The vast majority of American women have taken birth control pills at some point in their lives.

A lot of us take it for granted.

So why am I seeing so many videos like this?

Day 16 off of the pill, I'm still feeling really good.

So I got off the pill about a year and a half ago, and my life completely chained.

Negative impacts of birth control were outweighing the benefits.

My emotions and my fire, my soul, if you will, was starting to at least in my world, felt like it was getting cut off.

The pill has been huge for women.

The ability to make family planning decisions has led to our upward social and economic mobility, allowing us to set long-term career and educational goals.

But something's changing.

Between 2002 and 2017, pill use dropped close to 10%.

And you see this reflected in a wave of women on social media sharing negative experiences they've had with hormonal birth control, from low libido, hair loss, mood swings, and weight gain to stuff that honestly sounds so bizarre.

They call it #pilltok and some TikTok users are using it as a forum to tell women they should ditch the pill and other forms of hormonal birth control in favor of natural alternatives.

Bottom line, hormonal contraception users are frustrated and sometimes their experience doesn't line up with what scientific research says is supposed to happen to their bodies.

And I get it.

I've been there too.

So what's going on here?

What good alternatives are out there?

And before the men drop off, this episode's for you too.

So bring it back.

It takes two to make a baby.

Is male birth control the future.

Let's find out.

So say you're scrolling through TikTok and suddenly you're knee deep in a video about someone's experience on the pill, talking about hair loss, weight gain, nausea, the works.

That may be scary, but let's get one thing straight.

People who use the pill and other types of hormonal birth control don't have a uniform experience.

Everyone's different.

Let's take a closer look at the pill to understand why.

Hormones are chemical messengers that travel through your bloodstream to tell your organs and body systems how they should be running.

The pill is made from a combination of two synthetic versions of the sex hormones estrogen and progestin and sometimes progestin alone.

These hormones are busy at work in male bodies too, but in female bodies, they shape the whole cycle of ovulation and whether or not we get pregnant.

So the main mechanism of action of combined oral contraception are going to be to inhibit ovulation or to stop the ovary from releasing that egg every month.

Obviously no egg is being released, nothing can be fertilized, and so it works to prevent pregnancy.

Now, this has a lot to do with different hormone receptors, and oddly enough, there's going to be hormone receptors in our brain that communicate to our ovaries.

And so when our body receives that progesterone signal that tells our brain, don't stimulate your ovaries.

And when you don't stimulate your ovaries, you don't ovulate.

But two people using the same type of oral contraceptive can be sensitive to the drug in different ways.

Not.

All birth control is created equal.

There's close to a hundred different formulations if you sort of do all the calculus that includes the different modalities in which the hormones get into our body and then the different levels of the synthetic progestin, you multiply that amount of variability by the fact that each one of us metabolize hormones differently and we're going to have a different type of a response to the same product.

And another thing, for some people, the pill's not something they can decide to just toss in the trash.

Birth control does way more than prevent pregnancy and all of the health concerns that come with it.

Birth control, whether it is the pill or an IUD or the implant, they all can treat a variety of medical conditions.

One could be someone who struggles with heavy menstrual bleeding, someone who has endometriosis or pelvic pain, severe cramping.

It can be used to treat acne.

It can be used to treat some mood disorders as well.

And get this, the pill is one of the best tools we have to decrease our risk of ovarian cancer.

Women who have ever used oral contraceptives have a 30 to 50% lower risk than women who have never used them.

And that protection increases the longer you use oral contraceptives.

We are not here to bash the pill, but that doesn't mean we shouldn't have a critical eye.

People have been really reluctant to criticize or be critical of the pill and hormonal birth control just because it's been such an absolutely important force in women's lives.

Our standards for what's considered acceptable are pretty low just because the bar is pretty low.

Anyone who's been on the pill knows there's a lot of side effects.

Breast tenderness, nausea for some, vomiting and headaches.

I would say those are pretty standard and pretty common.

Now the good thing about these side effects is that they're not long-term.

It's usually as your body starts to get used to the medication, they get better after about a month or two of using the medication.

But some other side effects that I always like to discuss with patients as well is that one, it may affect your mood depending on the patient.

So I always explain to patients, be very aware of how you're feeling, but we do know that there is a correlation with birth control pills and it affecting your libido.

What about weight gain you ask?

Well, it turns out various scientific studies actually find that hormonal contraception use does not cause weight gain, but for some women, the side effects are 100% real.

Most women who are on hormonal birth control, even if they like their birth, birth control can still name for you a list of side effects that are not really what they bargained for.

When we take something like the hormonal birth control pill, which we're taking for this localized effect on ovulation, it's also going to flip switches throughout the body from head to toe.

If you take a birth control pill or if you have in the hormonal IUD, those hormones will get into the bloodstream and then they travel everywhere that blood goes, and then they get picked up by every cell in the body that has receptors for that hormone, and that includes cells in the immune system.

