Why I Quit Hormonal Birth Control
I can't remember which birth control pill I tried first — it was the '90s and the NuvaRing and Mirena IUD weren't out yet — but I know it made me feel nauseated, bloated, and moody. Even worse, it intensified the cramps it was supposed to relieve. I felt like I had PMS all month instead of the week prior to my period.
A year into college, I finally learned about endometriosis. (From a fictional book, not a doctor). I had been off of my birth control pills for about a year — they weren't resolving any of my symptoms and I wasn't sexually active — when I went to an on-campus gynecologist who told me I should just try another brand.
And thus started my decades-long journey with hormonal birth control. Now I know that birth control may provide symptom relief for some people, but it doesn’t treat or suppress endometriosis. So, there was no reason for me to stay on it if it made me feel worse. But here's what happened before I went hormone-free.
My cramps got worse
According to Planned Parenthood, the birth control pill can make shedding your uterus "a breeze" by "making your periods lighter and more regular, and easing menstrual cramps". My menstrual cycle is and always has been pretty regular. And I didn’t have any skin problems. So, those weren’t selling points for me. But I was definitely on board for pain-relief.
Unfortunately, I felt terrible with every pill I tried, including both low and high hormone options. When I wasn't cycling through pills, at least I got some relief when my hormones were low right after my period started. But when I took the combination pill — synthetic versions of estrogen and progesterone — my cramps were spread out the entire month. They radiated through my body the three weeks I took the pills as well as the week "off" when I was shedding my uterus.
Some pills made me bleed for months
After going through about five different kinds of combination pills, it was clear I couldn't tolerate synthetic estrogen. My doctors switched me to a continuous progestin-only option. He told me that if we could thin my uterine lining enough, maybe I would feel less pain and my period would stop.
This method still perplexes me because breakthrough bleeding is extremely common with these pills. With no estrogen to stabilize the uterine lining, I bled for three months straight. My cramps once again intensified, only worsening as I continued to bleed. (My current gynecologist wasn't surprised I was in so much pain on these pills because she told me the uterus contracts and causes pain as it sheds.)
My mood also went off the rails. I experienced what I can only describe as blinding rage coupled with a side of irritability. I decided it was time to quit when I started shedding solid chunks of uterine tissue in the third month.
Birth control did not prevent cysts
After my first laparoscopy, the doctor suggested I try the NuvaRing. Since it is absorbed into the bloodstream vaginally, it contains lower amounts of hormones to begin with and avoids the first-pass liver metabolism that birth control pills go through. While I didn't experience side effects like nausea, mood swings, or severe cramping, I also didn't experience symptom relief.
Even though I was on the NuvaRing for years, it didn't prevent a recurrence of endometriosis. About six years after my first surgery, an ultrasound revealed an ovarian cyst large enough my doctor felt it needed removal. During the laparoscopy, she found and removed even more endometriosis.
Three months after my second surgery — even on the NuvaRing — my cysts returned. That's when I gave up on hormonal birth control.
What do I do now?
Many people experience symptom relief with hormonal birth control, but I wasn't one of them. I stopped taking synthetic hormones about a decade ago. I feared that my endo would spread uncontrollably, but treating my symptoms holistically — with an anti-inflammatory, low-FODMAP diet along with meditation and exercise — has helped me feel better than I ever did before. And while I still have pain at ovulation and before my period, my latest ultrasound showed that my uterus is cyst-free and "normal."
In my next piece, I'll offer up some advice on how to better navigate the world of hormonal birth control.
Do you live with any other health conditions outside of endometriosis?