From Pills and Patches to Pull-Out and Paragard: Let’s Talk Birth Control

28 Days of Decoding Your Body: The Hormone Balance Challenge 🕯️🍵🕊️ Day 8-9

So I was on lo loestrin for about 10 years

And during that time, I didn’t bleed. Not once.

As a young gal this felt like the dream - no more cramps, never having to deal with a period, plus my skin was 🔥

Until I got old enough to start to say….erm….is this normal?

answers from the doctors: yes, tottalllllyyyy normal to not get a period for a decade

And they were right…not bleeding while on the pill is a normal response to the pill, but that doesn’t make it right or normal for our body and biology

and given that 65% of women are are hormonal contraceptives, oftentimes for years and years at a time….

doesn’t it feel like we should have a better idea of how it’s actually impacting our body?

3 empowered, educated sisters….all on different forms on birth control (FAM, pill, IUD). There’s no one size fits all. Just a weighing of personal pros and cons

Now I’ll be real with you… I don’t like dissing the pill. In many ways, it marked a turning point, giving women more autonomy and control over their reproductive choices.

However, whenever I bring up the very real concerns with the pill, I’m met with “how can you be a feminist and not pro-pill?”

So let’s be clear:

• There’s nothing inherently feminist about a system that fails to offer informed consent to women about how a medication work and its side effects

• The pill was tested on low-income Puerto Rican women without their consent and its rollout came at a deep ethical and human cost

• The pill is financially and hormonally more taxing that most other birth control methods (whereas FAM is literally free) and teaches us nothing about our body

and with that…I’m not anti-pill.

I’m anti-informed consent. I’m anti-overmedicalization of female bodies.

So I’m going to drop the information. The good, the bad, and the complicated around birth control….and then I’m going to trust that you get to decide for yourself

Today’s Hormone Balance Action Steps:

💪🏼 Action Step:

• Include 1 serving of cruciferous veggies x day (broccoli, cabbage, kale, Brussels sprouts, broccoli sprouts, or cauliflower)

✍🏼 Reflection: an inquiry into your connection with your true self

How Does Hormonal Birth Control (HBC) Work?

It depends on the type, but most forms of hormonal birth control (specifically the pill, patch or injection) work by delivering synthetic versions of estrogen and/or progesterone that override your natural hormones. This essentially…

• Suppresses ovulation. Normally, your brain releases FSH and LH to signal your ovaries to grow & release an egg. When you’re on hbc, the synthetic hormones trick your brain into thinking you’re already pregnant or hormonally “stable,” so you don’t ovulate

• Your own hormone production slows down. The synthetic hormones are doing all the talking so your natural hormones get dialed down

While your natural hormones usually rise and fall throughout your cycle, on hbc you’re now in a kind of flatline hormonal state (closer to a man or a woman just perpetually in the early follicular phase)

So What About the Hormonal IUD?

The hormonal IUD (like Mirena, Liletta, Kyleena, or Skyla) works differently than the pill, but still uses synthetic hormones - usually a progestin called levonorgestrel. While it is more local, it can still have systemic effects.

Unlike the pill, some women may ovulate and maintain their regular cycles while on the IUD, though others don’t.

Different types of mechanisms of action; different types of symptoms and tradeoffs; different benefits and pros….

Let’s dive in 👇🏼 scroll down to your birth control method to learn more. Remember, we’re just delivering information so you can make an informed choice for yourself or with your healthcare team

The Pill 💊

(Lo Loestrin, Junel, Levora, Yaz, and others)

💡 How it works: delivers synthetic hormones to suppress ovulation. It shuts down your natural hormone production and replaces it with a flat pattern.

🌷 Potential Benefits:

• Symptom relief (PMS, painful periods, etc) while on the actual pill (comes back when off)

• Can be helpful if suffering from PMDD while working on root cause

🤫 Myths:

• “It regulates cycles” → it just shuts it off

• “It helps acne” → only if you have specific type of acne and only while on the pill

• “It is the treatment for PCOS” → it’s a bandaid

• “It heals endometriosis” → for many, it can worsen due to high levels of estrogen

⚠️ Side Effects & Considerations:

• Deplete nutrients needed for fertility, egg quality, and hormones (B vitamins, magnesium, zinc, vitamin C)

