Comparing the risks and side effects of hormonal birth control vs. natural fertility awareness


While some have attempted to claim that pregnancy risks are greater than hormonal birth control risks, this is not an apples to apples comparison. A far better comparison is to assess the risks of someone using hormonal birth control (HBC) to someone who is not — as in the case of women who use fertility awareness methods (FAM) as natural birth control or to address reproductive health issues. In the final analysis, FAMs are the clear winner for promoting true women’s health rather than merely masking symptoms.

Hormonal birth control

Taking hormonal birth control involves a true risk vs. benefit analysis, as the risks are many. Hormonal birth control impacts far more than “just” the reproductive system and the parts of the brain that control it. In her book, “This is Your Brain on Birth Control,” evolutionary psychologist Sarah Hill, who is not opposed to contraception, said on p. 90, “The brain and the rest of the body are too flush with hormone receptors for the pill not to change women.” Also impacted are the areas of the brain responsible for “things like emotional processing, social interactions, attention, learning, memory, facial recognition, self-control, eating behavior, and language processing. And we’re also talking about non-brain body parts like the immune system, the stress response, and your gut hormones.”

Accordingly, the Mayo Clinic notes that the Pill is not recommended for women who:

  • have recently given birth
  • are older than age 35 and smoke, have high blood pressure, a blood clotting disorder, or a history of deep vein thrombosis or pulmonary embolism
  • have a history of breast cancer, stroke or heart disease, diabetes-related complications, liver or gallbladder disease, migraines with aura, or unexplained uterine bleeding
  • will be immobilized for a prolonged period due to major surgery
  • are taking St. John’s wort or anticonvulsant or anti-tuberculous agents

While the Cleveland Clinic cites stoppage of unwanted hair growth as a potential benefit of taking HBC, multiple versions of the Pill can actually cause male-pattern hair growth in women because the synthetic form of progesterone used in HBC is actually derived from testosterone. Testosterone-derived progestins are also linked to acne, weight gain, and decreases in good cholesterol (HDL). Additionally, HBC worsens migraines for some women.

The Cleveland Clinic cites potential for “irritability and moodiness” in HBC users, but the Mayo Clinic is more straightforward, noting that some women experience depression. In reality, both statements give an inadequate picture of the emotional distress many women, especially young women, experience on HBC. Hill shares on p. 174 of her book, “mood-related issues like anxiety and depression are super-common among women who go on the pill.”

Disturbing research from Denmark gave a framework for quantifying the risk, finding that women on hormonal contraception “were 50% more likely to be diagnosed with depression six months later” vs. non-HBC users, and that “women who were on hormonal contraceptives were 40% more likely to be prescribed an antidepressant” than non-HBC users. Worst of all, women taking HBC “were twice as likely to have attempted suicide” than non-HBC users during the eight-year study, and were three times more likely than non-HBC users to have been successful in taking their own lives, according to Hill’s book, on pages 179-180.

In addition, most forms of HBC can act as abortifacients, killing preborn children without a woman knowing she was even pregnant. Both the Cleveland Clinic and the Mayo Clinic acknowledge endometrial thinning due to HBC use.

Despite all of the risks, some women take birth control to prevent pregnancy, lighten periods, and lessen menstrual pain. Others take it to alleviate the symptoms of polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids, and more — though these conditions are actually masked by the birth control rather than addressed.

Fertility awareness methods

The truth is that the steady stream of tiny synthetic hormonal spikes in HBC merely band-aid the symptoms of the variety of reproductive issues it is prescribed to treat. FAMs help women to get to the bottom of their fertility health concerns, rather than masking the symptoms of irregular periods with “faux” regular periods that are actually withdrawal bleeds, for example. FAMs actually promote truly comprehensive pro-women’s healthbody literacy, and women’s ability to advocate for themselves.

Additionally, there are no physical side effects of using FAM, and ovulating normally each cycle has health benefits. Trained medical professionals can use a woman’s FAM chart data to help diagnose and treat the root causes of her problems, including endometriosis, PCOS, PMS, irregular bleeding, and more.

Women can expect to improve their health by using FAMs, though the same cannot be said for HBC users. Importantly as well, modern FAMs have similar pregnancy prevention effectiveness rates to HBC when taught by a trained instructor and used properly.

Comparing apples to apples, women who utilize fertility awareness methods for pregnancy prevention or to address reproductive health issues can expect to improve their health whereas women who utilize HBCs are automatically accepting certain physical trade-offs with varying degrees of seriousness.

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