Birth Control and Anxiety (Episode 361)

Full Transcript: Episode 361

Lisa: This is the Fertility Friday Podcast, episode number 361.

Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of the fifth vital sign and the Fertility Awareness Mastery charting journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with us today.

Today, I’m sharing a brand new episode in my Pill Reality series. So if you have been listening to the podcast for a while, you’ve likely heard a few of these episodes. If not, you can find a list of the episodes in the Pill Reality series over at fertilityfriday.com/pillreality. And although I call it the Pill Reality series, there are episodes about the pill and also different types of contraceptives. So the IUD, the hormonal and the non-hormonal IUD varieties. So also the implant and the shot. So I’ve interviewed women who’ve had, who’ve taken a variety of different hormonal contraceptives, and as I mentioned, also the copper IUD. And so certainly, I think it’s really important to provide a space for women to share what this really looks like for them. And so there’s certainly a mix, and especially if you listen to these episodes as well, is the Fertility Awareness Reality Series episodes. So the short link for that is fertilityfriday.com/famreality.

But if you tune into those episodes as well, you get the gamut. So the bottom line is that a lot of women have negative experiences with birth control. And if we look at the stats, within about a year of starting the pill, about 50% of women come off of it because of side effects. So certainly there’s an argument to be made, you know, not all women have negative effects, but certainly there’s a trend in our medical system to really minimize that, but legitimately, if half of the women who start using it come off of it because they’re not satisfied, then we should be taking that seriously. And what happens for a lot of women, as you would see kind of a running thread through a lot of these episodes, is that they go on one type, and when they have issues with it, they’re not presented with the idea that maybe there’s something wrong with the category, like maybe there’s something wrong with hormonal contraceptives as a concept. No, it’s just this medication isn’t a good version. Maybe the hormone variant isn’t the best.

And so you’ll hear the common thread in today’s interview as well as the other episodes in the series, where most women who have had issues in one way or another are often kind of jumping from one type to another, one formulation to another. Maybe if the pill didn’t work out they try the IUD, maybe the IUD didn’t work out they try the pill, but there’s this theme of kind of hopping from brand to brand. So with that said, without further ado, let’s jump into today’s episode with Gabby.

And I’m really excited to be here today with Gabby. Gabby and I connected on social media in one of the places she’s a member, participant of the Fertility Friday community, and as usual I was probably talking about birth control and you jumped in and shared that you had an experience, and I wanted to talk to you. So thank you so much for coming on the show and telling us about your experience of birth control.

Well thank you so much for having me. I am really excited to be part of this experience and to be able to participate in your show. I absolutely love it, and I love that I can relate to the stories I often hear here, so it’s actually really exciting and really nice to be able to share my experience as well. So thank you so much for inviting me.

Of course, and we were talking in the pre-chat, I just never get tired of sharing real stories. It’s something that we just all need to hear, and it’s, I always say these types of things at the beginning, but I spend my days talking to real women, teaching them about charting and hearing about their different experiences, you know, what led them to fertility awareness, what their experience was like on the pill. And sure, you can argue that I work with a lot of women who didn’t have a good experience with birth control because they’re obviously seeking a non-hormonal method, but these experiences are still real, right? They still happened, and so we should know about them. So just as a place to jump in, would you like to start by telling us when you got your first period, what that was like, and then take us into your birth control journey, like what did you use and all of that stuff?

