Birth Control Side Effects: How hormonal birth control impacts your sex life

4 MIN READ

G asks: I saw you mentioned you came off the Pill. What are the benefits of that if you don’t mind me asking?

G: I love discussing this!

A lot of the information out there around birth control side effects falls into one of two categories.

People who are pro-hormonal birth control tend to dismiss personal stories on the impacts of those hormones on people’s lives. Meanwhile, those against hormonal birth control demonize it and borrow the language of feminism to make their argument.

Both my experience and my professional opinion lie somewhere in the middle.

I went on the Pill at 16, after six years of brutal cramps and moodiness that kept me from school and work and hurt my relationships, every month. Birth control gave me my life back. Yes, I had a few negative birth control side effects on a few of the pills, namely mood changes and breakthrough bleeding. Overall, though, I had an easy run.

When I was diagnosed with two autoimmune diseases, taking the Pill became a burden amidst my other healthcare needs. I decided to go off it, honestly hoping that it might reverse some of the autoimmune stuff as I was told it would (it didn’t). After two years of contemplating and preparing, including working with a Justisse practitioner, I took my last Pill in August 2017.

Here's what happened for me:

To be honest, going off birth control has been really inconvenient and stressful. Tracking my cycle, knowing when I’m ovulating or not, and managing the natural side effects of my natural cycle is less than fun. Yet, like my decision to start taking the Pill at 16, it was the best one for my life right now—and that’s what counts.

Birth control side effects for your sex life.

In my list above, you see a mix of what many people would deem positive and negative outcomes. Like any medication or decision, there are associated side effects. Here are some of the sexual ones that stem from hormonal birth control.

Decreased libido.

About 15 percent of users notice a dip in libido while on the Pill. There are a few reasons for this. First, most hormonal birth control methods work by shutting down your ovaries. This means you don’t ovulate and therefore can’t get pregnant. It also means you produce less testosterone overall—involved in your libido—and don’t get that mid-cycle spike that makes you really horny. Plus the estrogen in hormonal birth control can increase sex hormone-binding globulin, which further reduces testosterone in your body.

Decreased lubrication.

Hormonal birth control can also make it harder to get wet. That’s because it can decrease your estrogen levels, the hormone that helps to keep the vagina moist. If this happens to you, supplement with a good lube.

Pain with sex.

Estrogen also helps maintain the thickness of the vaginal lining. Decreased estrogen production that can happen while on hormonal birth control may thin the vaginal lips and entrance, making play down there a bit more uncomfortable.

Less anxiety about getting pregnant.

While no birth control method is 100% effective, many of the most effective options involve hormones. If getting pregnant is a major concern for you, then having to worry about it less can increase your sex drive.

Less PMS.

Need I say more? Because hormonal birth control keeps your hormone levels even throughout the month, you don’t have the dips and peaks in mood, sleep, or libido that many people with periods experience otherwise. This can reduce tension in your relationship(s).

An easier period.

If you experience a bleed while on hormonal birth control, it’s not an actual period but a withdrawal bleed: aka your body responding to a lack of hormones. This often makes for less painful cramps and a lighter bleed.

Clearer skin.

Many people use hormonal birth control to treat their acne. This can boost one’s body image, and in turn one’s desire for sex. Negative body thoughts are one of the biggest mental distractions during sex.

What can you do about birth control side effects?

Before you blame the Pill for everything, take a more holistic look at your sex life and relationship. How do you feel about your body? How is the relationship with your partner? Is work, family, etc., stressing you out big time? Are you bored?

Libido in people with uteruses (and those with penises too!) is such a complex issue. It’s never about only one factor, but the interplay of many. It’s easy to blame a medication rather than look at what else is happening.

And also, sometimes, it really is the meds! If you aren’t happy with your birth control for any reason, explore other methods. That could mean switching pills, looking into long-acting reversible contraception, or exploring a fertility awareness method. No single method is right for everyone!

