Menstruation is a Sacred Right.
Hormonal contraception is a charged topic. I understand that for some, it is the best available option and I honor that choice. My intention in this article is to share my research on hormonal contraceptives and their impacts on the body and menstrual cycle. This is the information I wish I was given before prescribed the pill at sixteen.
On the one hand, I acknowledge and respect the role the pill and other forms of hormonal contraception have played in menstruating people’s sexual liberation. It has been transformative and can be viewed as a tool in reclaiming our sexuality.
And on the other hand... The pill robs us of our menstrual cycle. As a menstrual educator and human being, this is very concerning. In the push for equal access to hormonal contraceptives, we have forgotten to ask a very important question:
What are they doing to our bodies?
Hormonal contraception is the general term for all methods that deliver steroid drugs to suppress ovulation and ovarian function. Did you know the pill was the first drug created and prescribed for healthy people? (Grigg-Spall).
The pill does not regulate the cycle.
Currently, 100 million women will take some form of the pill and 1 in 3 will take it to “regulate” their cycle. Despite what we often hear, the pill does not regulate hormones. It switches them off entirely. When on hormonal contraception, you make no sex hormones of your own (Briden, 8). The use of them eradicates the production of the hormones that make up the menstrual cycle. In place of a natural rhythm, hormonal contraceptive users experience an artificial, flat stream of synthetic hormones (Grigg-Spall). These synthetic hormones are very different to our human ones. They do not support the essential functions of the body in the way our own do (Briden, 20).
Oral contraceptives are often prescribed to treat symptoms of hormonal imbalances. While they do suppress symptoms, they work as a band-aid approach and do not treat the underlying root causes. When coming off the pill, the symptoms experienced before taking it will likely resurface or will become exasperated. When we take a pill that effectively masks our symptoms, we miss out on the important opportunity to pinpoint imbalances (which may manifest in period pain, irregular cycles, acne, amongst others) before they progress further. For a natural approach to menstrual imbalances, I suggest The Period Repair Manual by Lara Briden.
The bleed experienced on hormonal contraception is not a real period.
The pill prevents the creation of our own hormones. The creation of our hormones (specifically estrogen) is what leads to ovulation. If ovulation doesn’t occur, true menstruation can not happen. The bleed experienced while on the pill is not a real period in any sense. The blood released during the week the sugar or placebo pills are taken, is known as a “withdrawal bleed”. This is when the body experiences a withdrawal from the synthetic hormones of the contraceptive.
The developers of the pill decided to incorporate a week of sugar or placebo pills, which result in the withdrawal bleed, as purely a sales tactic (Grigg-Spall). They believed women would perceive not having a monthly bleed as unnatural and would therefore be unlikely to trust it. There is actually no medical reason to bleed when on the pill (Briden, 19).
When on hormonal contraception, you do not have a cycle or a period. As someone who has spent years of my life on the pill, this is something I had a right to know. Doctors prescribe the pill frequently and carelessly. In the U.S., 80% of women will use oral contraceptives at some point in their lives (Grigg-Spall). Even though the vast majority of U.S. menstruating people will have a pill experience at some point, it’s rare for a doctor to disclose how the pill works and what the possible side effects are.
Risks and Side Effects
Depression
A study by the University of Copenhagen that tracked one million women over thirteen years, found that girls and women who use hormonal birth control are significantly more likely to be diagnosed with depression. In fact, those between the ages of 15 and 19 were 80% more likely to become depressed. This may be an underestimation too, as the research only looked at birth control users who went on to be diagnosed. A follow up study from the same group of researchers found that women taking hormonal contraceptives had triple the risk of suicide (Briden, 30).
Loss of libido
Testosterone is a hormone produced naturally by our bodies that increases sex drive. When on the pill, we don’t create testosterone. Loss of libido is one of the most common side effects of pill use. It’s ironic that a pill taken with the purpose of having sex without the worry of conception, in fact takes away our desire to have sex at all.
Hormonal contraception slightly increases the risk of breast cancer (Briden, 28) and recent research has shown that it alters the structure of the female brain.
Did you know the technology exists for male hormonal contraception?
Developers haven’t yet released it because it’s believed men wouldn’t risk the loss of libido and depression that comes from switching off hormones (Briden, 33). Why is it that women are expected to? Why is female sexuality and wellbeing of less concern? These are questions I’m reflecting on. A friend recently told me, if over a month a man had sex with 100 women, potentially, this could result in 100 pregnancies. If a woman slept with 100 men over the same period of time, this could only result in one pregnancy. The male body is fertile everyday. The female body is only fertile 6 days out of the cycle, yet bears the entire physical, mental, and emotional harm of hormonal contraception.
