The more I read about the pill the more I wonder how it’s even possible that it’s still the most commonly used method of birth control. It’s incredible that we’ve put up with the negative side effects for over 50 years.
We’ve been seduced by the promise that comes with it. The convenience of it. The trendy advertisements full of young happy women enjoying themselves. Even the cute packaging. But it’s time that we pull back the lens and look more critically at hormonal birth control.
I’m all for feminism and empowerment, but not if it comes at a cost. As far as I’m concerned the side effects outweigh the benefits. There are several known risks associated with hormonal birth control. After all, it is a drug.
Before I dive into the 6 reasons why you shouldn’t take the pill long term, I want to share with you the cliff notes version of how the pill actually works. The pill has 3 main modalities by which it prevents you from becoming pregnant:
- The pill interferes with the communication that takes place between your brain and your ovaries. It disrupts your hypothalamic pituitary ovarian axis. It must do this to work. This is how it prevents you from ovulating.
- The pill prevents you from producing fertile quality cervical mucus. Without mucus sperm can’t live inside your vagina or get anywhere near your eggs. If the sperm can’t get to your eggs then you can’t get pregnant.
- Finally the pill prevents your uterine lining from fully developing so even if somehow an egg was fertilized it would have nowhere to implant.
The reason why the pill works is because it disrupts the healthy function of your endocrine system. That’s why you don’t get pregnant on it (most of the time anyways).
But back to the main point, why you shouldn’t take it for the long term. Let’s clarify long term. As far as the scientific studies go, long term is 2 years or more, but we all know that a growing number of women use hormonal contraceptives for much longer than that. Many women have taken it for more than 10 years. Let’s talk about why that isn’t a good idea.
The pill lowers your sex drive
The pill shuts down your ovaries and prevents them from producing sex hormones. It prevents your ovaries from producing estrogen and progesterone, and that is one of the main reasons why it’s such an effective birth control method. When you’re not producing estrogen, you don’t ovulate, and when you don’t ovulate you can’t get pregnant.
What’s the downside?
When you shut down your ovaries, you shut down your testosterone production also. Your ovaries produce testosterone, and even though you’re producing only about one tenth the testosterone that men do, you need it. If that wasn’t bad enough, the little testosterone you have left is bound by a protein called Sex Hormone Binding Globulin (SHBG).
The pill increases your SHBG levels. The result is that SHBG binds to the rest of your free testosterone and prevents your body from having access to it. 
When you’re on the pill your free testosterone levels are 3 or 4 times lower than they would be if you weren’t on it. So say bye bye to your normal sex drive.
If you don’t think you’re affected by this, I want you to ask yourself how long you’ve been on the pill? How old were you when you first started taking it? In all fairness, are you sure your sex drive is still in tact?
I know that you’re much more likely to blame yourself, and assume there’s something wrong with you. But perhaps it’s time to look at that pill pack and consider if the reason you’re not really into sex these days is because of those pill hormones.
The pill shrinks your clitoris and causes painful sex
Although this might sound crazy to you, this is really a thing. Long term hormonal contraceptive use is associated with the decreased vascularization of your clitoris, as well as a reduction in the thickness of your vulvar tissues. 
Hormonal contraceptives are also associated with an increased risk of having pain with intercourse. Not a huge surprise there. If it’s messing with the tissues around your vaginal opening, then of course you’re more likely to have painful sex.
All I can say is that if you’ve ever experienced pain with sex and you’re not sure why it’s happening….and you’re still on the pill? Know that it is a known side effect of hormonal contraceptives and act accordingly.
The pill causes depression and anxiety
Remember when we talked about how the pill lowers your testosterone levels? Well wouldn’t ya know that low testosterone is also associated with an increased risk of depression. If that wasn’t bad enough, the pill interferes with your Vitamin B6 metabolism, and guess what? Vitamin B6 deficiency is associated with depression.
Maybe that’s why so many women complain of feeling lethargic, sad, depressed, moody, anxious, and generally like there is a haze over them while they are taking those little pills.
Long term pill use puts you at an increased risk of cervical cancer
The longer you take the pill the higher your risk of developing cervical cancer.  Honestly, you can’t make this stuff up. What’s interesting is that long term pill use is associated with a deficiency of folic acid, and it turns out that your cervix needs folic acid to stay healthy.
If you’ve ever had an abnormal pap, been diagnosed with cervical dysplasia, or had an HPV infection that won’t go away, all of these conditions are associated with a deficiency of folic acid.  If you’ve been on the pill for a long time you’re more likely to be deficient in folic acid. The longer you use it the higher your risk.
Long term pill use is associated with a delay in your return to fertility
If you’ve used the pill long term and you’re just coming off of it, it will take you about twice as long to conceive (on average) compared to women who have never used the pill.  One of the reasons for that is that it could take several months for your period to return at all. It could take even longer for your periods to return normally and come regularly.
Since you have no way of knowing if your period will come back right away or if it will take several months, it’s a good idea to come off the pill 1-2 years before you’re ready to actively start trying to conceive.
After using the pill long term you’re not 20 anymore – your fertility has changed
The biggest myth about your fertility is that it doesn’t change with time. We have been programed to fear our fertility to the point that we think we could get pregnant on every single day of our cycles.
Can you relate?
What happens after 10 years on the pill is that you are 10 years older. If you are now 34 years old and you’ve used the pill (or other hormone method) on and off for over 12 years, you are no longer 19 and your fertility is different than it was when you first started taking the hormones.
At some point you need to restrategize in terms of your plan to start a family someday. You don’t have the luxury of assuming that you’ll just get pregnant right out of the gate.
You might…and you might not.
What if it takes you a whole year to get pregnant after coming off the pill? What if it takes 2 years? What the research shows is that your fertility is more likely to be delayed when you come off the pill as you get older, so it’s up to you to decide how to manage your fertility when you enter into your mid 30s and early 40s.
Get off the hormones while you have time on your side. Find out what your natural cycles are like and go from there.
Grab a copy of my new book The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility for more on the side effects of the pill, how it impacts your fertility when you’re ready to have a baby, and why I recommend coming off the pill 18 months to 2 years before you start trying to conceive. Click here to read the first chapter for FREE.