Some 14 percent of women between the ages of 15 and 49 are currently taking hormonal birth control pills in America, according to government data. That’s more than 10 million people, about the equivalent of the entire population of Portugal.
According to a 2019 United Nations report, about 151 million women take the pill worldwide.
Kristin, a mom of two, was one of them. She was prescribed birth control pills when she was still in high school. While her doctor told her the pills would help with her headaches and irregular and heavy periods, no one talked to her about the risks associated with taking them.
However, when she was 20 years old, she had an elective surgery. Although Kristin had no complications from the surgery itself, a few days later, she was unable to take a full deep breath and she felt a pain in her arm. She knew something was seriously wrong, but she had no idea that she was having a pulmonary embolism.
A pulmonary embolism, which can be lethal, happens when a blood clot gets logged in an artery in the lungs.
This medical crisis, which kept her hospitalized for six days and on medication for six months afterward, was from taking hormonal birth control pills as a teen, Kristin told me.
“Everyone has been in agreement that it was from the birth control,” said Kristin, who asked not to use her last name because she’s currently part of a class-action lawsuit.
Oral Contraceptives Increase Risk of Death
Indeed, in 2018 a team of researchers, led by Dr. Lynn Keenan, M.D., at the University of California–San Francisco’s Fresno campus, found that women who use oral contraceptive are between three and nine times more likely to have of blood clots in the lungs, legs, and brain than women who don’t take oral contraceptives.
They also face a much higher risk of death because of blood clots. The same study found that between 300 and 400 healthy young women die unnecessarily every year due to hormonal birth control.
“Women should be informed of these risks,” the researchers concluded.
Pill Linked to Depression, Bloating
Taking hormonal birth control is also associated with a host of other negative health outcomes.
For example, a 2016 study of a million women in Denmark found that taking hormonal contraception was associated with depression, especially in teenagers.
Oral contraceptives have also been linked to lower levels of the steroid hormone DHEA in the blood and a decreased ability to gain muscle during exercise, according to a 2009 study.
Another older study, from 2008, found that these pills can cause bloating, while an earlier study found that oral contraceptives lead to women having more subcutaneous fat and other changes in the way the body stores fat.
Though many women report gaining weight while taking the pill, the peer-reviewed literature on this seems to be inconclusive, according to a 2014 Cochrane review.
It’s clear from the scientific literature, however, that oral birth control use also increases a woman’s risk of developing breast cancer and cervical cancer.
Routinely Prescribed, Not for Birth Control
“Neither of my daughters can menstruate on their own,” a mom of two young adults, ages 21 and 23, told me recently. “They’ve both been on the pill since they were teens.”
While girls in the United States usually begin menstruating around age 11 or 12, the onset of menses is widely variable and precocious puberty (before age 8) is becoming more common. Recent research from Italy has found that precocious puberty has increased during COVID-19. One team of researchers hypothesized that this may be due to stress, lack of sunlight, lack of exercise, and exposure to a higher number of environmental toxins, especially endocrine disruptors.
Doctors routinely prescribe birth control pills to tweens, teens, and young adults who are menstruating but not sexually active to treat the following conditions:
- Amenorrhea (lack of menstruation)
- Cramps and other menstrual pain
- Heavy periods
- PMS and mood swings
I found this out when my oldest daughter, who is 22 now, was still in middle school.
“Mom,” she said to me one day, “I think I should take the pill to help me with my acne. That’s what my friends are doing and they say it works.”
Harms of Hormonal Birth Control Pills
Birth control pills disrupt the endocrine system, essentially fooling the body into believing it is pregnant, in order to stop ovulation.
We know we should try to avoid disrupting children’s hormones. As Joseph Braun, Ph.D., an associate professor of epidemiology at Brown University, explained in a 2017 peer-reviewed article, endocrine-disrupting chemicals increase the risk of childhood diseases “by disrupting hormonally mediated processes critical for growth and development,” and may be contributing to obesity and neurodevelopmental problems.
“In residency, you learn to use birth control like you learn to wash your hands,” said Nathan Riley, M.D., who is unabashedly critical of the practice of prescribing contraceptives to young woman to treat menstrual problems.
“You bring it out anytime that anyone has an issue,” Riley said. “We use it for everything. You’ve got a quote ‘lady problem’? Let’s put you on birth control.”
Then, he said, if the birth control pills themselves cause side effects, doctors add more prescription medications to the mix.
“Synthetic hormones lead to mood disorders, depression, anxiety, and sleep disorders, among other things, all of this is well documented,” Riley said. “Women have complained about everything under the sun. But their doctors say it’s not the birth control. And instead of stopping the medication that started the problem, their doctor gives them an antidepressant.”
He believes this is harmful, arguing that the practice of rushing patients through appointments and writing prescriptions for the pill makes the pharmaceutical industry richer, while making female patients sicker.
Hormonal birth control alleviates symptoms without treating the underlying problems, he said. The key, he insisted when we spoke, is to treat the root cause of the menstrual irregularities.
For instance, a woman’s periods may be irregular because she’s severely anemic, either because she is not eating iron-rich foods or suffering from malabsorption.
Thyroid malfunction can also be at the root of menstrual irregularities, Riley said. As can poor liver function and disrupted gut health.
All of these health problems are treatable, he said. While prescription medications can help for the short-term, the goal is to get the body back in balance. To do so, he talks to his patients about making lifestyle changes, including dietary improvements, engaging in daily movement and exercise, getting adequate and high quality hydration, improving sleep, limiting exposure to electromagnetic fields, learning to do breathwork, and improving both your attitude and your emotional intelligence.
“Sometimes you do need a temporizing measure like birth control,” Riley said. “But it shouldn’t be used for long.”
Marie (her middle name) is a 32-year-old lawyer based on the East Coast. She was first prescribed birth control pills for endometriosis when she was 15, and it seemed to help.
Besides, she really liked taking the pill: It made her breasts bigger and cleared up her acne. So when her periods suddenly became more painful, even on the pill, and her doctor told her to start taking it continuously (so she would not menstruate at all), she didn’t think to question it.
Her doctors said taking the pill would help her avoid surgery for endometriosis. But she ended up having surgery anyway, in 2018, to cauterize tissue in her pelvic cavity.
It wasn’t until Marie had a miscarriage at age 27 and it took 15 months to get pregnant again—and only with the help of fertility drugs—that she started to regret taking hormonal birth control for so many years.
The science is inconclusive about whether the pill negatively affects fertility. In fact, some studies, such as one published in 2002 in Human Reproduction, show it may increase the odds of getting pregnant after quitting the pill.
But when I interviewed the late science writer Barbara Seaman, who had written several books about women and hormones, several years ago, she insisted that hormonal birth control is a causative factor in infertility and that it can take women as long as 12 to 24 months after taking the pill to become pregnant without assistance.
Marie, like many other women, is convinced her long-term use of birth control for endometriosis contributed to some of her continuing health challenges, including fertility issues.
“I was just not healthy as a teenager,” she confessed.
For Kristin, the decision to go on birth control as a teenager and subsequent pulmonary embolism made her two pregnancies more dangerous. She was considered high-risk and had to inject herself with anti-coagulants during the pregnancy and for one month afterward.
“I will never be on any hormones ever again,” Kristin told me. “I really wish I knew of alternate, more natural ways to have treated my adolescent issues. The psychological damage it’s caused is irreversible. I hate how doctors are so quick to take out that pen and pad and throw meds at teenagers.”