. Can you explain the risks and benefits specific to my health history? Those three questions are huge, especially if you feel like you have a rushed appointment and you feel like you don't have all the information. You're not being difficult, you're being responsible. So what if you're coming off of the pill? Here are some steps that I do inside period mastermind to help women support their bodies to come off the pill with as little rebound as possible. We support your liver, we nourish your gut, we replenish depleted nutrients, we stabilize your blood sugar, we track your cycle, and we give your body three to six months to recalibrate. You're not broken if your symptoms flare, you're healing. Birth control is a tool, not a cure. And you deserve to understand precisely what the tool does so you can choose it with confidence instead of confusion or fear, or just not understanding any of it. You deserve a doctor who answers your questions, you deserve to understand your own hormones, and you deserve informed consent, always. And if this episode helped you, DM me the word options, and I'll send you a guide that breaks all this down in an easy-to-follow format with questions to bring to your next appointment. And remember, your symptoms are real, your concerns are valid, your body deserves support, not suppression without explanation. Again, birth control is a tool that may or may not be right for you, and we want to pull the tool when we need it, not just to suppress your symptoms so you can just keep moving throughout your day. This is Healthy Period, and I'll see you on the next one.