• Can suppress libido

• Linked to increased risk of SSRI use and depression

• Disrupts gut microbiome

• Burdens the liver

• Lots of others…. (blood clot risk, increased risk of certain cancers, migraines)

🌿 Other Factors to Know:

• You don’t get a true period on the pill—bleeds during the placebo week are “withdrawal bleeds,” not real menstruation

• Long-term use may mask underlying hormone imbalances

🌱 What to consider when coming off:

• You may experience a “post-pill rebound” of acne, irregular cycles, or hair shedding as your body recalibrates

• Don’t panic if your period doesn’t return right away - it can take 1–3 months depending on the person. Any longer, and it’s time to look deeper

• Focus on estrogen and liver support the first month and half when coming off

• While on it or when coming off, bring in prenatal, multi or b complex to replete

The Hormonal IUD 🦋

(Mirena, Liletta, Kyleena, Skyla)

💡 How it works:
Releases a synthetic form of progesterone locally into the uterus. This thickens cervical mucus (blocking sperm), thins the uterine lining (reducing likelihood of implantation), and may suppress ovulation.

🌷 Potential Benefits:

• Lower overall hormone exposure compared to the pill

• Convenient, long-acting

• May reduce painful periods in the short term

• Can help with management of endometriosis (!!)

🤫 Myths:

• “It’s hormone-free” → Nope. It contains synthetic progestin

• “It only acts locally” → While the hormone is released into the uterus, we’re finding it still can have systemic effects

• “You’ll still cycle naturally” → Depends on the person. Ovulation may still happen, but many experience blunted hormonal signaling and disrupted rhythms

⚠️ Side Effects & Considerations:

• Can lead to mood changes, anxiety, or depression

• May trigger or worsen acne or hair thinning (androgenic activity)

• Spotting, cramping, or ovarian cysts are more common

• Systemic absorption may still impact our hormonal cycles

• Can lead to chronic yeast infections (yeast can grow on the IUD)

• Can deplete vitamin D and research now showing may also deplete B vitamins

🌿 Other Factors to Know:

• Can shift vaginal flora and impact cervical mucus long-term

• PAINFUL to insert and remove (you are now able to request an anesthetic. Speak up and if your doctor refuses, refer them to ACOG’s updated guidelines)

🌱 What to consider when coming off:

• Acne and mood shifts may pop up post-IUD as your body re-learns its own hormonal rhythm

• Replenish nutrients like B vitamins and vitamin D

The Copper IUD 🧲

(Paragard)

💡 How it works:
The copper IUD is wrapped in copper wire, which creates an inflammatory reaction in the uterus that’s toxic to sperm. It prevents pregnancy by impairing sperm mobility. That means you still ovulate and cycle naturally with this method.

🌷 Potential Benefits:

• Hormone-free birth control

• Fertility typically returns immediately after removal

• Long-lasting (up to 10 years)

• Appeals to those wanting to avoid synthetic hormones but don’t want to do FAM

🤫 Myths:

• “It’s totally natural” → It doesn’t contain hormones, but the copper creates chronic low-grade inflammation in the uterus

• “No systemic effects” → Copper can accumulate in the body over time and impact mineral balance and zinc levels

• “It’s side-effect free” → Many experience heavier and much more painful periods, especially in the first year

⚠️ Side Effects & Considerations:

• Can increase menstrual bleeding and cramping in the beginning

• Raises copper levels, which may displace zinc and impact mood, skin, and immune balance

• High copper may increase histamine issues in sensitive women

• May not be well tolerated by those with estrogen dominance, endometriosis, fibroids or slow detox pathways

🌿 Other Factors to Know:

• Doesn’t prevent ovulation → You can still track your cycle naturally!!

• If copper is retained or unbound, it can act like a pro-oxidant and contribute to inflammation

• Can lead to painful, crampy cycles the first few months

🌱 What to consider while on it or when removing it:

• Support mineral balance: focus on zinc-rich foods (pumpkin seeds, oysters, grass-fed meat) and consider a zinc supplement when on it or when coming off

• Monitor estradiol, copper and zinc levels periodically (I also would check retinol and ceruloplasmin and iron panel)

• Watch for signs of copper imbalance: worsening PMS, anxiety, skin issues, or fatigue

• Cycle tracking is still possible and helpful!

The Barrier Method 🛡️

(Condoms, diaphragms)

💡 How it works:
Barrier methods work by physically preventing sperm from reaching the egg. No hormones involved.

