How hormonal birth control works

All this talk about learning your cycle, ovulation, estrogen and progesterone rises and learning to jive with it… well what about if you’re on hormonal birth control? The pill, the patch, the shot, the ring…

Well none of it applies to you. Sorry. And if that doesn’t make you sad, as if someone has robbed you of a chunk of your being, it should.

How does HBC work

As part of my nursing work, I have handed out birth control to a lot of women, so I want to start off this conversation by noting that some women love their birth control. They’ve been on the pill for 8 years. They know it works and, although it does still give them some side effects, they love knowing that its 99.4% effective when taken at the same time everyday.  For them, that decrease in anxiety about an unwanted pregnancy is worth the side effects, and they’re happy with it. Or maybe it causes them zero side effects at all. Or maybe it has helped them to prevent serious hell during shark week, including a bleed that’s only a few millilitres shy of a hemorrhage, leaving them feeling weak, exhausted and anemic all the time. So, if this is you, keep on keepin’ on. I truly believe that there are women out there who are in fact very well educated on fertility awareness and menstrual/hormonal health, who don’t experience that many negative side effects, and are just happy with their current method of birth control.

However… if you aren’t one of those people, if you do experience side effects that negatively impact your day-to-day life and you feel like its your only option to prevent an unwanted pregnancy, it’s not. If you are one of the people who takes hormonal birth control and has current health issues and you aren’t sure if they are caused by your birth control, please read on.

Lets first start by discussing how hormonal birth control works to prevent a pregnancy. There are two main methods that the pill works:

  1. It stops ovulation.
  2. It thickens your cervical mucous so that sperm cannot reach the egg.


How does it do this? It basically shuts down your natural hormones and replaces them with a daily dose of synthetic steroids with names that are close (“estridol” for estrogen, “progestin” for progesterone) but not the same. They are steroid hormones. If you started taking birth control for heavy periods, irregular periods, painful periods, acne, it was likely because you had a hormonal imbalance to begin with. Of course birth control has made this better because it just shut that system down. You aren’t having the natural hormonal shifts so your periods aren’t as bad and now instead, you have, as Dr. Lara Briden calls it “a Pill-bleed”. She describes a Pill-bleed in her book Period Repair Manual as a bleed that “does not proceed from ovulation. Instead, it is a withdrawal bleed from the drugs that stimulate your uterine lining but shut down your ovaries.”

“Okay, so who cares if my ovaries are shut down right now? I don’t want a baby anyways..”

Other than literally spitting out an egg intended to be fertilized, ovulation is a major indicator of your overall health. If you aren’t ovulating regularly, something is not right. Your hormones are likely not in balance. Ovulation is what helps us produce female reproductive hormones, which keep our metabolism and mood in check. Additionally, hormonal birth control over time can mess up your gut healthy gut bacteria, make you depressed, cause weight gain and decreased libido, and also has been linked to cancer.

If you are trying to navigate some health issues or would like to come off of hormonal birth control but are worried you’ll break out into a serious case of adult acne or nearly bleed out, In conjunction with speaking with your doctor, I’d highly recommend checking out Naturopath Lara Briden’s book called Period Repair Manual, which has some great information about getting of hormones that has been helpful to so many women. It may also be helpful for you to then start tracking your cycle, which you can learn about here.


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