How the Birth Control Pill Interferes with your Body

The first females to take the birth-control pill—way back in 1960—were amazed by its life-changing strength (yay, reproductive freedom!). But today's women don't give the ultra-common contraceptive much thought. They should: Turns out, the Pill can affect everything from your bones to your brain to, yes, your sex appeal.

The Pill works by tricking your body (via artificial versions of the female hormones estrogen and progesterone) into thinking it has already ovulated. In other words, your ovaries don't release a monthly egg (sorry, eager-beaver sperm). The process sounds deceptively simple, and it works. But the steady levels of excess hormones floating through your bloodstream are doing much more than pushing the pause button on reproduction.

How the Pill Changes Your Looks
Recent studies confirm the Pill can alter your appearance—but not as much as you might think, thanks to new types with lower doses of hormones.

The Skin Solution
The Pill has long been rumored to clear up a pimply complexion, and indeed, studies show that artificial estrogen can spur the production of a protein called sex hormone–binding globulin (SHBG), which, in turn, tamps down testosterone levels. Because testosterone ups your body's output of sebum—the pore-clogging stuff that can lead to zits—the less you have of the hormone, the clearer your skin might look.

The Weight-Gain Debate
Used to be, if you took the Pill you could expect to pack on a few. Early versions were full of high doses of estrogen, which may prompt the kidneys to step up the body's water retention. The result: big-time bloat. Lots of artificial estrogen may also encourage breast tissue growth, leading to a bumped-up bra size. Recent research, however, shows that low-dose Pills (some with less than half the amount of hormones in the original kinds) are just as effective at preventing pregnancy. And a University of Massachusetts study found that women on low-dose Pills didn't gain any more pounds than women in a control group. Despite this reassurance, weight gain remains a top concern for would-be Pill takers, says Suzanne Gilberg-Lenz, M.D., an ob-gyn in Beverly Hills.

How the Pill Changes Your Health
News reports have made much of the Pill's effects on bones and blood clots. Here's what the science really says.

The Bone Truth
A 2010 study found that young women on low-dose estrogen Pills had a 6 percent lower spinal bone density than nonusers. What's happening? Natural estrogen peaks can stimulate bone growth, but the Pill keeps estrogen levels steady, says study author Delia Scholes, Ph.D., senior investigator at Seattle's Group Health Research Institute. "What we don't know," says Scholes, "is what happens to your bones when you quit the Pill." In other words, though it might negatively affect bones, there's no proof that taking the Pill leads to osteoporosis or bone fractures.

The Blood Clot Connection
It's true that Pill users are at a slightly higher risk for venous thromboembolism (VTE), blood clots that form in the legs. But your risk depends on the kind of Pill you take: A study in the British Medical Journal found that women on kinds with drospirenone—a new type of artificial progesterone—were about three times more likely to develop certain VTEs than those who took Pills with an older progesterone called levonorgestrel. Still, even with drospirenone, the rate is only three in 10,000. That slim possibility "shouldn't be a deal breaker or paralyze someone from taking the Pill," says ob-gyn Ashlesha Patel, M.D., M.P.H., a Women's Health advisor. If you have a family history of clots or if you smoke—a major no-no when you're on the Pill—be sure to talk with your ob-gyn about all the ingredients in your potential prescription.

The Cancer Risk
Whether or not the Pill's artificial estrogen increases a woman's breast cancer risk is still up for debate. A recent Boston University study found that some Pill takers had a 65 percent higher risk of developing estrogen receptor–negative breast cancer than nontakers; however, a study published in The New England Journal of Medicine found the opposite—that past or current Pill use did not affect breast cancer risk. (The current bottom line is that if you're already at high risk—if you have a family history, for instance—you should always get a second opinion before taking the Pill.) Some much better news: Studies evaluating Pill users' risks of developing other cancers are clear-cut. Taking the Pill may decrease your risk for ovarian cancer by 50 percent, as well as slash your risk for endometrial cancer by more than 40 percent.


How the Pill Changes Your Mind
You probably know hormones rule your moods. Those in the Pill are no exception.

The Potential Brain Boost
New research shows that Pill users might have increased gray area in brain regions such as the prefrontal cortex (your memory and decision-making hub). Study author Belinda Pletzer, Ph.D., cautions, however, that it's too early to speculate whether this bigger brain volume could lead to better brain function.

The Desire Dampening
That spike in SHBG (the protein that zaps acne) can knock down the testosterone levels that put you in the mood. Fortunately, some women make sufficient testosterone to counteract the effect, says sex medicine physician Irwin Goldstein, M.D. If you rarely feel frisky, he says, ask your ob-gyn about nonestrogen birth control such as the IUD.

The Attraction Factor
Women typically go for guys whose immune systems differ from theirs (it's an evolutionary thing). But gals on the Pill might actually prefer men whose systems are similar to their own, per a University of Liverpool study. Some experts speculate that by halting ovulation, the Pill essentially mimics pregnancy, a condition that compels women to seek support from genetic kin. What's more, new science shows men might subconsciously pick up on Pill-induced hormonal changes and find women with low odds of conceiving less attractive.

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