Sure. So I got my first period when I was 13. It was just like a month after I turned 13, so it was pretty classic, and it was pretty uneventful. It was really typical. I got regular periods, just 28 day period length. I didn’t have a lot of pain, I didn’t have any PMS, it was pretty normal or pretty typical, so I didn’t have a lot of problems with that. I was not very aware of it as well, it was just like, okay, so this month came, that’s it. I was pretty used to it, so I didn’t have any problems with it during my teen years or my teenage years. So right after I started college, well of course I started dating more, so I obviously started thinking about birth control methods, so I used condoms at first, it was like the obvious option. But as soon as I started dating on a regular basis and I had my first serious boyfriend, so I decided to go on the pill because it was like the other obvious option. So my friends were taking it and they would regularly talk about it, so it was just, I know, it just came naturally to me that the pill was the option to go with. So I wanted to do it responsibly, so I went to a doctor and I was like, okay, so hey, I wanted to start taking the pill but I don’t know if I am healthy enough to do it, I know it has some risks, and so I just want to make sure that this is good for me. So the doctor sent a few exams or a few tests, and I just got a prescription for the pill. I was just like, okay, so you have this one, just take it every single day, there you go. So I even got the first package for free, so I started taking the pill, and I was aware of some of the risks, I knew it was problematic for some of my friends with weight gain and maybe acne or migraines, and I was like, very, I was staying on top to see if something happened, but nothing happened. So I consider myself lucky, and I was like, okay, so the pill goes easy on me, I just don’t have any side effects, I’m just fine. I was not fine, but I did not know it.

So it was a few months after I started taking the pill, I started struggling with my anxiety, and I didn’t notice that it was because of that, because anxiety has always been a challenge for me since I was a child, but it was manageable. I was like, okay, I can handle this, I was able to identify my emotions and work from there, so I was able to just keep calm and just manage the situation. But a few months after I started on the pill, I was not able to manage my anxiety. I was very proud of my sleep, of the quality of my sleep, I used to sleep like a rock, I would just fall and nothing would wake me until morning, and I was so proud of that. And then I just started pulling all-nighters, just overthinking and just awake crying, thinking about a hundred possibilities in my life that just weren’t real, and I thought it was because I had a boyfriend, and I started feeling like, okay, so this is normal, so I’m concerned about losing him or I am concerned about failing in this relationship. And so I thought it was kind of normal, so I would talk to my boyfriend at that time and we were just like, okay, we can work this out, you’re going to be fine. I had a few stomach problems, like I had a stomachache, so I went to the doctor again, and they just switched me to another pill that was like, this will go easier on you, and that was it. The stomach problems were fixed, but my anxiety problems were not fixed, and it just went worse from that.

So when I started working, I really loved my job, I really liked it, and I had a bunch of friends and I had a bunch of support, and I was doing actually great, I was growing within the company, and I was enjoying the challenges because everything was easy. So when it got difficult, my anxiety was just not manageable at all, I just lost control of it. And when it got to a point that I just cried every single day at work, and when I stopped sleeping at all, and when I would go to any meetings and just felt the urge to just go away and run from it, and just every single mistake, any tiny typo would be a trigger for me. It was like, I am terrible, I am incapable of doing this, I am not able to face this challenge, everything was big, everything was a huge monster I was not able to fight, so I just chose to run. So because I thought that I was not able to manage or handle the situation, so I started therapy before deciding to quit my job. Spoiler alert, I quit my job. So I started therapy just to try to help manage my anxiety, and my therapist was great actually, but the focus was my anxiety, was just how to handle it and how to manage it, and it was not working. I mean, it could have helped a little bit, like, okay, just breathe and just take control of your emotions and just try to focus on other things to try to cool yourself down, but it really didn’t work that great for the episodes I was having. So I was having a lot of anxiety crises at that time.

I just wanted to ask, you shared some of the specific symptoms that you were having, so you talked about not being able to sleep, and obviously I think the word catastrophizing might be a good one because it’s like everything was just such a big deal, and so it was really obviously really hard to function. Did you have any other symptoms of anxiety? I ask just so, you know, imagine all the women who are listening who may have had similar experiences who kind of just thought they were nuts, right, because that’s what we usually do, especially as women, when we have experiences like this we’re supposed to be emotional and all this kind of stuff. So yeah, if you want to share some of those, if there’s anything else that comes to mind, like did you have any physical symptoms?

Yes, I had my heart pounding all the time, like my pulse just accelerated a lot for no reason, and I often would find dangerous situations that were just daily, I mean like just riding a bus, I was like, this is dangerous and we’re going to die, we’re going to crash and we’re all going to die, and it was just not rational. I was never at peace, I could never find ease or calm, I was never comfortable in a place. I was constantly biting my nails, I was constantly picking on my lips, I found it hard to breathe when I got into difficult situations. Well, I did have a few panic attacks, like riding in really neutral situations, like just getting off the bus to walk to my house, and I would have a panic attack right there.

Can you describe the panic attack, like what happened?

Yeah, so I would start, just like I got off the bus, and just start heavy breathing and start hyperventilating, and my heart was just feeling like it was a thousand miles per hour, just pounding really really fast. I would feel a lot of nausea on the spot, and my ears would be like, I don’t know how to say, like a ringing kind of thing in my ear, so I was not able to hear, it was like in the movies when you hear people very far away, like you are within a bubble, kind of like an echo chamber.

Interesting.

Yeah, some of those were some of the symptoms, and of course, the feeling I was going to die or something horrible was going to happen right after that.

And how old were you when this was happening? And then also, for how long did you have these types of experiences?

When my anxiety was this bad, I was around 25, and I started regularly taking the pill at 22. So it started gradually ramping up, it was during college when I started taking the pill, so it was like I was under stress, but it was like regular student stress, like everybody around me was the same, so we were all busy with homework and exams and projects. So when I was at work it was kind of different because the pressure was a little bit higher on my individual performance, and it got difficult, I really got stuck in a really ugly situation at work. So it was difficult, now even when I’m off the pill I see it, and I acknowledge that it was a difficult situation, it was just that I could have handled it differently. Now I think that if I was on the pill, because actually after I quit my job, I thought for a minute that things were going to improve, but they didn’t. So I even had another job prospect, another job opportunity, and I was excited about it, and then the pandemic started, so the symptoms just persisted, and I was now in lockdown, and I was just having anxiety crises, I was falling into depression. There were some days where I just couldn’t get up from bed, or I just got up because my family was there and just got me out of there, but I didn’t feel like I wanted to, and I didn’t feel like there was light or hope for the situation.

So it was during the pandemic, that I was in lockdown apart from my current boyfriend, that I decided to go off the pill. I was like, okay, I’m not even using this, like I’m not even having the benefits of the pill, so I know it has a lot of risks, so why am I taking this, maybe there’s another way for me. So by then I had started listening to your podcast and following some Instagram accounts that would talk about fertility awareness, so I was just curious, so I decided to go off the pill, and my situation or my circumstances didn’t change at all, like I was still unemployed, I was still during a pandemic, I was still on lockdown, I still had the same circumstances that would trigger the anxiety. But a couple of months after I went off the pill, I just suddenly was a different human being. I stopped having panic attacks or anxiety crises, I haven’t had one in almost a year since I left the pill.

So every situation that was before a monster, or I was catastrophizing it, just became manageable, it was like, okay, this is a challenge, that’s it, and I had the resources. And I think that’s the main side effect I had, not even the anxiety, but I lost my ability to believe in myself or to have self-confidence. I just lost the ability to think, okay, I can do this, I am able to actually face this challenge, because everything seemed so big and I didn’t feel resourceful at all, I felt like I had no tools to face any challenge, I had no strength, I had no ability, and I would just give up. And now it’s just different, I started believing in myself again, I even started thinking about creating a business, and I started having dreams again, and I started having hopes again. And somehow the world was super foggy for me, and then suddenly it was not, and it was just a huge change. And the more and more I read on the subject, on the pill and its effects, I was like, I have been living like this for more than five years, and I didn’t even notice the situations that would have triggered an anxiety crisis before, now they happen to me and it’s just a regular situation, and I’m like, okay, I can handle this, that’s it, it’s fine.

