things I wish I knew before taking birth control: part 6
Continuing the series! A friendly reminder, this post comes from a place of absolute love, genuine curiosity and knowledge empowerment. There is no judgement or shaming here, and any such comments will be removed.
Do hormonal contraceptives (HCs) affect our fertility? Let’s take a look at the data.
EGG QUALITY/QUANTITY
Women ages 19-46 on oral contraceptives (OCs) - adjusted for variables - had up to 30% lower AMH and up to 20% lower AFC. (Petersen et al)
🥚AMH = Anti-Müllerian Hormone
🥚AFC = Antral Follicle Count
These indicate ovarian reserve and egg quantity. The decrease was noted to be potentially temporary. Other research shows markers can improve over time.
ENDOMETRIAL LINING
10+ years of OC use was associated with a thinner uterine lining. (Chang et al)
Once an egg is fertilized, it needs to be able to successfully implant itself on the lining of the uterus.
OVARY SIZE
Combination pills are shown to shrink the ovaries by ~50%. (Deb et al)
Shrunken ovaries can be related to primary ovarian insufficiency.
CYCLES
OC users can experience 12 months of shorter luteal phases and 9-12 months of longer cycles. Overall, it can take 9-18 months for cycles to normalize, hence a period of subfertility. (Gnoth et al)
PREGNANCY
It can take ~8 months for OC or IUD users, ~10 months for implant users, ~15 months for inj3ct@ble contraceptive users to conceive. The longer the use of hormonal contraception (2+ years), the higher the average. (Hassan et al)
NEW ISSUES
HCs also increase our risks for new issues that may affect fertility. (Brighten)
When I was prescribed the birth control pill, I asked my doctor if it could affect my fertility. I distinctly remember her saying it couldn’t and that I could get pregnant right after coming off. Obviously, this is not the case for everyone.
I’m sharing this because I’ve witnessed countless women deal with so much heartache trying to conceive post-HCs.
↪But what if we were informed about this?
↪What if our grief is a misalignment with poorly set expectations by our providers?
↪What if our bodies don’t need fertility treatments, but just a little more time?
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♥️
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Not medical advice.
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This is not medical advice. Always consult your healthcare professional before pursuing any changes to your personal healthcare regime.
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References
Brighten, J. (2019). Beyond the Pill. New York, NY: HarperCollins Publishers.
Deb, S. Campbell, B.K. Pincott-Allen, C. Clewes, J.S. Cumberpatch, G. Raine-Fenning, N.J. (2012). Quantifying effect of combined oral contraceptive pill on functional ovarian reserve as measured by serum anti-Müllerian hormone and small antral follicle count using three-dimensional ultrasound. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/21997961/.
Gnoth, C. Frank-Herrmann, P. Schmoll, A. Godehardt, E. Freundl, G. (2002). Cycle characteristics after discontinuation of oral contraceptives. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/12396560/.
Hassan, M.A. Killick, S.R. (2004). Is previous use of hormonal contraception associated with a detrimental effect on subsequent fecundity?. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/14747178/.
Hendrickson-Jack, L. (2019). The Fifth Vital Sign. Fertility Friday Publishing.
Petersen, K.B. Hvidman, H.W. Forman, J.L. Pinborg, A. Larsen, E.C. Macklon, K.T. Sylvest, R. Anderson, A.N. (2015). Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/26311148/.
Talukdar, N. Bentov, Y. Chang, P.T. Esfandiari, N. Nazemian, Z. Casper, R.F. (2012). Effect of long-term combined oral contraceptive pill use on endometrial thickness. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/22825095/.
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