Why the pill will never regulate your periods

Perhaps you've heard from others, or even been told yourself that going on oral contraception or "the pill" will help to make your periods 'normal'.

The thing is often it's some well-meaning GP or specialist who will first suggest that the pill is an option to help support you and your hormonal health because this is one medication that fits into the box of 'hormonal health' that they have in their tool kit.

But the oral contraceptive pill does nothing to help support your hormonal health - in the short term and definitely not in the long term.

Let's start with how the pill works

1. It provides synthetic forms of hormones: This introduction of synthetic hormones creates somewhat of a 'flatline' of hormones in your body - in a 'pill-free' state the female body would ideally produce a regular cycle whereby there are natural rises and falls of estrogen and progesterone. The pill can be a combination of estrogen and progestin (combined oral contraceptives e.g. Brevinor, Levlen, Yazmin, Norimin) or progestin alone (progestin-only pills, or mini pill e.g. Noriday, Cerazette). NB: there is a world of difference between progestins and our body's own progesterone.

2. It then inhibits the production of hormones by the brain: The hormones in the pill prevent the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland in the brain. FSH is required to mature ovarian follicles, and LH triggers ovulation.

3. No FSH/LH = No egg release: Without the surge of FSH and LH, the follicles' maturation and an egg's release (ovulation) do not occur.

As well as producing a secondary line of defence against pregnancy...

Progestins can thicken cervical mucus making it difficult for sperm to enter the uterus and reach any eggs that might be released.

Endometrium can become thinner: The hormones in the pill can also cause thinning of the uterine lining, making it less cozy for a fertilized egg to implant.

Here's a little summary to help illustrate such a finely executed hormonal 'dance '

(Image source: Unknown)

"But I still get my period on the pill"

Let's unpack the difference between a pill bleed and a menstrual bleed or period...

Possibly one of the most common chats I have with female clients in clinic revolves around this.

It's important to note that the bleed you can experience while taking the pill, particularly when you take the sugar pills, is a withdrawal bleed, not an ovulatory cycle.

An ovulatory cycle is one whereby your body has been able to reach the maturation stage of a follicle (egg) and then it is released. This process requires a lot of your body's own hormone production to get to this stage - FSH, LH, and Estrogen (Estradiol). We would then see a surge and then fall of progesterone and estrogen (shown in the image below) to confirm ovulation and providing there was no pregnancy the endometrial lining would start to degrade and then this tissue becomes what we know as a period, or menstruation.

NB: It is still possible to have a period without ovulation aka anovulatory cycles - you can read more about this here.

(Image source: Dr. Jolene Brighten)

What about a Mirena or Jadelle

A hormonal IUD like a Mirena or Jadelle can inhibit ovulation for up to the first 12 months due to the high dose of levonorgestrel or progestogen it contains. As the dose decreases over time, ovulation can resume. A hormonal IUD prevents pregnancy by inhibiting the buildup of the uterine lining and altering cervical mucus rather than working by suppressing ovulation.

So to summarise

If an unwanted pregnancy poses the greatest risk to your overall health e.g. emotionally, mentally, financially, etc then some kind of contraception is often going to be required. Knowing your options here is really important, along with knowing the risks of each.

After being on the pill it can take some time to restore the communication between the brain and the ovaries which is a reason periods can seemingly go MIA.

With the pill, you can experience bleeding without ovulating, while with the hormonal IUD, you may ovulate but may or may not bleed.

Ultimately restoring ovulatory cycles is key in restoring regular cycles where your body gets to make precious progesterone and estrogen.

Now that you know the dance between the brain and the ovaries and all that is involved in creating an ovulatory cycle, I hope you can see why so much needs to go right to result in a healthy, regular ovulatory cycle!

I'll leave you with some words of the wise to ponder...

"Ovulation and ovarian function is not just to make a baby,

but for the general long-term health of the woman."

- Lara Briden

If working on restoring a regular menstrual cycle is something you want to do, or perhaps you just want a greater understanding of how your body and hormones could function a little better I would love to hear from you.

Helping you understand how your body works and connecting the impact of stress, sleep and all other modern life things that can affect your health is my passion.

I am here and available with appointments and packages for both new and existing clients.

You can book online for these here or if you are unsure what to book, please don't hesitate to reach out here.

I'm Amy Donovan, a qualified and registered Naturopath, Medical Herbalist and

Massage Therapist working from my private clinic in Te Awamutu, New Zealand.