Is The Birth Control Pill Aging Your Ovaries?
I was on the birth control pill for ten years, and I did pretty well on it. In fact, I loved it for years. I still had some acne breakouts here and there, and I still had what I labelled at the time as PMS, but I otherwise felt fine. But, every so often, the thought would pop into my head that I needed to ovulate – I couldn’t explain it, but it was something that kept coming up for me, so I asked my doctor.
My doctor assured me that there was no reason for me to ovulate, and that if I wanted to stay on the pill for both birth control and to manage my acne, that I should just stay on it continuously. I did just that, but a few years later, I decided to take a deep dive into what the pill was doing to prevent ovulation.
How the pill stops your ovaries from working
In a natural cycle, the hypothalamus gland in your brain notices low hormones during your period and tells the pituitary gland (also in your brain) to release follicle stimulating hormone (FSH) to let your ovaries know that its time to start making estrogen. When estrogen levels reach a certain point, the hypothalamus tells the pituitary to release a different hormone – luteinizing hormone (LH) , which causes you to ovulate. When you ovulate a mature egg breaks out of this little sack on your ovary. This little sack then starts to produce progesterone, which is the hormone that dominates the second half of your cycle.
When you are on the pill, , you’re ingesting hormones every day. This means that when your hypothalamus scans your body, it sees that your body already has a certain amount of hormones available, and it tells your pituitary not to do anything. So your pituitary gland stops telling your ovaries to get to work. This pituitary (brain) and ovary connection sort of lies dormant, and your ovaries not only stop producing eggs, but they stop producing estrogen and progesterone almost entirely. This is how the pill prevents pregnancy: by shutting down your ovaries.
What this means for your fertility
When you’re on the pill, you’re obviously not fertile (that’s usually the whole point!). But what you may not know is that when you’re on the pill, your 20-something ovaries will look like those of a woman much closer to menopause. They actually shrink – by up to 50%!
Sure, chances are, if you’re healthy you will be able to conceive following hormonal contraceptive use. But it may not be as easy as it would be if you had a nice, fully established fertile cycle. A recent study in the United Kingdom found that couples who had previously been using hormonal birth control took twice as long to conceive than couples that had previously been using condoms. Delays in conception have been found in other studies as well.
Additionally, as more and more of us are postponing having children until our 30s when our fertility starts to decline, the pill masks any indicators of our fertility. Medical tests for ovarian reserves are not conclusive for women who are on the pill. Furthermore, the changes your body goes through during a natural cycle provide you with an opportunity to make sure everything is still working smoothly – you get no such heads up that your fertility may be in decline if you are on the pill.
Re-establishing the brain-ovary connection after the pill
When you go off the pill, depending on how young you were when you started and how long you were on it, it could take quite a while for your brain and your ovaries to start talking again. Typically, you’ll go through a few low-hormone months as the synthetic hormones from the pill leave your body and your body learns to make its own hormones. During this transition phase you may experience:
- breast changes
- changes in sex drive
- hair loss
- heavier or lighter periods
- irregular periods
- no periods
- mood changes
- more intense cramps
- lack of ovulation
- intensified PMS
As your pituitary-ovary connection is re-established, your body will start to make its own hormones and symptoms will subside. Make sure to eat healthfully and get plenty of rest during this time. Because the pill depletes your body of nutrients, you may want to take a good prenatal vitamin (even if you’re not currently “trying”), magnesium and a B-complex vitamin.
If it seems like this connection is taking a long time to re-establish, vitex chasteberry is a supplement commonly used to help trigger ovulation and boost progesterone levels. If you are experiencing acne, saw palmetto is a supplement that can be used over the short term to reduce this symptom (though it does not actually address the underlying imbalance). For hair loss, you may want to try MCT oil until things get rolling. There are a number of issues that could be at play, so its best to speak to consult with a naturopathic doctor or your physician before determining a course of action.
Hopefully this helps you see that your lady balls (aka ovaries) are probably better off connected to your brain and churning out those hormones and eggs. If not, you’ll be better prepared to come off the pill when the time is right for you!