The Birth Control Pill: The Dark Side of "Easy" Contraception

The birth control pill is being misused by modern medicine. Did you know this? As women in our sexual partnerships, we are typically saddled with the conundrum of how to prevent pregnancy. In our modern world there is still not a viable contraception option that will take some of the responsibility (and physiologic burden) off of the woman… yet. When women come into my office and are on the birth control pill (or “OCP”, the oral contraceptive pill) I simultaneously sigh in exasperation and also feel my heart going out to this woman: I know your struggle. We have no easy options!

With that said, I still feel very strongly about women not choosing OCP’s as their form of contraception, but even more so that women do not start the Pill as a tool for managing other symptoms. Here is where we start to see it being applied ignorantly and inappropriately. When an MD puts a woman on the Pill to address symptoms of heavy bleeding, acne, mood swings, etc. it really gets my goat! I feel strongly that if women knew all of the reasons I land on this side of the debate, they, too, would shift their thinking. So, I am here to share with you my passionate case for why NOT to take OCP’s.

First, let’s just get an understanding of what a menstrual cycle is about. As my colleague, Dr. Julia Christensen, ND said “the menstrual cycle, also known as the moon cycle, exists as the result of an orchestrated symphony involving many hormone pathways from the brain to the ovaries.” Beautifully stated. Women’s bodies are quite complex. The pituitary gland (in the brain) communicates with the ovaries constantly, but the waves of hormones vary, depending on where you are in your cycle. From the day you bleed (day 1) until the day you ovulate (roughly day 14), your body is in an estrogen dominant state. This estrogen dominant state stimulates a lovely thickening of the uterine wall to provide a nice home for a fertilized egg to implant should fertilization occur.

When you ovulate, your ovaries are stimulated to release an egg by the hormone luteinizing hormone (LH), which is released from the pituitary gland and triggers the shift in the ovary to send that egg on down the fallopian tube. As that egg makes it’s way, your ovaries shift gears and release progesterone. Now, from day 14 to day 28 (or so) your body will be in a progesterone dominant state. This is the hormone that will be supportive of early pregnancy, so the first few weeks after an egg has been fertilized. If no fertilization occurs, the egg will not implant (which causes a whole new cascade of hormones) and the body will peak at a high level of progesterone on day 21 of your cycle, and then it will begin to fall. The reason you bleed around day 28 is because that rich thickening of tissue that developed during the estrogenic portion of your cycle, and was nourished by the presence of progesterone during the second half, is suddenly deprived of hormonal stimulation when the progesterone levels fall. The bleed is due to progesterone withdrawal.

Got all of that? Good. Now, for The Pill:

To start, if you are on OCP’s to “regulate” your cycle, be not fooled! They are not actually regulating your cycle. The Pill does not regulate your menstrual cycle.

The Pill is inducing a state much like pregnancy, which means that you are not ovulating. This means that this whole “symphony” of hormonal conversation between your brain and your glands is not happening. This means, therefore, that you are not actually cycling. Your body is not in its normal, natural state.

So what about if you are on the OCP to help with acne, mood swings, PMS, endometriosis, PCOS, or any other symptom? The Pill is not addressing the cause of any of these issues. In fact, the Pill is masking the underlying cause of these issues, and disturbingly, might be making all of these worse.  Each of these symptoms indicates that some other aspect of your physiology is off. The possibilities range from adrenal dysregulation, liver congestion, gastro-intestinal imbalances, nutrient malabsorption, stress responses, and more.

Here are more interesting facts about OCP’s:

·      They disrupt the healthy balance of gut bacteria and can contribute to intestinal permeability and inflammation. We need healthy gut bacteria to have a healthy immune system, to break down food and properly absorb nutrients, to metabolize hormones (Estrogen & testosterone, as well as thyroid hormones), and to maintain a healthy metabolism. [1]

·      The combination of the Pill inducing an estrogen dominant state and the disruption of the gut bacteria (which leads to an ineffective clearance of excess estrogens) leads to an overall estrogen dominant state of being for a prolonged period of time, which can lead to symptoms such as ovarian cysts, fibrocystic breasts, heavy bleeding (especially once the Pill is discontinued), mood swings, and weight gain.