Gabby, obviously I’m not laughing because this is funny, it’s just, this is the reason that I just keep plugging away and keep doing these episodes, because this is what I have. If anyone has my book, even that I wrote two years ago, look, there’s literally, you know, in the pill chapter, the most aggravating one, I interjected several stories, some of which I think actually were from the Pill Reality series that I had transcribed and corrected the grammar or whatever, but the point is that when you say certain things, I’ve heard those types of things said in different ways by many, even hundreds of women over the years, things like, you said the world felt foggy and then it was clear, you started believing in yourself again, you felt like a new human, and this is one of the challenges when people talk about the side effects of birth control, you know, there certainly is, I don’t get a lot of trolls to be honest, I don’t get a lot of people coming at me, and I think the reason that I don’t get a lot of people coming at me is because I’m talking about fertility awareness, and it’s a very kind of niche thing, like everyone under the sun doesn’t necessarily want to do fertility awareness, so I feel like I’m insulated a bit because I have kind of a friendly audience, and of course the Fertility Friday audience is the best. But honestly, there are other colleagues that I know who are also in this space who get a lot more of that kind of stuff. But I guess the point is that when you share this type of information, people tend to come out of the woodwork at some point and say, well, I took the pill for 10 years and I never had any bad experiences, and you’re discouraging women from taking the pill because blah blah blah, and this is something that I’ve always been someone to question things, and even when someone tells me things I question. So when someone says I was on the pill for 10 years and I had no side effects, I understand that you may perceive that there’s nothing that is different, but every woman on birth control, it suppresses your hormone production. So if you do a blood draw you will see that women on birth control produce at minimum 50% less free testosterone that’s available than women who are not on the pill, and so it makes sense, since we’re not all the same person, that some women are going to experience low libido and sexual issues and et cetera, and other women may not necessarily perceive that. And then the other thing I say is that a lot of us, including myself, were put on the pill when we were in our teens, you know, I was using the pill when I was 15, 16, and arguably I didn’t know myself from a sexual standpoint, I wasn’t having sex when I was on it, but if it had, for example, lowered my libido and then I had continued on it and ended up in a relationship, how would I know what to compare that to?

So this is a really long way of getting back to a question, which is, you know, you said that when you were taking it you didn’t realize it, you said like I came off of it and then I realized, so could you share with us, kind of looking back, what that was like for you, because if we had had this conversation then, when you were like 24, and someone would have been like, the pill, blah blah blah, do you think you would have said, no, the pill is great, I have no side effects?

Yeah, I would have absolutely said the pill is great, I had no side effects, I’m doing fine with the pill, I’ve been taking it for a while, and I would have just recommended it to anyone who would have asked, I would have recommended to go to a doctor first just to make sure, but I was thinking more in terms of the stroke risks and not the other side effects, I was like, okay, I can manage any other side effects, because I thought they were like migraines or acne or weight gain or mood swings or anything, I was like, okay, I can handle that, it’s not that bad. I didn’t know I was going to experience side effects that bad, and that I would realize them after I went off the pill. I just thought I was living a regular happy life for a woman in her mid-20s, and I thought that every single issue I had regarding my anxiety, or the feeling that I was not able to fight or to cope, I just thought it was in my head, like it was me, that’s it, that’s me, that’s how I am, that’s who I am, that’s what I do, it’s just the regular thing for me. So I do have anxiety, that’s a bummer, but well, what are you going to do about it, that’s just me, I just have to figure out my thoughts, I just have to work this out and make sure that I make an effort that it’s good enough to get me out of there. But I thought it was just me and my head who was struggling to handle situations, and it turns out it was not.

Well, and you said something earlier, because you were taking one brand of contraceptive and then you said that you had some gut problems and then you switched to a different one, and again, this is, as you well know, how these things are managed so often when I’m having these types of conversations with women, if they do have certain issues that are a little bit more obvious, you know, could be related, it’s not even necessarily thought of as, this is a problem with birth control as a concept, it’s thought of as, okay, this is a problem with this specific brand, so let’s try this other brand. And it’s interesting because for a birth control that supposedly is miracle, within the first year the statistics tell us that upwards of 50% or more women either switch or come off within the first year, so for something that’s so ubiquitous, I mean, women aren’t necessarily happy having a great experience, I mean some women are for sure, but many women are not, and we just kind of are conditioned to think that it’s just par for the course. It’s really interesting if you think about it that way.

