Health knowledge made personal
Join this community!
› Share page:
Search posts:

Question of the Week: Birth Control

Posted Oct 05 2009 10:02pm


Hey guys!

First of all, thank you for your feedback! Wow, I am so grateful to everyone who voiced a favorite recipe, and really touched to see how many of you have tried my little creations. (If you missed it, please scroll back to the comments of my last post to pipe in about your favorite Choosing Raw recipe). Looks like the cashew alfredo and zucchini marinara are slightly in the lead. Viva la veggie pasta.

Also, I’m so happy that the root vegetable medley looks pleasing! I really love the recipe (and the dressing) and hope you guys will give it a try.

I’m here with a question I’ve gotten from several readers, most recently Alejandra:

Hi Gena,

I recently came across your blog and was very interested in your approach to all things vegan and raw.
You mention in that post that you are not on a contraceptive. I have been on mine for 12 years now. Never comfortable with taking hormones everyday but I was never offered any alternative that sounded less invasive and reliable enough.

I was wondering if you have found a contraception that doesn’t involve taking hormones or polluting the earth (condoms), I would be very interested.

Thanks for reading my email, I look forward to hearing back from you.


There are certain questions—and this is one of them—that I wish I had days and days to research in depth and respond to with a lengthy, well considered essay. Instead, I’m forced to respond with the information I do have, my intuition, and as much as I can write in the time I have.

I should preface this post with the following disclaimer: oftentimes, conversations about the pros and cons of hormonal birth control get intertwined with conversations about weight. Let me make something clear: I experienced no fluctuation of weight on the pill, and my feelings about it have nothing to do with weight gain or loss. I know that many of you may have stories akin to “I gained 10 lbs on the pill” and may want to vent your frustration. But I’m going to ask that, if your feelings about birth control are 100% weight-centric, please don’t; obviously, what you experienced is a valid source of frustration, but I like to keep the conversations on this blog focused more on health than on weight loss per se. I also want to say that, for those of you who’ve experienced no adverse reactions to the pill, this post is not meant to open a Pandora’s box of worry! Just as with food, we all respond differently to medicine. What works for one body won’t work for another. If the pill is working for you, go ahead and stick with it.

On that note, let’s have some girl talk, shall we?

The truth of the matter, Alex, is that this is a question I have yet to come to terms with myself. I wish that there were a birth control method that was totally natural, totally reliable, and totally convenient. Alas, it’s just not so. We’re meant to reproduce, and trying to shut that biological imperative down is not likely to be an easy project.

If you’re asking for my thoughts on the pill, here’s what I have to say:

I don’t offer up the slightest bit of criticism or judgment to those who are on birth control. It is the single most reliable way to prevent pregnancy, and therefore the most logical choice for couples who are in long-term, monogamous relationships. From a philosophical and political standpoint, too, I am deeply grateful for the pill: its advent was the single most decisive step in liberating women from what was once the tyranny of being susceptible to pregnancy, both within marriage and without. Without it, quite frankly, a great many women would find themselves in a position of being either servants to their uteruses, or forced into making decisions about terminating unwanted pregnancies.

From a health standpoint, however, I’ll say quite honestly that I’m not a fan of hormonal birth control. I believe firmly that altering natural hormonal function through any kind of synthetic hormone replacement is highly questionable. Our bodies exist in a state of natural hormone balance, and messing with that—whether through birth control, estrogen replacement, or the many hormones that are loaded into conventional dairy and meat and poultry—is a hazardous enterprise. The preponderance of hormone-responsive cancers, including some types of breast cancer, is all the more reason for women to think carefully about whether or not any sort of hormone alteration is wise for their bodies.

As you all know, I’m not—nor do I claim to be—a medical doctor, and I’m well aware that there are some doctors who argue sanguinely for the use of bioidentical hormone replacement. This is fine; that’s their prerogative. It’s not a position I agree with, but it’s one that exists within the medical community.

My main reasons for scowling at the pill–at least within my own life–are personal. I took the pill for four years, and while I can’t claim to have had a horror story with it, I can say that it was detrimental to my health. While it lessened my cramps and afforded me piece of mind within my monogamous relationship, it also made me frequently lethargic, ultimately lessened my sex drive, and, most importantly, left me with chronic yeast infections for nearly a year (I’d never had one before taking the pill). This is no surprise: one of the worst consequences of altering hormone levels is that it tends to make women’s bodies highly susceptible to yeast overgrowth. (For more on yeast and what it does, check out my low sugar dessert post ). This is a fairly commonplace, and very frustrating, experience for many women.

It’s also worth sharing last weekend’s New York Times article examining the health risks of Yaz and Yasmin. I, like many young women, took Yaz, and I smoked heavily while I did. Today, I’m grateful that my foolish behavior had no grave consequences. Of course, this hazard is contingent more upon how responsibly one uses the pill than on the pill itself, but it deserves a mention.

So what to do within a long-term, monogamous relationship if you’re not into the pill? Well, there are condoms and diaphragms. I know. Buzzkill. Truth be told, we ladies are no more fans of condoms than you fellows are: I think it’s safe to say that we all find them annoying and mood-quashing (many women, myself included, also find them rather uncomfortable). In addition, condoms aren’t great for the environment. Further buzzkill.

There are copper IUDs (which, unlike Mirena, are hormone free), but it’s very hard to find a gynecologist who will allow a young woman who isn’t married to get a copper IUD—a policy which I find slightly discriminatory. There are calendar based methods, which I have nothing but the highest reverence for, if one’s cycle is regular enough, and intuition good enough, to make those work. But I’m rather neurotic, and I don’t doubt that using a calendar method would leave me constantly anxious and waiting fervently for my monthly friend.

So, the verdict? Once again, I admit defeat. I wish I could offer you all a perfect solution, but for every one of the options above, there’s either a risk or a major pitfall. All I can say is that you should all do what feels right for you in terms of personal health, lifestyle, and your relationship with your sexual partner.

If you do choose not to take birth control, I sympathize and support you. The pill is so ubiquitous today that we don’t often stop to think about whether or not taking it is right for us. Many women are pressured into taking the pill by boyfriends and by gynecologists, and this is absolutely not right.  The choice to take hormones is a personal one—as personal as any other choice you make about your reproductive health—and no one, not even your lover or life partner, should make you feel as though you have to do it. If your boyfriend moans and groans a little about your going off the pill? Well, you can offer some humorous and good natured sympathy, but let him know that your mind is made up. If he freaks out? You might want to consider how much he has your best interests at heart.

Naturally, if you suffer from some sort of medical condition that necessitates the pill or other hormone treatment, or if you’re taking the pill to regulate your cycle, or if there’s any other reason why a trusted medical professional has recommended you take it, you should of course take that advice to heart. We all have to create hierarchies of our health priorities; not taking the pill might fall somewhere on the hierarchy, but if you have a serious condition that the pill will stabilize, then that condition is probably higher up. Honor it.

I hate to leave a question of the week so ambiguously answered, Alex, but there it is. I really welcome my readers to chime in on this topic if you’re so inclined. I’m clearly no expert here, and so it would be great to hear some alternate perspectives. In the meantime, Alex, I hope you listen to your intuition and do what’s right for you—all the while knowing that whatever you choose, no one should fault you, and you shouldn’t fault yourself. Reproductive health is a minefield of imperfect solutions and scenarios, and all we can do is our very best to navigate options intelligently.

I’ll be back this week with a less somber topic. And on Thursday, I’ll be off to New Orleans for five days to visit my Chloe, which means three very awesome guest posts for you guys!


Post a comment
Write a comment: