Doctors Are Lying About the Pill...Again

I never wanted to be a mom. Married, maybe, but a mom? Not so much. My dreams always looked much more like spy thrillers and Cops than Little House on the Prairie. A lifetime goal of mine was to be an interrogator of the world’s nastiest terrorists. That still is a goal, albeit one of many. Another goal — having children — only pressed itself upon me when I married the right man.

Immediately after reconnecting with my now-husband, my biology started pestering me for offspring. Once I stopped taking the birth control pill, its wailing only strengthened. This biological and spiritual yearning to be a mother scared me, but I finally felt ready and willing to take up the mantle.

The dream…

To prepare myself for immediate pregnancy after we said our “I do’s,” I tracked my menstrual cycle for two months using the Fertility Awareness Method (FAM). For the uninitiated, this natural method involves tracking one’s fertile signs such as basal body temperature, cervical mucus, and hormone levels. Unlike the always-consistent daily hormonal cycle experienced by men, women have two distinct phases in a month: the follicular and the luteal.

The follicular phase is the first two weeks of the menstrual cycle, wherein two hormones — LH and FSH — work together to mature an egg and pop it out into a woman’s Fallopian tube, ripe for fertilization. This “pop” is called ovulation. After ovulation, the hormone progesterone takes over for the next two weeks, thickening up a woman’s uterine lining to be able to receive a fertilized egg. If all goes well, a high-quality egg will be fertilized by a well-timed, high-quality sperm and the new human will safely travel down the Fallopian tube to nestle into its new home.

So many elements of this delicate cycle can go wrong. An underdeveloped egg is more likely to end in miscarriage, as is an egg fertilized by a sperm with fragmented DNA. Low progesterone in the luteal phase can make the uterine lining inhospitable to life. Interacting with endocrine disruptors, eating highly processed foods, smoking, drinking alcohol, and so much more can increase the risk of complications. The list is endless.

With all the obstacles standing in its way, it is a miracle life begins at all. Unfortunately, I was naïve. My mom had always told me that I would get pregnant without issue — I was young and no one in my family had much trouble getting pregnant. My cycles were regular too, and I had been off birth control for a while. Surely all of the Pill’s side effects — not that there were any — would be long gone by now.

Imagine my surprise when I didn’t ovulate for two months after my wedding. I chalked this up to stress, but I visited a doctor anyway, as I had years-old lab results indicating low cortisol and other hormone imbalances that I had done nothing about. Plus, I had never not ovulated before, so I was alarmed. After an initial consult, my physician sent me for hormone testing during my next luteal phase.

My results came back, and they were anything but positive. My progesterone levels were the lowest my doctor had ever seen (her words). My estrogen was not much better; it had dropped off a cliff after the first blood draw. My androgens — like testosterone — were extremely high. My thyroid hormones were similarly out of wack; one hormone was attempting to stimulate another to produce more energy, but the stimulated hormone appeared to be asleep at the wheel. This looked like a classic case of Polycystic Ovarian Syndrome, also known as PCOS.

I was devastated. Getting pregnant would likely take longer than I had hoped, if it was even still possible. On the other hand, I was relieved to know I was not crazy. My luteal phases were extremely short and my periods were extremely light. I was gaining crazy amounts of muscle in the gym — and quickly! My acne was hormonal (thanks a lot, testosterone.) I was thrilled to know that my weight fluctuation and sugar cravings were part and parcel of my diagnosis, so I did not have to feel guilty about them anymore.

Still, I was not going to take PCOS lying down, so I started reading everything I could get my hands on. I learned that a key characteristic of the syndrome is insulin resistance, similar to diabetes where diabetics struggle to regulate their blood sugar. I gleaned that there was no scientific consensus on PCOS’ genesis yet, but one causal theory surprised me. That was the birth control pill.

You have got to be joking, I thought. I had just written a detailed tirade about the drawbacks of the Pill, and I had missed this glaring one. According to recent studies, the Pill can cause or exacerbate PCOS, mostly through its effect on insulin. To make matters worse, the Pill is often a first-line “treatment” for PCOS, mostly because it stops ovulation and hormone production and thus, many of the unwanted symptoms.

Unfortunately, the Pill may increase the insulin you produce by up to 20-40%. It may also stop exercise from improving your sensitivity to insulin — this could be why many women report gaining weight on the Pill. To make matters worse, if you try to go to the gym to lose the Pill weight, the darned thing may inhibit any muscle growth. Also, your metabolism on the Pill slows down, thus affecting your ability to metabolize stressors like caffeine. In addition, by design, the Pill causes a chronic high level of LH (as does PCOS itself), thus stopping ovulation and upsetting the delicate balance between LH and FSH. As a last whammy, the Pill could also be harming your gut health, resulting in yeast overgrowth and periodontal disease.

In short, the Pill cures nothing — not one syndrome or disease affecting women — and exacerbates everything. Yet it is handed out like candy by doctors, the majority of whom have not been trained in holistic care. The standard model of care for any fertility issue is to wait until a couple has tried to conceive for at least one year with no success, then to hand her the Pill or recommend artificial reproductive technologies (e.g. IUI, IVF), often before any other hormonal testing is administered. If medical professionals do order hormonal testing, they often do not order the most crucial or accurate ones.

I consider myself lucky that my doctor did not turn me away at the door for coming in before the one-year-of-trying mark. However, I have become increasingly frustrated with the medical model of womanly care over these past few months. After a few lackluster appointments, I started to do my own research on PCOS and discovered that there were lifestyle changes and natural supplements I could take for my condition that were just as, if not more effective than the leading medications on offer. As a bonus, they had no side effects.

At the beginning of my diagnosis journey, I thought my doctor would have some ideas for a treatment plan. I earnestly sought her expert recommendations for diet, lifestyle, and hormone support. I got almost nothing in return, except a prescription for two hormones and a “Keep trying” attitude. I cannot complain though, because I know many other women do not even get this level of care. Often, they are told to “go away and lose weight” — a nonsensical proposal for a PCOS sufferer — or their symptoms are outright dismissed. Often, PCOS patients have to go to two or three doctors before one will order basic hormonal testing.

Due to my research and growing worry about the state of women’s health, I am now a PCOS evangelist. Everywhere I go, I meet people with diagnosed PCOS or with suspicious PCOS-like symptoms (e.g. irregular or long periods, acne, fatigue, cravings, etc.). In the latter cases, I always encourage women to get checked, as any lifestyle changes made to assuage symptoms often take six months to a year to manifest.

According to the latest research, PCOS affects 5-15% of reproductive-aged women, which is no small number. I have an unprovable hunch that numbers are going up in concordance with the modern woman’s chronic stress, inflammation, poor dietary options, and Pill use. Thankfully, there are still a few doctors who are trained in identifying root causes of chronic diseases like mine. The ones that do typically run under a few names — naturopaths, functional medicine, and the like. They see you as a whole person, not just a machine with a broken part.

In short, there is hope for women like me beyond artificial reproductive technologies and drugs like the hormonal birth control pill. The Pill is not a solution — for anything — and as usual, women are not told about its negative side effects. In my case, the Pill likely exacerbated my existing underlying condition. Its lingering influence will prolong my recovery and my husband and I’s journey to parenthood. For others, the Pill alone can entirely cause PCOS. This is a true travesty, as many will only discover what a decade on the Pill has done when they struggle with infertility after ceasing its use.

All in all, I am grateful for my diagnosis, because I have the time and the sheer will to pour over articles that doctors have either no time or will to read. However, I cannot say that I’m not disappointed in where we are in medicine when well-crafted, 15-year old studies are still not incorporated into common practice. Women deserve better.