That includes cells in the brain, that includes cells in our metabolic system, our circulatory system, and so on.

And that's something that's been understudied.

One area that researchers are increasingly looking at is mood and behavior.

Large European cohort studies have found an association between oral contraceptive use and the risk of depression across the lifetime.

A recent study looked at the data of over 250,000 British oral contraceptive users finding that women who started the pill as teenagers had a 130% higher incidence of depression symptoms.

Teenagers were especially impacted even after quitting the pill, leading some researchers to wonder about the effect of hormonal contraceptives on adolescent brain development.

It would be almost impossible for using hormonal birth control not to affect adolescent brain development, given the profound role that our hormones play in that process.

So the pill is imperfect and we need more research into the varied ways it could be affecting female users' body systems beyond its already well-established safety and efficacy.

So say you're worried about or experiencing some side effects of the pill.

Dr. Rodriguez, how would you guide a patient in this situation?

Just because you tried one form of birth control, it didn't sit well with you, you didn't like the side effects, don't knock all the other ones, right, because like I said, there're different formulations.

There's different doses and there's different forms.

Other forms of hormonal birth control that are available are going to be things like the IUD or the intrauterine device.

That form only has progesterone only.

And also the implant also called the Nexplanon.

That little bar that goes in the arm again, that one is also progesterone only.

The injection or the Depo-Provera.

The nuva ring is a great option.

It's a plastic flexible ring.

It's inserted vaginally and it stays in place for 21 days.

A lot of people report less of the nausea and vomiting with it.

Is it still a possibility?

Of course, but it tends to be tolerated more.

The patch is another form of birth control.

It's like a little sticker.

You can wear it on your shoulder, on your back.

Remember if you want or need to avoid hormonal methods, but you still don't want to get pregnant, you do have other options.

The most popular one out there is going to be the copper IUD.

So it is an IUD, no hormones.

It just has copper in the little arms of the IUD.

And it works by creating a toxic environment to sperm, so it sits inside of the uterus.

When sperm come in contact with copper, they're gone.

They die.

And it's actually one of the most effective forms of birth control that we have available on the market.

The other form of non-hormonal contraception that's available on the market is called fxi, and that is a vaginal gel.

So it comes in like a little tampon applicator.

And this is something that is applied within one hour of having sex.

And then obviously making sure you're tracking your cycle or doing natural family planning, being aware of your symptoms of the changes to your vaginal discharge of your basal body temperature.

This is also a great form of non-hormonal contraception, but you also have to have a history of normal periods or this simply isn't going to work.

Now, if you're in a position to be off birth control and you have a male partner, or if you're a male watching this, wondering what your options are, why not male birth control?

I mean, if sex involves two people, why should birth control only be a woman's responsibility?

The vasectomy, it requires no use of hormones to anyone involved.

And when you compare it to getting your tubes tied on a woman, it's actually cheaper.

It's a better recovery, it's a quicker recovery.

There's also several new male birth control options currently in clinical trials, and all it takes is rubbing gel into your shoulders or a pill a day.

The gel uses the hormones nesterone and testosterone to switch off sperm production while keeping testosterone at a healthy level to minimize side effects.

Unfortunately, the men in hormonal birth control trials reported acne, weight gain, changes in mood, changes in sexual function and sex drive.

I know, I know these side effects are similar to what women already go through.

Now, with all that being said, men are still interested in taking the pill.

One study found that 78% to 98% of men, depending on the country, would take it.

So the male birth control trial that I joined was something that I had always wanted to do since sometime in college.

I had wanted my own reproductive toolkit or a new way to protect myself and protect my reproductive health because that's something that traditionally has always been either done via barrier methods or of the partner.

The researchers were testing a drug called Dimethandrolone undecanoate or DMAU.

It's a hormonal form of contraception.

They had a huge syringe and they injected it into my butt.

And then they had a second visit about a month later where they did that again.

In the past, I've had more than one relationship where my partner had struggled with hormonal contraception and all kinds of different issues came of that medicine.

And having something like this drug like DMAU where the side effects were so minimal for me means that I could share the burden and I really would prefer to be able to do that.

I was fortunate enough to be the youngest of five girls.

My dad dragged me into Planned Parenthood in a headlock at 16 and asked for a birth control that didn't require me to remember it daily.

And I've been on the NuvaRing ever since.

But like me, some women have been on birth control for so long that they don't notice how their bodies may change off of birth control.

I have friends that are naturalistas or have had past negative experiences who are completely against birth control, but still don't want children right now.

And I have other friends who need birth control for other reasons, like heavy periods, but still want more education or options.

I hope this episode finds its way to all the women out there that need to see it.

And I hope you learned a lot, like me.

We love a good health chat.

So if you're comfortable, share your journey with birth control in the comments.

And men, how do you feel about male birth control?