“I thought all I had to do was stop the pill and I’d be pregnant the next month,” Janie shared with me in her first visit. “My doctor assured me that the pill wouldn’t cause any fertility issues. Does birth control affect fertility?,” she asked.
There is emerging evidence that hormonal birth control, like the pill, can negatively impact fertility for some women. Which women? Well, we don’t really know. And because the story doctors have told for so long is “contraceptives have no impact on your fertility” not a lot of women, let alone doctors, have been questioning it.
Here's the deal, there's a lot of ways that hormonal birth control can interfere with fertility.
And if you're like me, I did the pill for 10 years, every yearly annual visit I'd find myself having a conversation with my doctor about my fertility. Every time I would be assured that there was no impact whatsoever. You've probably been told this too.
Does Birth Control Affect Fertility?
Janie had been told that her sixteen years on the pill would have zero impact on her fertility. When she and her husband decided to try for a baby, she was told that it was likely an issue she always had and the pill was just covering it up.
But how could she know when her doctor had given her the pill at age fourteen, insisting it was the best thing for her health…and implying she was irresponsible if she didn’t take it.
Janie had started her period at thirteen and after just one year of menstruating her doctor wrote a prescription to shut down her entire reproductive system with no regard for her future fertility.
But let’s take a minute to think about how birth control works. If you are using a drug that is strong enough to stop how your brain talks to your ovaries and shut down your fertility, how could it not cause some long-term issues?
We're talking about a drug that shuts down a part of your endocrine system (hormone system). And we know that every single hormone is affected by one another. If it's strong enough to do that it's certainly strong enough to have some major long-term consequences and affect your fertility.
Now whether or not you want to have a baby you want to be fertile. Why? Because when you're ovulating you have healthy levels of progesterone or at least you should. And with that, your periods get easier, you feel way more chilled out and calm, and you love your life a whole lot more. It's some good stuff.
How Birth Control Pills Affect Fertility
I explained to Janie that there are several mechanisms that are being explored in women’s medicine to understand how birth control affects a woman's fertility. We still need a whole lot more research to understand the extent by which birth control affects fertility, but here's what we understand so far.
One mechanism by which the birth control pill, and some of these other hormonal contraceptive, can actually mess with your fertility is its effect on your endometrium. There have been studies to show that women who are long-term users of the pill, so we're talking 10 years or more, have thinner lining of their endometrium. Let me explain what the endometrium is and how the pill can affect it.
How Does The Pill Change Your Endometrium
The endometrium is the tissue that lines your uterus. The endometrium needs to be a certain thickness for baby (aka embryo) to call your uterus home. Think about the uterine lining, like being a nice soft bed with a big thick down comforter versus sleeping on the floor. Which one would you choose?
Obviously baby and you would want to choose that nice, comfy, thick comforter instead of the hard floor. Now it's not because the uterus is “hard” but just that it isn’t very comfy without that fluffy endometrium. The thickness of the endometrium can affect the implantation of the baby.
Now, this is a really sad situation when a woman can become pregnant, but not maintain a pregnancy. The result is a miscarriage.
How Does Birth Control Inhibit the Growth of Your Endometrium?
Well one theory is that the birth control pill down-regulates the receptors for estrogen and progesterone in the endometrial tissue. You need those hormones to stimulate the tissue so that it thickens to the right thickness for accommodating a baby. Whether or not you want to have a baby your body will still go through this every month.
When there is no baby this is what you shed. The endometrium sheds out of the uterus and that's what we call your period.
For women like Janie who have used the pill for 10 years or more, there is a possibility they are going to have compromised fertility because the baby will not be able to implant. That means egg can meet sperm, you can become pregnant, but you won't be able to remain pregnant because your uterus won't be able to support baby.
Now there is not a lot of research taking place in this arena, the reproductive endocrinologist are the first who really made these observations within their fertility clinics. We are just now seeing the science starting to explore how we help women support women's fertility after birth control.
Restoring Fertility After Birth Control
In Janie's case, she wasn't ovulating regularly, which we learned from her symptoms and lab testing. But the other clue that her endometrial tissue wasn't being stimulated appropriately was a period that lasted only 2 days. “Sometime all I need is a panty liner for my entire period,” she explained.
Her estrogen levels were normal on her labs, which pointed to an issue with estrogen stimulating the receptors of the endometrium. “A period should really be 3 days or more,” I explained.
Janie was committed to reseting her health and hormones after birth control so we got her started on the Brighten Protocol diet, which is a targeted way of eating to improve hormone health. She also went through a 14-day detox to support her liver health and we added in some gut support.
While Janie's thyroid was functioning well, her adrenal glands were in much needed support. We brought in adaptogenic herbs and started her on a quality prenatal to help her replenish the nutrients that had been depleted by birth control.
Every woman's case is different and for Janie, it took about eight months of working diligently on restoring her health after birth control in order to get pregnant naturally. She is now the mama of a beautiful and healthy girl.
If you're a woman who is struggling with hormone imbalances, difficulty becoming pregnant or staying pregnant after birth control, then I'd like to invite you to join me and over 45 health experts for Post-Birth Control Syndrome Awareness Week.
During the awareness week we have over 45 classes covering everything you need to know about hormonal birth control to minimize side effects and avoid Post-Birth Control Syndrome.
What is The Goal of Post-Birth Control Syndrome Awareness Week?
To help you make informed decisions about birth control — whether you want to get on, get off or reverse/prevent side effects. Awareness Week classes were designed to…
- Expose the truth about the harmful side effects of birth control and create an awareness of Post-Birth Control Syndrome
- Introduce you to practitioners who can help you conceive, lose weight, get your mood and energy back, feel like having sex again, and get rid of chronic acne
- Connect you with a community of women, physicians and practitioners who believe we have the right to know the impact of birth control so we can make informed choices.
Classes Take Place November 5th through the 11th.
What you receive when you register:
- Access to the most up-to-date (not even in medical textbooks yet) information about the true impact of birth control. (It’s not as safe as we’ve been led to believe.)
- 45+ Classes from leading health and medical professionals focused on healing your mood, skin, periods, hormones, and more.
- The PBCS Awareness Program Guide with speaker tracks outlined to ensure you don't miss the information you need.
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Grow DR, Iromloo K. Oral contraceptives maintain a very thin endometrium before operative hysteroscopy. Fertil Steril 2006;85:204–7.
Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003;18:2337–41.
Ohno Y, Fujimoto Y. Endometrial oestrogen and progesterone receptors and their relationship to sonographic appearance of the endometrium. Hum Reprod Update 1998;4:560–4.
Oshrit Lebovitz, Raoul Orvieto. Treating patients with thin endometrium—an ongoing challenge. Gynecological Endocrinology 2014 30:6, 409-414
Petersen, K, et al. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan, Human Reproduction, Volume 30, Issue 10, 1 October 2015, Pages 2364–2375
Talukdar N, Bentov Y, Chang PT, Esfandiari N, Nazemian Z, Casper RF. Effect of long-term combined oral contraceptive pill use on endometrial thickness. Obstet Gynecol. 2012 Aug;120(2 Pt 1):348-54.