You know your body and life best. The best way to avoid or manage birth control side effects? Inform yourself about all of the options and choose the one that’s best for you, knowing that you can always change your mind or switch to another method. Don’t let a healthcare provider (or a period coach or anyone else) tell you what’s best for your life and preferences.

Kait xo

Pregnancy With an IUD When You Are The One Percent

5 MIN READ

In 2011, after the birth of my third child in three years, I was desperate to find a form of birth control that would actually work for my body.

I had mood swings and gained weight on the Pill.

took a shot at Natural Family Planning (NFP), but due to some bad mental math while things were getting hot and heavy, I wound up pregnant with number two.

We even went with the tried and true condoms and pull-out method and that is how we have number three.

When my midwife told me about the copper IUD it almost seemed too good to be true. I wouldn’t have to remember to take anything or count days, and the hormones were localized so I wouldn’t be affected by mood swings or weight gain. Needless to say, I was very excited and had my IUD implanted that day.

An entire year went by with no issues. I made a habit of always checking for my strings on the first day of the month, and none of my usual, unwanted symptoms had reared their ugly heads.

Unusual symptoms.

However, in July 2012, I started to feel another set of usual symptoms. But these were not birth control symptoms. No, these were pregnancy symptoms. Around 9pm one evening I looked at my husband and told him that, at the risk of sounding irrational and possibly deranged, I was just going to take a pregnancy test and put these questions in my head to rest.

Two minutes later, I had two little lines staring back at me confirming my suspicions. I couldn’t believe it. The IUD is supposed to have a 99 percent success rate and here I was, part of the one percent. You never expect that you will be a part of the tiny number they warn you about, but I was.

I told my husband and even though we were excited, we were still shocked. Thankfully, we wanted another child and, though it didn’t happen at quite the right time, we could get on board with the idea fairly easily. A couple of hours later, I went to bed hoping that in the morning I would call my midwife’s office, get my IUD out, and everything would be fine. Healthy pregnancy, healthy baby.

That night.

Unfortunately, that is not how this story goes. I tried lying down and felt in my shoulder discomfort I had never felt before. I sat up and the pain immediately went away. Uncertain, I propped myself up on some pillows and tried to fall asleep. I was OK for about thirty minutes until the pain came back again with a vengeance. I got up to sit in our recliner and again, felt a bit better. I tried drifting off to sleep and got maybe another thirty minutes of rest before the excruciating pain was back.

I decided to get in the bathtub but the fluctuating pain carried on all night. I think I drifted off in the tub a few times, but mostly I stayed awake, talking to this new life inside me and encouraging the tiny force to be reckoned with. At 8am, I called my midwife’s office. I told them what was going on and they told me to come in right away. My husband’s job wouldn’t allow him to take off work on such short notice, so we called my mom and his sister and they came to be with me. My mom came and loaded me into her car; by the time we left I was very, very ill. The shoulder pain had increased exponentially and everything hurt.

When we arrived at the building I waddled in, the pain immense, and slowly made my way up to the third floor in the elevator. As I started to get out of the elevator, I knew I wasn’t going to make it. I collapsed right there in the hallway. My mom ran into the midwife’s office and the office staff came out immediately to help.

Moments later, one of my midwives came to check on me. I was sitting up on the table answering her questions as best I could. She asked me to lie down so she could check my IUD strings and I started crying as the pain was unbearable. She said she understood and she would be quick, but it needed to be done. So I laid back, pain washed over me, and I passed out. I came to about 30 seconds later and the room was in a panic. The midwife told me she thought the IUD perforated my uterus and I was bleeding internally.

My midwife called my OB, I was checked into the ER, and the doctors immediately administered an ultrasound. My OB told me that there was so much fluid in my abdomen that he couldn’t actually see where my IUD was or what the cause of the bleeding was, so he was going to have to go in blind and I would have to trust him. Thankfully, this man had already been an amazing doctor with one of my pregnancies and he had all of my trust.

