MENSTRUATION MATTERS

Guest Post by Dr. Lara Briden, ND

Photo supplied by Lara Briden

The onset of menstruation (menarche) is an important time for girls. It heralds their future fertility, of course, but it’s much more than that. Menarche is also when girls start to make female hormones for the first time.

Making hormones is not easy. It requires regular ovulation, and that can take a few years to become established. That’s why the early years of menstruation are exactly the wrong time to take hormonal birth control. Yet, unfortunately, that’s when more and more girls start taking it. According to a new study [1], this decade has seen a 50 percent jump in the number of young teens (12-15 years old) using medication such as Pills, injection, implant, and Nuvaring. These girls are at risk for many of the side effects of hormonal birth control including:

  • impaired bone density [2]
  • altered brain structure [3]
  • increased risk for depression [4]
  • suppressed libido [5]

Side effects occur partly from the synthetic hormones themselves and
partly from lack of girls’ own estrogen and progesterone.

Ovulation is How Girls Make Hormones

Ovulation is not just about making a baby. It’s also the main hormonal event in a menstrual cycle, and the only way to make estrogen and progesterone. When we shut down ovulation with hormonal birth control, we rob girls of the hormones they need for metabolism, bone health, cardiovascular health, mood, and more.

Girls who take synthetic pseudo-hormones via the Pill lose the ability to produce their own hormones. Pseudo-hormones have some similarities to real human hormones, but they also have many differences. For example, the progestin levonorgestrel causes hair loss, but the body’s own progesterone stimulates hair growth. The progestin drospirenone increases the risk of blood clots, but progesterone improves cardiovascular health. Ethinylestradiol, the synthetic estrogen in the Pill, impairs insulin sensitivity [6], but estradiol improves it. These synthetic hormones do not have the health benefits of the human hormones they replace.

Pill Bleeds Are Not Periods

Hormonal birth control is often prescribed to “regulate” periods, but that is nonsensical because a pill-bleed is not the same as a real period.

A real period is the end result of a series of important hormonal events including ovulation. In contrast, a pill bleed is a withdrawal bleed dictated by the dosing regimen of the drug manufacturer.

Newly menstruating girls often have irregular or heavy periods. That can make it tempting for doctors to suggest and for mothers to agree to give them hormonal birth control to mask the problem. But irregular and heavy periods are normal at that age. They occur because girls have not yet established regular ovulation. Hormonal birth control further suppresses ovulation, and that’s why it’s exactly the wrong thing to do. Hormonal birth control won’t promote future ovulation or menstrual regularity, and will probably make it even harder to ovulate in the future.

Better Treatment for Menstrual Problems

Teens have many non-hormonal treatment options for troublesome period symptoms.

Heavy periods: Teens will usually outgrow heavy periods after a couple of years. In the meantime, they can use natural treatments such as a dairy-free diet and the herbal medicine turmeric. Short term use of ibuprofen can also be helpful. I discuss these strategies in this article on Natural Treatment of Very Heavy Periods.

Irregular periods: Irregular periods are common in the first couple of years of menstruation and they usually do not require treatment. If periods do not start to become more regular, then please seek a medical diagnosis. The best treatment will not be the Pill, but rather it will be something to address the underlying cause of irregular periods. For example, the common hormonal condition polycystic ovarian syndrome (PCOS) requires diet and exercise to normalize blood sugar. The Pill is not appropriate treatment for PCOS, contrary to what your doctor might say.

Acne: Teen acne responds extremely well to a dairy-free, sugar-free diet and to the nutritional supplement zinc. Natural acne treatments work more slowly than the Pill, but they’re a better choice in the long term because they’re a permanent cure. In contrast, the Pill’s synthetic estrogen will only mask acne for the duration that it’s used. As soon as the Pill is stopped, acne will typically return even worse than it was before.

Better Birth Control

For those teens who need birth control, there are a couple of good non-hormonal methods. The advantage of a non-hormonal method is that it permits healthy ovulatory cycles and hormone production.

  1. Copper intrauterine device (IUD): Unlike hormonal birth control, the copper IUD does not suppress ovulation or hormones. Instead, it prevents pregnancy by impairing sperm motility and implantation. It is also highly effective with a failure rate of just 0.6 percent. The September 2012 guidelines from American College of Obstetricians and Gynecologists (ACOG) state that copper IUDs are safe for women who have never had children and for teenagers. This overturns a pervasive—but unfounded—opinion that IUDs should not be used until after childbirth.
  2. Combination condoms and Fertility Awareness Method: Teens should use condoms on every occasion of intercourse. In this way, they can avoid sexually transmitted disease as well as unwanted pregnancy. Teens can also learn to recognize their peak fertile days (charted according to fertility awareness-based methods), and then abstain on the those few days per month. Strategic, short-term abstinence will greatly reduce their risk of pregnancy in the unlikely event of a broken condom. Fertility awareness also teaches girls body literacy which is important for their future health choices. For Fertility Awareness information and a list of instructors, please visit Justisse Healthworks for Women.

By supporting teens to develop healthy ovulatory menstrual cycles, we put them on the road to better long-term health.

Lara Briden is a board certified naturopathic doctor who qualified from the Canadian College of Naturopathic Medicine in 1997. She currently runs a busy hormone clinic in Sydney, Australia, and posts regularly at Lara Briden’s Healthy Hormone Blog. Early in 2015, Lara released her book Period Repair Manual: Natural Treatment for Better Hormones and Better Periods.

References

  1. Rashed AN et al. Trends and patterns of hormonal contraceptive prescribing for adolescents in primary care in the U.K. J Fam Plann Reprod Health Care. 2015 Jul;41(3):216-22. PMID: 25398724
  2. Sholes D et al. Oral contraceptive use and bone density in adolescent and young adult women. Contraception. 2010 Jan;81(1): 35-40. PMID 20004271.
  3. Petersen N. Oral contraceptive pill use is associated with localized decreases in cortical thickness. Hum Brain Mapp. 2015 Jul;36(7):2644-54. PMID: 25832993
  4. Kulkarni J. Depression as a side effect of the contraceptive pill. Expert Opin Drug Saf. 2007 Jul;6(4):371-4. PMID: 17688380
  5. Panzer C et al. Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction. J Sex Med. 2006 Jan;3(1):104-13. PMID: 16409223
  6. Kojima T et al. Insulin sensitivity is decreased in normal women by doses of ethinyl estradiol used in oral contraceptives. Am J Obstet Gynecol. 1993 Dec;169(6):1540-4. PMID: 8267059
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