In some ways, this is not surprising when we think of cultural beliefs around menstruation, fertility, female sexuality and cyclical living. As women and cyclical beings, we function following the rhythm of a cycle – hormonally, emotionally, physiologically and energetically speaking. We experience peaks and falls in energy levels, sex drive, mental clarity and focus, communication skills, creative capacity and intuitive insights, amongst others. But in our current paradigm, we are not given permission or encouraged in any way to trust this intelligence. We are instead expected to function as if we inhabited a male body, showing up in our work, school, and relationships as if we were the same every day. This mode of operating is supportive of the male body and hormonal cycle, which follows a 24-hour repetitive rhythm. Hormonally speaking, the male body is the same everyday. This mode is not supportive however, of the (on average) 28-day hormonal rhythm of the menstrual cycle - one where we change according to the day of the cycle we’re on.
We bleed and cycle for a reason.
Our hormonal cycle regulates 150 essential functions, all of which are suppressed by steroid contraceptives (Grigg-Spall). Our menstrual cycle is an essential indicator of our health and wellbeing and known by the American Committee of Obstetricians and Gynecologists to be the fifth vital sign of health. If we are to move away from the widespread use of hormonal contraception, we need also prioritize empowered and comprehensive menstrual education. Understanding the way our body works is understanding our power.
There are medical, emotional and spiritual reasons to bleed and cycle. This was built into our bodies for a reason. It is our sacred right. Cultivating menstrual cycle awareness can be a guide in our journey of self-discovery, connection, creativity and healing. It is a source of feminine power, and so makes sense that it has been shamed, layered with taboos and deemed “irrelevant” by the patriarchal mentality and Western medicine. Anything that is this charged and has a strong opposition against is reflective of the power it holds. Every human being is alive because of this fundamental process. Supporting the health of the menstrual cycle is in everyone’s best interest.
Our menstrual cycle is our ally.
As a young woman exploring my sexuality in my early years of fertility, I was prescribed the pill with no questions asked or information given. I was given a pill that took my sexual desire and menstrual cycle away from me, just as I was acquainting myself with them. This is a common experience and from it, I internalized the belief that my fertility and body were working against me, constantly conspiring to get me pregnant. I believed that I needed to “control” my fertility (and eradicate my cycle) with steroid drugs in order to have responsible sex. I remember getting that shiny teal pack of birth control and feeling proud, as if taking it was my rite of passage.
Imagine if instead, we were given the tools to understand, work with, and respect our cycles. Rather than taking synthetic hormones at the first sign of sexual activity, we were empowered to learn body literacy and ways to pinpoint our fertile window through recognizing key signs. Instead of a sex education that was either absent, disembodied or taught through porn, we received a holistic approach that named pleasure and consent and ways to respect and listen to our bodies throughout the exchange. The lack of comprehensive menstrual and sex education is what fuels me to share.
The pill has played an important role in our history, and I wouldn’t say it’s never the right choice. But my prayer is that all menstruating people are supported to make an informed choice from an empowered relationship of trust with their bodies.
The good news: there are other methods of non-hormonal contraception!
The Fertility Awareness Method
Much different to and more exact than the ‘rhythm method’, the Fertility Awareness Method (FAM) tracks basal body temperature, changes in cervical fluid and cervix position to pinpoint ovulation and our fertile window. According to the study by the journal, Human Reproduction Today, this symptothermal method (as taught by instructors) is equally effective to the oral contraceptive in preventing pregnancy. I would recommend searching online for a trained FAM practitioner to help in beginning this process. The book The Fifth Vital Sign by Lisa Hendrickson Jack is a comprehensive resource for learning the FAM method.
Coming off the pill
When coming off hormonal contraceptives, there may be a transitioning period and it’s normal for menstruation and our natural cycle to take some time to return. Be patient with your body as it relearns its rhythms and finds its way. Implementing leafy grains, healthy fats and carbohydrates, as well as supplementing with B vitamins and magnesium will help in supporting the return of your period and cycle. Vitex (chaste tree) is also beneficial in restoring hormonal balance post-contraceptive use.
A simple and powerful practice - place your hands over your womb and take deep breaths into this space. Feel or sense a warmth or light building here, connecting you to your root center. Take a moment in gratitude for your womb’s support, intelligence and life -generating wisdom. Silently or aloud, communicate to your body and womb that you would welcome the return of your cycle and will honor its process and timing.
by Samantha Neal
Works Cited
Briden, Lara. Period Repair Manual. Pan Macmillan, Australia, 2018.
Grigg-Spall, Holly. “How Does the Pill Work? You Asked Google – Here’s the Answer.” The Guardian, Guardian News and Media, 9 Nov. 2016, https://www.theguardian.com/commentisfree/2016/nov/09/google-autocomplete-how-does-pill-work.
“Massive New Study Links Birth Control to Depression For the First Time.” PBS, Public Broadcasting Service, www.pbs.org/wgbh/nova/article/massive-new-study-links-birth-control-to-depression-for-the-first-time/.
Heil, et al. “Effectiveness of a Fertility Awareness Based Method to Avoid Pregnancy in Relation to a Couple's Sexual Behaviour during the Fertile Time: a Prospective Longitudinal Study.” OUP Academic, Oxford University Press, 20 Feb. 2007, academic.oup.com/humrep/article/22/5/1310/2914315.