The oral contraceptive pill has undoubtedly had a profound impact on both the history and future of women’s health, for better and for worse.
Whilst providing sexual liberation to many, it also came hand in hand with misconceptions around how the pill actually works, and what it’s doing to your menstrual cycle and health overall.
Despite the pill coming on the market in the 1960s (a whopping six decades ago), pervasive misconceptions about the pill and menstrual health continue to this day.
Below are three common myths about the pill we are dispelling today. Chances are you have heard one, or all, of these before!
Myth 1: The pill regulates your menstrual cycle
Fact: The pill cannot regulate the menstrual cycle.
Whilst at first glance it can seem as though taking the pill has regulated a menstrual cycle as a bleed is coming at a regular and predictable time when we look deeper we can see the truth is quite different.
The menstrual cycle is comprised of 4 phases: the menstrual phase, the follicular phase, ovulation and the luteal phase. To read more about the ins and outs of the menstrual cycle, check out this blog here.
The menstrual cycle is governed by communication between the brain and ovaries and requires ovulation to take place. Once ovulation has occurred, a period will predictably arrive in approximately two weeks (aside from pregnancy).
The pill works by shutting down the communication between the brain and ovaries, preventing ovulation and pausing fertility. This is what it is supposed to do as a contraceptive!
The bleed that then ensues when taking the pill is a result of taking a week’s break from the active tablets containing synthetic hormones, and having the sugar pills. The bleed is a withdrawal bleed. The appearance of the menstrual cycle now becoming regular is a result of taking a break from the active tablets at regular intervals. In reality, the withdrawal bleed would occur whenever you have the week’s break from the active tablets. That could be once a month, once every two months, or once every 6 months!
The underlying factors that were causing irregularity in ovulation and therefore the menstrual cycle are not addressed by taking the pill and are likely to remain after coming off the pill.
Myth 2: The pill is treatment for PCOS
Fact: The pill hides signs of PCOS, but doesn’t fix it.
Polycystic ovarian syndrome (PCOS) is a complex endocrine & metabolic disorder that can result in signs and symptoms such as irregular menstrual cycles, hirsutism, weight gain, hair loss and more. Taking the pill doesn’t change the various underlying mechanisms that have resulted in a PCOS presentation.
Truly addressing PCOS requires a whole-body approach, looking at blood sugar regulation, liver health, gut health, microbial health, stress and environment and more. It is a whole-body systems approach.
There are often high levels of testosterone being produced with PCOS, taking the pill stops ovulation and therefore testosterone production (ovulation is how we make testosterone!). However, this can be likened to chopping off a foot for a sore toe. Getting rid of testosterone production entirely hasn’t addressed why it was high to begin with or created an environment for the body to regulate its production itself.
Myth 3: The pill saves your eggs
Fact: The pill doesn’t help your egg count.
This is one I’ve heard many times over the years as a practitioner. Many women are under the impression that because they are not ovulating whilst taking the oral contraceptive pill, they are saving up those eggs they would have otherwise ovulated which is then benefiting their fertility for the future.
Unfortunately, this couldn’t be further from the truth. Let’s say hypothetically you took the pill for 10 years. This is approximately 120 ovulations that *didn’t* happen.
Now let’s take a moment to understand folliculogenesis – the development and maturation of ovarian follicles.
In utero, a baby girl has roughly 6-7 million eggs at 20 weeks of gestation. This number drops to 1 million at birth and decreases to around 300,000 – 500,000 by puberty. We can see here that egg cells are lost prior to puberty, prior to ovulation and having a menstrual cycle, and this process of egg cell death continues on and is a normal mechanism within the ovary.
Trying to “save up” such a small number of potential follicles by being on the pill doesn’t have any actual impact as thousands of egg cells are dying off each cycle regardless. This is not something to be fearful of, it is a normal part of ovarian health.
However, if you want to be proactive about your future fertility, shift your focus from the intangible number of eggs you may have, and towards how you can improve the quality of your egg cells, as well as menstrual health – as this is the foundation of your fertility.