Yeah, it’s definitely part of the experience, like I would tell my friends, okay, I don’t like this brand that much, I mean I’m waking up in the morning and I just gotta go and throw up, and I think it’s messing with my gut, and I just decided to go to the doctor, just complain about it and switch brands, that’s it, easy peasy, and my friends would be like, oh yeah, that brand is just bad for me but this one’s good. So it was just like regular conversation, just assuming the pill is just fine, just switch brands, you’re going to be okay with this one, or just switch until you feel comfortable with it, which is not bad, switching until you feel comfortable, but it’s not like we take into consideration that the pill in general does serious changes in our bodies that would impact us. So yeah, I definitely think that you wouldn’t notice at first, and you would just talk about it like something you would regularly do, like okay, just switch and you’ll be fine.

Well, and then a question for you, because you were in a position, I mean the world is in a position, but you were in a position that you kind of had that moment of, well, I’m not exactly actively in this relationship at this exact moment in time anymore, and so you had the grace of not needing birth control right now to be able to go off of it. So for women who are listening that’s like, yeah, that’s all well and good, but I can’t get pregnant right now, how would you address that, and also, have you then kind of, depending on where you are in your relationship now, is birth control an issue for you right now, are you still in that grace period, or how are you planning to manage that aspect of it?

Well, I don’t have, I mean I complained about the pill, but the pill did its job while I was taking it, I mean I did not have any children, I was able to finish my career and I was able to do what I wanted to do. So right now I’m no longer in that grace period, now I do see my boyfriend, and I am very, very careful, I’m actually educating myself in the fertility awareness method just to make sure that I can use it as a birth control method, I’m not there yet, I have a lot of information, I am seeing an instructor from the method, so I am not doing this alone, but I’m not there yet where I can use it as a birth control method, so we are very cautious, we take a lot of precautions. I did talk to my boyfriend when I decided to go off the pill, and I was like, okay, I’m not really comfortable with this anymore, so I’m just going off of it and we’re going to figure out what we’re going to do. So at first, right after the grace period, we just stopped engaging ourselves in exchanges that would put us at risk, because I had very, very clear that I didn’t want to jeopardize my mental health anymore in order to avoid a pregnancy, I did not sign up for that when I was taking the pill, because I was sacrificing myself in order to avoid pregnancy, and it’s just, I mean, I don’t want to be a mother, but it’s not worth it to just forget about yourself and get lost in that. So I did have the conversation, and I was like, okay, so I don’t know how we’re going to do this, but I’m not taking the pill any longer, I just don’t feel comfortable with it, and so we’ll have to manage. So it has been really great since we had that conversation, because he has been on board since the very beginning, he was okay, whatever you feel comfortable with, okay, I’m in this with you, what do you need? So he actually started learning with me, so I was the only one that started reading books and everything, but I would sit down with him and just, okay, so this is how this works and this is how we’re going to do it, and I hope this can work for both of us in the future. So we’ve been using condoms like we used to before, but we make sure we are out of any fertile window, just to make sure we don’t have any surprises, because we are not at a point where we can just say, okay, fertility awareness is just safe for us and we can use it as a birth control method, but we definitely are on our way to get there, and I think communication is key, and I know it’s difficult to just give up certain types of interaction or exchanges you have with your partner, but it’s definitely worth it to just take some time to understand how your cycle works and how you can find new ways to interact in order to avoid consequences. You don’t have to miss on pleasure, you don’t have to miss on the joy of sharing with your partner, it’s just finding new ways until you find something that fits you or that works for you. So I wouldn’t say that I don’t recommend the pill at all for people, I mean for some people it’s just the right choice, I know it’s not for me, I know I’m never going back to take any hormonal birth control methods, I am just not doing that anymore, but it’s okay if other people decide to, I just don’t feel comfortable with the idea of not being informed or not being aware of all the risks and all the changes your body is going to go through when you take hormonal birth control.