Terrifying moments in the ER.

By this time, my husband had arrived at the OR and it hit me that this could potentially be the last time I ever saw him. As best I could, I told him I loved him and to tell the kids I loved them. Then I just cried. From hurt, from pain, from uncertainty. They rolled me back to pre-op and shortly after arriving, I passed out from pain again.

When I woke up after the surgery, I was in a lot of pain but surrounded by family. I felt dead; I couldn’t move freely and it took an incredible amount of effort to even try. My OB came in not long after I awoke and explained that my IUD had perforated my uterus which caused an ectopic pregnancy, an egg that was fertilized in one of my fallopian tubes. The growing pregnancy caused the tube to rupture, and I was bleeding internally for nearly 15 hours.

My doctor went on to explain that I lost between one and a half and two liters of blood—about a third of a person’s total blood volume. He said it was incredible I was still here to tell the tale and had I shown up to the hospital even 30 minutes later, I would have died from losing too much blood. He had to resect my left fallopian tube, leaving me with just the right tube to work with if I ever wanted to get pregnant again.

For two days I lie in recovery even though I felt there was no life left in me. I couldn’t speak out of sheer exhaustion. My doctor finally ordered a blood transfusion and after four bags of donated blood, I started to feel better.

Recovery.

It was a slow recovery and I still feel lasting effects to this day. I have a much harder time regulating my body temperature and the catastrophic event caused a hormonal response from which my thyroid has yet to bounce back.

I don’t share my story to scare people into different forms of birth control. There is no doubt that the popularity of IUDs has increased over the past few years and many women have had success with them. I share my story as an example of the one percent of cases you always hear about on warning labels but never believe will happen to you. It’s imperative to fully and wholly educate ourselves so we can all make the best decisions for our bodies and our health. I share my story so it becomes real, so other women are aware of what can happen, and so women can learn how to advocate for their health.

The Link Between IUDs and Depression That We Need To Talk About

4 MIN READ

At 15, having my painful and irregular periods managed, manufactured, and scheduled by the Pill seemed like The Best Idea Ever.

 But at 27, I started to question the long-term effects of the artificial hormones that had been coursing through my body for over 12 years.

The rest of my self-care routine was in the midst of an all-natural makeover—organic vegetables, grass-fed beef, skincare ingredients straight from Mother Earth—and the Pill didn’t seem to make sense for me anymore.

I researched some other birth control options, and landed on an IUD; specifically, Mirena: One appointment, three to 10 years of baby-free sex, and a lower dosage of localized hormones.

My OB-GYN was just as enthusiastic about my decision as I was; I had the IUD implanted 20 minutes after my initial consultation. But in the weeks following my birth control switch, I felt decidedly less enthusiastic. Besides the bloating, acne, and slight mustache that had sprouted on my upper lip (true story), I fell into a deep pit of depression. I blamed my constant state of general blah-ness on a recent move, job drama, and the stress of planning my upcoming wedding…but after months of living under this heavy haze with no end in sight, I started to wonder, was my IUD causing my depression?

Can hormonal IUDs actually cause depression?

In short, yes. “A 2016 study of over a million women in the the Journal of the American Medical Association revealed that progestin-only contraceptives, like the IUD, were associated with a higher risk of depression,” reveals Dr. Jolene Brighten, a Functional Medicine Naturopathic Medical Doctor and the author of Beyond the Pill. This isn’t exactly an uncommon side effect, either. “Some studies have stated that progestin intrauterine devices (IUDs) were shown to nearly triple the number of both depression diagnoses and antidepressant use among young women [as compared to those not on birth control],” Dr. Jessica Shepherd, an OB-GYN and women’s health expert, tells Blood and Milk.

Studies show that hormones in IUDs can affect our brain chemistry.