🌷 Potential Benefits:

• Completely non-hormonal - no biological side effects

• STI protection

• Easy to start and stop at any time

• Cheap and easily accessible

🤫 Myths:

• “They kill the mood” → Okay so I kinda get this, but if you’re having sex with someone (stranger, FWB, BF or husband) I hope there is a certain level comfortability or confidence (ideally both) that allows this standard to be set. Plus, you can get creative and make a moment out of it 😏

⚠️ Side Effects & Considerations:

• Some individuals are sensitive to latex or spermicides, which can cause irritation or inflammation

🌿 Other Factors to Know:

• Non-toxic, sustainable condom brands (like Sustain or LOLA) are available

🌱 What to consider if relying on them long-term:

• Track cycle so you're more precise about when you're actually fertile

• Explore pairing with FAM for dual protection

• Communicate clearly with partner about use and expectations

• Always check expiration and proper storage (especially with condoms)

The Fertility Awareness Method 📊

(Basal body temp, cervical mucus, LH tests, cycle tracking apps)

💡 How it works:
FAM is based on observing and charting fertility biomarkers - like basal body temperature (BBT), cervical mucus changes, and hormone surges (like LH) - to identify when ovulation occurs. You then avoid unprotected sex during the fertile window (or use backup protection during that time).

🌷 Potential Benefits:

• 100% non-hormonal - preserves your natural rhythms, mood, and ovulation

• Empowers deep body literacy and hormone awareness

• Can be used for both pregnancy prevention and optimizing fertility

🤫 Myths:

• “It’s not effective” → With perfect use, FAM is ~98–99% effective. It requires training and consistency, not guesswork (but is just as effective as other forms of bc)

• “I’ll get pregnant right away” → see above. We’re going on 4 years with FAM + barrier method…no pregnancy scares

⚠️ Side Effects & Considerations:

• It does require EFFORT. Daily tracking and body awareness are a part of this. So not ideal for people who aren’t willing to be consistent. This isn’t just a “wing it” or “go off an app” vibe

• Needs backup (condoms, diaphragm, or abstinence) during fertile days

🌿 Other Factors to Know:

• Can reveal valuable insights into cycle health (e.g., short luteal phase, delayed ovulation, signs of estrogen dominance) and piece togther symptoms

• Perfect for those seeking a deeper relationship with their cycle

🌱 What to consider if using FAM:

• Commit to at least 3 months of consistent tracking before relying on it for birth control

• Learn from a certified educator or well-reviewed course or book (avoid relying solely on apps…resources below)

• Know that your “fertile window” can and does vary…we aren’t static machines. Don’t expect your ovulation window to be the exact same month to month

we cover some of actual cycle tracking here

How to Know If Your Period is "Normal"? 🤔

The Down Low:

• The pill and other systemic hormonal methods suppress ovulation and squash our hormones. The side effects are many and it has systemic short and long term impacts on the body

• The hormonal IUD may allow ovulation but still can have systemic effects

• The copper IUD allows you to ovulate but comes with increased inflammatory symptoms for some

• The barrier method is effective & simple but people can be sensitive to lubricants, textures or “the mood”

• The FAM method is effective, free, and allows for a deeper understanding of the body and our hormones, but requires consistent effort and intention

There’s no right answer…just the one that’s right for you

Put It Into Practice:

Okay my girl, today’s action step is one that I start so many of my clients off with ASAP

Bring in 1 serving of cruciferous veggies x day

• 1 serving = 1 fist worth (if doing broccoli sprouts, than aim for 1-2 cups)

Cruciferous vegetables contain something called DIM, which works to help support metabolism of estrogen and ease estrogen symptoms (like painful periods, acne, bloating, etc). In other words….cruciferous veggies = happy liver = happy hormones

What are cruciferous veg?

• broccoli or broccoli sprouts

• cauliflower

• kale

• Brussels sprouts

• cabbage

Pretty simple, but this habit can go a looonnnngggg way

Pst: recipe inspo + pro-tips on cruciferous veg down below

So now in your line up you have….

1. Drink water with lemon within 30 minutes of rising

2. Take 5-10 minutes to meditate

3. Bring in a serving of cruciferous veggies x day

You’ve got this 💪🏼

Time to Reflect:

We’re back…take a deep breath, grab your notebook, and let’s dive a little deeper into our selves.

Give yourself this moment.