Hormone regulation and birth control pills

Posted by Saul Marcus, ND, April 17, 2010

Women are often prescribed birth control pills for many conditions such as: PMS, acne, irregular menstruation, endometriosis, and PCOS. I have even seen women who were prescribed birth control pills just so they would not have to bother having their period.

Very often women are told that the birth control pills will “regulate” their cycle. This is a myth. Birth control pills in no way “regulate” a woman's cycle, they suppress the cycle to such an extent that there is no ovulation.

Under normal conditions a woman's monthly comes from a precise choreographed interactions between several hormones:

  • Estrogens
  • Progesterone
  • Luteinizing hormone (LH)
  • Follicle stimulating hormone (FSH)


The first part of the cycle, the “Follicular Phase” follows menstruation. During this time estradiol is high and progesterone is low. Estradiol's job is to build up the inner lining of the uterus called the endometrium. This is necessary to get the uterus ready for implantation of the embryo if conception happens to occur.

Estradiol surges during during mid-cycle. This signals the brain to release LH and FSH, which trigger ovulation.

At ovulation the ovaries release a follicle, which is called the corpus luteum. The corpus luteum then turns into an endocrine gland and produces progesterone. A major job of progesterone is to maintain the endometrium lining in case of implantation and pregnancy. In that case progesterone remains elevated. However if pregnancy does not occur then progesterone levels drop, the endometrium can no longer be maintained and this triggers menstruation.


This is a rather simplified explanation of very complex hormonal interactions, but the key point is that those four hormones, estradiol, progesterone, FSH and LH must be working together in proper balance for everything to go right. If a drug or supplement truly “regulates” a woman's cycle that would mean that it helps return the delicate balance of these hormones to normal.

There are natural substances that do just that. For example the herb Vitex agnus-castus is believed to do that by telling the pituitary gland to secrete more LH, which in turn will raise progesterone levels. Or the compound indole-3-carbinol helps the liver detoxify excess estrogen.

These natural therapies when appropriate which truly help “regulate” the balance between a woman's hormones. Often when these hormones are brought back into balance symptoms such as menstrual cramps, acne and PMS go away.

However birth control pills work in a totally different way. They contain synthetic estrogens and synthetic progesterones. The only way this could theoretically “regulate” the cycle is if a women had a deficiency of estrogens and progesterones, which was being corrected by taking the drug.

If this were the case then the birth control pills would actually aid women in becoming fertile. The fact that birth control pills cause women of child-bearing age to become infertile means that they do not bring hormonal imbalances back to normal.

Birth control pills work by deregulating a woman's hormonal balance to the point where ovulation ceases to occur. Although women still bleed while on birth control pills a totally different phenomena is occurring.

Normally the period is a result of ovulation and the corpus luteum increasing then gradually decreasing progesterone. With birth control pills there is no ovulation and no progesterone produced by the corpus luteum. Instead women take placebo birth control pills for a few days, which do not contain progesterone and bleed as a result of synthetic progestin withdrawal.

Even though the birth control pills don't “regulate” anything many people still may not care.

A misconception many women have is that a long as their symptoms go away then does it really matter how the drugs work.

In fact it does, and for three reasons.

  1. Often symptoms that women have around their period can be helped naturally, for a lot less money and in a way that actually returns the body to normal function without needing to take medications indefinitely.
  2. By correcting physiology through natural means a woman's overall health will be improved. Suppressing symptoms with drugs still leaves the original problem, which may manifest later as a different symptom.
  3. The estrogens and progesterones in birth control pills are not the same as the estrogen and progesterone the body naturally makes. For example the common synthetic estrogen Premarin is actually made from pregnant mare's urine (pregnant mare urine). These synthetic hormones may look similar to human hormones but they are not the same thing and body knows it.

According to the National Institute of Health's web site side effects of birth control pills include: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601050.html (accessed 4/17/2010)

  • nausea
  • vomiting
  • stomach cramps or bloating
  • diarrhea
  • constipation
  • gingivitis (swelling of the gum tissue)
  • increased or decreased appetite
  • weight gain or weight loss
  • brown or black skin patches
  • acne
  • hair growth in unusual places
  • bleeding or spotting between menstrual periods
  • changes in menstrual flow
  • painful or missed periods
  • breast tenderness, enlargement, or discharge
  • difficulty wearing contact lenses
  • swelling, redness, irritation, burning, or itching of the vagina
  • white vaginal discharge

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

  • severe headache
  • severe vomiting
  • speech problems
  • dizziness or faintness
  • weakness or numbness of an arm or leg
  • crushing chest pain or chest heaviness
  • coughing up blood
  • shortness of breath
  • pain, warmth, or heaviness in the back of the lower leg
  • partial or complete loss of vision
  • double vision
  • bulging eyes
  • severe stomach pain
  • yellowing of the skin or eyes
  • loss of appetite
  • extreme tiredness, weakness, or lack of energy
  • fever
  • dark-colored urine
  • light-colored stool
  • swelling of the hands, feet, ankles or lower legs
  • depression, especially if you also have trouble sleeping, tiredness, loss of energy, or other mood changes
  • unusual bleeding
  • rash
  • menstrual bleeding that is unusually heavy or that lasts for longer than 7 days in a row

Oral contraceptives may increase the chance that you will develop liver tumors. These tumors are not a form of cancer, but they can break and cause serious bleeding inside the body. Oral contraceptives may also increase the chance that you will develop breast or liver cancer, or have a heart attack, a stroke, or a serious blood clot. Talk to your doctor about the risks of using oral contraceptives.

Oral contraceptives may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

How birth control pills de-regulate the normal female cycle


If a women wants to use birth control pills as a contraceptive, then that is her right to do so. However she should go over the medication with her doctor and make an informed decision about the pros and cons of the drug. Birth control pills as contraception, is not medication meant to treat any health condition or improve health. Rather the birth control pills are foreign substances designed to disrupt and stop ovulation, which is a normal and healthy process in women of child-bearing age.

If a women is prescribed birth control pills for any other reason she should not be told that they are meant to “regulate” anything unless the doctor has good reason to believe so. Birth control pills are powerful drugs and contain hormones that are not natural to the human body. They should be used with care and not handed out like candy.