Dr. Brighten concedes that there hasn’t been enough research in the space to fully understand why hormonal IUDs like Mirena can cause mood swings and depression, but there’s evidence to suggest that it comes down to progestin, the synthetic hormone found in many contraceptives. “It appears alterations in brain chemistry that lead to increased production of neurotoxins, elevations in inflammation, alterations in gut health, and nutrient depletions are some of the reasons hormonal birth control may alter mood in some women,” she explains. “We also understand that your [naturally-produced] progesterone stimulates GABA, a calming neurotransmitter in the brain, but progestin, the synthetic hormone in contraceptives, does not.”

Upon hearing all of this, my mind was kind of blown. The reason I opted for an IUD in the first place was because of its localized hormone delivery system, specifically targeted at the uterus—so how, exactly, do these hormones end up messing with our brain chemistry? “Although the intrauterine system primarily works locally, it still delivers [hormones] to the systemic circulation,” Dr. Shepherd explains. Which leads me to another question: Why aren’t people talking about this?

The link between IUDs and depression is real, but often ignored.

If you Google “IUDs and depression,” over 5 million search results prove that people are talking about it. But why aren’t doctors and OB-GYNs talking about it with their patients? Why wasn’t I told that my whole localized-hormones-must-be-better theory didn’t check out? Why wasn’t I asked, “Do you have a history with depression or anxiety?” before being implanted with a one-inch piece of plastic that had the potential to turn my world upside down? Yes, it turns out that women with a history of mood disorders have a higher likelihood of developing IUD-induced depression.

“From what is understood in the research, women with a personal or family history of depression or other mood disorders are more susceptible to experiencing these side effects with hormonal contraceptives, including the progestin-based IUD,” Dr. Brighten shares. Dr. Shepard even goes so far as to say that women with significant depression “are not ideal candidates for the hormonal IUD.”

One reason OB-GYNs may not be addressing this issue? “The package insert on the Mirena states that only around 5 percent of women in clinical trials have depressive mood and nervousness as a side effect,” Dr. Brighten says—in other words, not a significant percentage. “But that doesn’t account for what happens in the general population,” she adds, citing that outside of control groups, the adverse effects of Mirena and other hormonal IUDs may be more widespread than we think.

“Sadly, women are often dismissed in medicine when it comes to mood symptoms,” Dr. Brighten admits; so those who do take these concerns to their OB-GYNs may not be taken seriously. That’s precisely what happened to me when, after doing some independent study and concluding that my IUD was messing with my mood, I confronted my doctor. “It’s in your head,” he said, with a smile and a wave of his hand. “This is just stress from the wedding.” Needless to say, I booked it out of his office (and maybe kind of cursed him out just a little bit) and set up an appointment with a new OB-GYN, who respected my decision to have the IUD removed.

Doctors estimate that it takes about three months for our systems to completely clear IUD-delivered progestin from the body, so my symptoms didn’t immediately go away. But today, six months later, I’m not only happy with my decision—I’m also just plain happy.

What to do if you’re experiencing IUD-induced depression.

Having the hormonal IUD removed isn’t the only solution, though. “There are several progestin-based IUDs that have varying amounts of progestin,” Dr. Brighten says, noting that a lower dose of progestin may be all your body needs to re-stabilize. “There are also non-hormonal contraceptive options, like barrier methods and the fem-tech devices approved by the FDA”—as well as the hormone-free copper IUD. That being said, she doesn’t condone mixing hormonal IUD with psychiatrist-prescribed mood stabilizers or antidepressants. “I don’t recommend women begin medications to manage side effects caused by a medication if it is possible to have an alternative contraceptive that wouldn’t cause side effects,” she says.

With issues as complex and nuanced as reproductive health and mental health, there’s no single approach that will work for everyone. That being said, there is one universal truth: Birth control exists to offer women freedom. It shouldn’t leave you feeling trapped under the weight of depression; and if it does, talk to your doctor—preferably one who will present you with the facts, individualize your care, and listen when you tell them that something’s not right.