People are worried about the hormones in my birth control. When I mention that I was on the pill and now have a Hormonal IUD, people ask me, “Can’t you feel all those unnatural chemicals pumping all around your body? Aren’t those hormones turning you into a depressed, cancer-prone maniac?” I know that the fear around hormones comes from a good place. Other people want me to live a long, healthy and happy life, and they think that being “natural” i.e., not using hormonal birth control, is the right way to do that. What they do not know is that for me, and for plenty of others who have a vagina, taking hormonal birth control is much safer for us than letting nature take its course.
For the most part, nature is not on my side. Until this last century, dying in childbirth was “natural” (1). Having an unplanned pregnancy is “natural”. Suffering from debilitating period pains is “natural”. The pill, the implant and the Hormonal IUD were created by doctors and scientists to stop people like me from dying from avoidable diseases. In fact, hormonal birth control has “decreased all-cause mortality in women” (2) . One study observed 46,000 women over 39 years and found that women who had taken the pill at any point were 12% less likely to die than women who had never taken it (3) . For example, the pill reduces “the risk of ectopic pregnancy”, “a leading cause of maternal mortality in early pregnancy”, by 90% (4) . Women who have ever taken the pill are less likely to die of any “gynecological cancers”, including “uterine” and “ovarian cancer” (5) . This leads to 308 fewer deaths per 100,000 women by age 70 and over (6), and saves thousands of lives at a national level.
Hormonal birth control also stops people like me from suffering unnecessarily. I first got my period aged 11, and for two days per month I get searing cramps and contractions that hurt so badly that I would often cry in pain on the floor. In total, during my 10 years of “natural” periods I spent 240 days in pure, unrelenting pain and took about 2,160 pain killers, almost half a kg of ibuprofen. But then, I got a Hormonal IUD. After a quick, uncomfortable insertion up my vagina and a couple weeks of spotting, my IUD stopped my period for the next for 3.5 years. Getting a Hormonal IUD has been completely transformative for me and has helped me get weeks of my life back that I had written off to my “natural” period. Instead, I use that time to focus on my studies, work, exercise and have fun with my friends.
I’m not alone in suffering from bad periods. In one study, 84% of female college students reported that they experienced period cramps (7) . The implant and the Hormonal IUD make most people’s periods less heavy, less crampy and shorter (8) , and the word is catching on. From 2002 to 2014, the percentage of the female population using an implant or an IUD in the United States grew 7x, from 2% to 14% (9) (10) (11) . In the world of birth control, this rate of adoption is viral.
Hormonal birth control has also been miraculous in giving me control over when I want to get pregnant, and I can continue to use birth control indefinitely. For example, research on the pill has found that having “an unintended pregnancy” “poses a bigger health risk than using the pill” (12) , so “a healthy patient can take the pill for as long as she wants and only needs a break if she would like a pregnancy” (13) . Once my IUD runs out, I plan to get another one so that I can stay period-free for as long as possible. When I do want to get pregnant, researchers have also found that in the long run hormonal birth control “has no impact on a patient’s inherent fertility” and that the “return to fertility is very rapid following discontinuation” (14) .
At the end of the day, not everyone is going to love every type of hormonal birth control that they try. There are also good forms of nonhormonal birth control out there, the Copper IUD being the most effective (15) . But for me, taking hormonal birth control has been far better for my health and wellbeing than being “natural” will ever be. I’ve been sexually active for 9 years and have never been pregnant, and I’ve said goodbye to my nightmarish periods. I’m grateful to live in a time and a place where I have access to hormonal birth control, and I wish someone had been there to praise me for getting my IUD.
So, if you have made the responsible choice to take hormonal birth control, then you’re doing a great job. If no one has praised you for it yet, I’ll be the first to say: Congratulations on getting your birth control 👏
(1) CDC, Ten Great Public Health Achievements - United States, 1900-1999, 2001. Retrieved from CDC: Morbidity and Mortality Weekly Report: https://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm
(2) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 291
(3) Hannaford, PC. Iversen, L. Macfarlane TV, Elliott AM, Angues V, Lee AJ. Mortality among contraceptive pill users; cohort evidence from Royal College of General Practitioners oral contraception study, BMJ, 2010, 340-c927
(4) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 291
(5) BMJ 2010;340:c927 doi:10.1136/bmj.c927. Retrieved from https://www.bmj.com/content/bmj/340/bmj.c927.full.pdf; page 1
(6) BMJ 2010;340:c927 doi:10.1136/bmj.c927. Retrieved fromhttps://www.bmj.com/content/bmj/340/bmj.c927.full.pdf; page 8
(7) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 41
(8) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 43
(9) Kavanaugh ML, Jerman J and Finer LB, Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009–2012, Obstetrics & Gynecology, 2015, 126(5):917–927, doi:10.1097/AOG.0000000000001094
(10) Kavanaugh ML and Jerman J, Contraceptive method use in the United States: trends and characteristics between 2008 and 2014, Contraception, 2018, 97(1):14–21, doi:j.contraception.2017.10.003
(11) Finer LB, Jerman J and Kavanaugh ML, Changes in use of long-acting contraceptive methods in the United States, 2007–2009, Fertility and Sterility, 2012, 98(4):893–897, doi:10.1016/j.fertnstert.2012.06.027
(12) M. Foreman and J. Speiler, Contraceptive Evidence: Questions and Answers, 2013. Retrieved from www.prb.org: https://www.prb.org/wp-content/uploads/2013/08/contraceptive-evidence-2013.pdf; page 14
(13) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 292
(14) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 292
(15) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 100