·      Thyroid hormone binding globulin is increased on the Pill, which means that your body experiences a hypothyroid state. This can lead to weight gain, moodiness, lack of energy, hair loss, dry skin, and several other symptoms. [2],[3]

·      Sex hormone binding globulin is also increased, which binds up sex hormones and makes the body unable to use them. This includes testosterone, which is essential for your sense of drive in the world, for mood and interest in life, healthy muscle mass, and for libido.

·      From a nutrient standpoint, OCP’s interfere with many of the essential ingredients for a healthy body. Levels of B6 (required for healthy neurotransmitters and a balanced mood), magnesium, zinc, phosphorus, calcium, and selenium. [4] It can also increase iron and copper, which can cause agitation and anxiety-like symptoms.

So, at the end of the day, now you can see the mess that I see when a patient sits down and tells me she has been on the Pill. As I noted, I understand how difficult it can be to choose a method of contraception. However, when the Pill is used to treat any other symptom the body is presenting, it is just sloppy medicine, in my opinion. Not only does it fail to address what is really being communicated by the body, it is very likely exacerbating the root of the issue and many, many more physiologic functions beyond that.

For help in getting off the Pill and repairing your gut, hormone balance, metabolism, thyroid function, fertility, and anything else that may have gotten out of whack, find a licensed Naturopathic Doctor, licensed acupuncturist/ Chinese herbalist, or functional medicine doctor. And remember to ask any prescribing doctor whether the medication they are giving you is helping your body to heal, or if it is just a band-aid to cover up symptoms. Ultimately, it is your choice as to whether or not symptom management is your end-goal, but I encourage people to really understand what they are putting into their bodies and why. As a doctor my job is to educate you about what your symptom picture means and help you to understand what your options are for returning to a balanced state. If I have not done that, then I have not done my job.

[1] https://www.ncbi.nlm.nih.gov/pubmed/26658991

[2] https://www.ncbi.nlm.nih.gov/pubmed/1219185

[3] https://www.ncbi.nlm.nih.gov/pubmed/12521654

[4] https://www.ncbi.nlm.nih.gov/pubmed/22224344

Endometriosis, or Excruciating Menstrual Pain!

Your cycle is regular. 28 days +/-, right?

Your pain is predictable.

Your bleeding is heavy, and maybe goes on for 4 or 5 or 7 days.

You sweat, you vomit, you curl up in a ball on the cold bathroom tiles.

Uterine cramps? Hah! Where is that uterus anyway? My ENTIRE BODY is gripping in pain.

Your nose bleeds just before your period starts- that is how you know it is coming. It's not much blood, but enough of a drip that you know what it means.

You start to bleed and you dread the next 3 or 4 bowel movements because the pain in your rectum is so startling, and holds such a peculiar grip on your low back and perineum that you literally levitate off the toilet seat in efforts to get away from it.

Your sacrum drags. Your shoulders hurt. Your head feels compressed. Your legs ache.

You are exhausted.

You have been told that surgery and hormones are the only answer. "We need to do the surgery to confirm you even have endometriosis. Then once we know we can treat it.. with hormones." You don't want to take hormones or have surgery. You know what is wrong and you want it to go away.

You can research endometriosis, but we don't have a lot of answers right now. We have some interesting leads, but will the science help you to heal today? Immune system dysregulation? Yes. Retrograde menstruation? Sure. Hormone imbalance? Possibly.

One of my favorite features of Naturopathic medicine is that this approach recognizes that every individual has a unique story. Your endometriosis may not have evolved the same way the woman's next to you did. To heal your body, we have to follow the messages it gives to us. If you are seeking true healing and permanent relief from symptoms without pharmacologic or hormonal intervention, call me for a consult. And read here to learn why I am so passionate about this subject.

