In a groundbreaking discussion on YouTube, two renowned experts in the field of reproductive health, Dr. Sara Gottfried and Dr. Andrew Huberman, discuss the often-overlooked impacts of birth control, particularly estrogen-based oral contraceptives, on women's health.
The conversation begins with a thought-provoking question from Dr. Huberman: "What are your thoughts on pure estrogen birth control?" This seemingly simple inquiry sets the stage for an engaging and highly informative exchange.
Dr. Gottfried starts by introducing a term for long-term users of oral contraceptives - Olympic oral contraceptive users - an apt moniker for those who have been using estrogen pills for a decade or more. Despite the risks, these pills have played a significant role in providing women with reproductive choice - a critical facet of women's health rights.
"In terms of benefit, I think that, especially when they first came out and even now, it gives women reproductive choice, and that's essential," Gottfried asserts.
A significant benefit of using oral contraceptives, according to Gottfried, is a reduction in the risk of ovarian cancer. This cancer often goes undiagnosed due to the nonspecific nature of its symptoms, which include common experiences like bloating. She says, "...it reduces the risk of ovarian cancer. So there's something about this idea of incessant ovulation. That is not good for the female body." Gottfried explains that the pill's suppression of ovulation can decrease ovarian cancer risk by 50% over five years.
However, it isn't all benefits when it comes to oral contraceptives. Dr. Gottfried warns about the potential pitfalls of these pills. She shares that these contraceptives can deplete certain micronutrients, affect the microbiome, increase inflammatory tone, and impact thyroid function. Moreover, she warns about the increased rigidity in cortisol production, a hormone integral to stress responses.
"The oral contraceptive depletes certain micronutrients, so magnesium. There are certain vitamin Bs that are depleted. It also affects the microbiome. That data is not as strong, but there seems to be some effect. And there's also an increased risk of inflammatory bowel disease and autoimmune condition. It increases inflammatory tone," warns Dr. Gottfried.
One shocking revelation from Dr. Gottfried is the fact that these contraceptives could lead to a decrease in the size of the clitoris by up to 20%. It's a dramatic fact that could have profound implications for women's sexual health. However, she highlights the issue isn't so much the use of these contraceptives, but rather the lack of informed consent women receive before starting them.
"Maybe the most important out of all of these things is that it can shrink the clitoris by up to 20%. Any time you take oral estrogen, it raises sex hormone binding globulin, and you've talked to other podcast guests about this," Gottfried reveals.
By the end of their insightful discussion, it is evident that while oral contraceptives have revolutionized women's reproductive health, it is vital for users to be informed about the potential long-term impacts.
Indeed, it's difficult to consider the benefits of birth control without bringing attention to some of its potential drawbacks, such as potential nutrient deficiencies and autoimmune conditions. These downsides need to be acknowledged alongside the positive aspects. Gottfried points out that many oral contraceptives can deplete certain micronutrients like magnesium and several B vitamins. Plus, it can alter your microbiome, which, while not fully understood yet, is suspected to play a crucial role in overall health. Increased inflammation, another potential side effect, can potentially lead to a host of problems.
"It increases inflammatory tone. So the studies that I've seen increase one of the markers of inflammatory tone, high-sensitivity CRP, by about 2 to 3x. It seems to make the hypothalamic-pituitary-adrenal axis more rigid so that you can't kind of roll with the punches and wax and wane in terms of cortisol production the way that you can off the birth control pill. It can affect thyroid function." - Gottfried
It's important to understand how birth control might affect the body's natural hormone balance. In many ways, it's akin to running a program that overrides your body's natural operating system, which can bring about certain unintended consequences.
A reduction in sexual desire?
Interestingly, Gottfried points out that taking oral contraceptives raises sex hormone-binding globulin (SHBG), a protein that soaks up free estrogen and testosterone in the bloodstream. This process can decrease free testosterone, potentially affecting sex drive and other aspects tied to the hormone.
"Sex hormone binding globulin, I think of as a sponge that soaks up free estrogen and free testosterone. So when you go on the birth control pill, you raise your sex hormone binding globulin. It soaks up especially free testosterone." - Gottfried
The consequences for women can range from vaginal dryness to a decrease in sex drive. But Gottfried highlights an issue that often goes unspoken - the effects on a woman's confidence and agency. Lower testosterone can potentially impact these aspects and more, altering a woman's personality and behavior in subtle but significant ways.
A dramatic impact
But the most shocking revelation Gottfried made might be the impact on the physical structure of women's bodies. According to Gottfried, taking oral contraceptives can shrink the clitoris by up to 20%, a dramatic and potentially devastating consequence for women's sexual health.
"Maybe the most important out of all of these things is that it can shrink the clitoris by up to 20%. 20%." - Gottfried
This statistic is startling and underlines the importance of considering all potential effects of long-term contraceptive use. The alteration in physical structure and its potential impact on sexual health and pleasure is not something to overlook lightly.
It's crucial to note, however, that while these side effects are potential risks, they won't happen to everyone, and some women may experience other side effects not listed here. Individual responses to birth control can vary greatly, which is why it's essential to have these in-depth discussions with a healthcare provider.
An important takeaway
The conversation between Gottfried and Huberman reveals the nuanced reality of birth control. It's not as straightforward as simply preventing pregnancy; it's a multifaceted issue that affects various aspects of women's health and wellbeing. The birth control pill is an essential tool for reproductive freedom, but we must also be aware of its potential pitfalls.
Above all, these revelations highlight the importance of informed consent. Women should be fully aware of both the benefits and potential risks associated with long-term use of oral contraceptives to make the best possible decisions for their health.