Friday 21 April 2017

Hormonal Contraceptives (The Pill/s) by Norma Benjamin


I was recently engaged in a discussion with two of my pageant sisters about hormonal contraceptives; birth control/family planning pill and the morning after pill/Emergency contraceptive (Plan B). 

They both contain hormones to change the way the body works and prevent pregnancy but the family planning pill will not allow a fertilized egg to implant while the emergency contraceptive kill an implanted egg. In this case hormones in the pill control the ovaries and the uterus; hormonal birth control prevents the egg from being released from the ovaries, thicken the cervical mucus to prevent sperm from entering the uterus and thinning the lining of the uterus; making it hard for the egg to stick, to prevent pregnancy.   


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To understand how hormonal contraceptives works we have to understand how the menstrual cycle works. The 28 day cycle with day one being the day your period starts and day 14 being ovulation day. A typical cycle is approximately 24 to 35 days and the average 28 days for most women. Hormones include from the pituitary gland in the brain - the follicle stimulating hormone (FSH) and the luteinizing hormone (LH) and from the ovaries estrogen and progesterone. The main hormones that affect the female reproductive organs is estrogen and progesterone. 

On Day 1 of the menstrual cycle, estrogen and progesterone levels are low. Low levels of estrogen and progesterone signal the pituitary gland in the brain to produce Follicle Stimulating Hormone (FSH). In the first half, FSH hormone stimulate the follicle in the ovary to mature and ready to release an egg to ovulate around day 14. The follicle produces more estrogen to prepare the uterus for pregnancy. At ovulation, there is an LH surge which results in the release of an egg from the follicle. ( around the 14th day). If the egg is not fertilized, estrogen and progesterone levels drop and on day 28 the menses begin. 

The Birth Control Pill, aside from being contraceptive, fundamentally changes how a woman’s body was made to function. It basically tricks her body into thinking it is constantly pregnant. The family planning pill contains both estrogen and progestin while emergency pill contains only progestin.What happens is that estrogen and progesterone stabilize a woman's natural hormone levels and prevent estrogen from peaking mid cycle. Without estrogen bump, the pituitary gland does not release hormones that normally cause ovaries to release a mature egg. Constant estrogen levels present causes FSH to be down due to the negative feedback (no follicular development for ovulation). So basically estrogen stops the pituitary gland from producing FSH and LH (decrease in) in order to prevent ovulation. Now progesterone levels present causes LH to never surge due to the negative feedback and stops the pituitary gland from producing LH in order to prevent egg release. It also makes the uterus lining inhospitable to fertilize an egg, partially limit the sperm ability to fertilize an egg and thicken the cervical mucus to hinder sperm movement.  

Weight gain is a controversial side effect argued. *especially in Dominica* Clinical study have found no consistent association between birth control and weight gain. However estrogen influences insulin resistance; causing the insulin in your body to make more because the cells get somewhat numb to the insulin.  So more insulin is needed because fat cells to grow. I have a friend who recently started birth control and she experienced some weight gain as well as rapid weight loss when she made the decision to stop the pill. So maybe birth control and weight gain are somewhat linked for some people. 

To conclude, as teenagers we constantly think of the future ahead of us and when engaged in a relationship, the topic of starting contraceptives may come up. Starting it is all about choice and for the females you may feel like a walking baby machine but you're not. To make this decision one needs to understand that this affects the natural functioning of your body. Your choice of contraception is most certainly a personal one. And in a world full of modern medical technology, we have been taught that taking a pill is the answer to any health problem. However, unnatural choices have unnatural consequences.

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