Why I Maintain A Naturopathic Medical Practice

Originally Posted on October 22, 2013

Most of my patients come into my office with a host of physical complaints along with an extensive list of over the counter herbal and nutritional supplements. Half the time they have appropriately chosen remedies for their condition. I typically have a preference for a different dosage than they are taking, but often I will let the person continue their regimen for the time being so as not to change everything at once. That said, I have serious concerns about the quality of supplements patients are purchasing and consuming, along with their motivations for taking them in the first place. I do struggle, as a physician, with the obvious conflict of interest in my line of work. You see, as an ND I not only assess people’s state of health and disease, but I also advise certain treatment protocols that come directly from my shelves. Patients need to purchase remedies and supplements from me in order to fully adhere to my treatment protocols. The upside to this practice, however, is that I only purchase products from highly regarded nutraceutical companies who have extensive 3rd party testing and quality control practices. I can guarantee the purity of whatever remedies I am prescribing. Furthermore, I understand the biochemistry behind what I am prescribing and can match its actions appropriately to your specific needs. This article really highlights why it is important for people to work with someone who understand the supplement industry and how to navigate it not only for one’s consumer-pocketbook needs, but also from the medical perspective. http://www.medicalnewstoday.com/releases/267363.php

Lastly, as a naturopathic physician I also have a deep understanding of what it means to truly heal one’s condition. When you have sleep issues, taking 5-HTP is not addressing the underlying issue. If you have high cholesterol, red rice yeast extract does offer you a non-pharmaceutical alternative to statins, but you have not dealt with the cause of your high lipids to begin with. It takes a keen eye and a deep understanding of human physiology to truly unravel the complexity of disease in order that a patient may truly heal. But it can be done and my colleagues and I do it everyday. So why do I maintain my practice? Because people need experts in natural medicine in this day and age of unregulated nutritional supplements in order to be a wise consumer, but also to have someone on their team who can truly help them to heal.  Just because you have been diagnosed with multiple sclerosis, rheumatoid arthritis, colitis, or any other autoimmune or chronic disease, this doesn’t mean you are sentenced to a life of illness. If you have endometriosis, surgery and hormones are not your only option. You can continue to live your life free of symptoms and disease progression. And you can truly heal yourself. 

Hand, Foot, And Mouth Disease, Fevers, and Childhood Illnesses

Hand, Foot, and Mouth Disease reared its head in the Berkeley area schools earlier this spring and started causing a stir. This childhood illness is caused by an enterovirus, which is a very common type of virus. These types of viruses enter the human host through respiratory or gastrointestinal secretions. Hand, Foot, and Mouth Disease is generally a mild illness in a healthy child, although it can cause high fevers. For those of you whose children have already had the infection you may have recorded temperatures close to 103 F. Other symptoms are malaise, lesions in the mouth and a blistered-looking rash on the hands and feet, and occasionally on the buttocks.

The Flu

“Should I get a flu shot?”   “The flu is really bad this year”

“I am afraid of getting sick- what should I do?”

People are initiating conversations like this with me a lot these days. The media has done an excellent job of making us think our only protection from serious illness is a vaccination. I wondered out loud to my physician father “What would our country look like if we put as much effort and media coverage into the prevention of gun-inflicted injuries and death as we do into the flu?” He chuckled, as he raised his eyebrows. He worked for 35+ years at Johns Hopkins Hospital, which sees more than its fair share of gunshot wounds. Quietly, without saying much, I know he has “seen it all.” And he doesn’t seem fazed by this year’s flu any more so than any other threat to our national health. The wisdom of our elder healthcare providers is certainly one to call upon as, with each passing year, the press would like to have us think that this year’s flu is the worst to date. I would argue that it is not, but that we now have an industry that stands to profit from the fear. 

The Dirty Little Secret About Cholesterol

In the last year or so there has been a niggly little voice in my head telling me to write or speak about cholesterol.

I love my fats, you see. It must be my Norwegian ancestry. My husband scoffs at the amount of butter I use and how much I embrace all things creamy. When we first met he insisted I would die of heart disease because of how seemingly unhealthy some of my habits were. I challenged him on it and he is finally coming around to realize that fat is not bad for you and eating some grass fed beef will not “clog your arteries”.