So I think we live in a time that seems to be very either divisive or very kind of combative, and so it’s almost like if you share your experience with the birth control pill and it wasn’t great, that you’re vehemently anti-pill or something. And ultimately, I mean, I always say like I’m sure I come across as someone who’s super anti-pill, right, because I have an entire Pill Reality series and so many episodes about it, but ultimately, if anything, I’m pro-woman, and I think that we need to have all the options available to us as well as all the information available to us. And I took the pill also, I took it, I went to the doctor when I was a teenager because I had bad periods and I didn’t know what else to do, and I wanted the pill, that was my goal, and it was easy because the doctor was writing the prescription before I finished the sentence.

And ultimately, you know, like for at that particular time of my life, I can’t say that the pill didn’t give me great fake bleeds that were easier to medicate, less pain, I didn’t have to take all the painkillers and all that when I had my fake periods, and it was like magic, and definitely I was able to do my sports and do those things. But there were things that I didn’t know, looking back, that was the only time in my life I’ve ever had migraines, and the doctor didn’t say, well, it’s not good to have migraines with aura when you’re on the pill because it could mean that you’re at increased risk of a stroke, he said, let me give you these other pills to deal with the migraines. So of course, like, for what could have happened, we don’t know, right, I obviously survived to tell the tale, but all of this is to say that when you share with me your experiences, and these are experiences I’ve heard many times, there’s a lot of things that come to mind, one of the things that comes to mind, similar to my experience and the experience of the vast majority of women that I’ve spoken to over the years, is that we’re kind of aware peripherally of the life-threatening risks, so the blood clot, the stroke, the pulmonary embolism, but of course those seem impossible when you’re 19 or 22, it seems impossible, so you understand that’s a thing, but it really doesn’t occur to you that it could be like you or someone that you know. But those are kind of the only risks, but they’re not really risks, they’re side effects that most of us are aware of, and so we’re not necessarily aware of the most common, which would be the anxiety, the depression, the libido, the sexual side effects, so some women have decreased sexual function, difficulty to orgasm, or pain with sex and things like that, and those are actually the most common, but the ones that are least likely to be linked to birth control. And so even when you mentioned, so you went to a therapist when you were at your job and you were struggling, and we were focusing on my anxiety, there’s always that part of me, no surprise here, that says, like, do therapists do a history and ask if their patients are taking medications, are they aware of the fact that, I mean the pill is not the only medication that has side effects, but there’s a part of me that, now I want to interview a psychologist or a therapist and say, was there any part of your training where they talk about this, because if you’re seeing all these female patients that have anxiety and it never occurred to you to do a little workup and see if they’ve ever taken birth control, if you listen to this podcast or this series it would actually make logical sense if you’re literally seeking support, and you are on the pill, for anxiety or depression, an emotional issue, that someone should say out loud, well, we know there’s a link between hormonal contraceptives and mood effects like anxiety and depression. So before we go into full-blown therapy as if you have a mental problem, like an emotional imbalance, maybe we should just see if you would be open to another option, and if you’re not then we just go with it, because that’s okay too, if you’re like, no, I can’t come off of this medication, but most of us would be willing to consider that, or even to switch to something different, or just have that conversation. And even, this is something I say all the time, teenagers on birth control are more likely to be on antidepressants as well, teenage girls, and so at some point, I just keep, this is why I just keep putting these episodes out, hopefully something will change, because imagine what the experience would have been like for you if your therapist said, I’ve had a lot of young women over the past couple years who are on birth control, they have anxiety issues, and I just want to let you know that, like, what would that have done? We’ll never know, but just what do you think that would have done if the therapist had said something like that?

Okay, it’s actually funny, because, well, I am a psychologist, so training to be a therapist, I’m not currently working as a therapist because I work in a big company as a recruiter, but I did receive training, and never, not even a single time, nothing was mentioned about birth control, nothing, not at all.

Because that’s incredible, because I didn’t know that.

Yeah.

I mean, when I was in university I took a couple of psychology classes, and I remember I took introduction to clinical psychology, and of course when you’re taking it you think you have all the diseases. I can’t imagine going to med school, and we went through generalized anxiety disorder and a lot of the personality disorders and things like that, and I can’t remember, but certainly I don’t know that it was a thing. So yeah, again, this is why it’s important to have conversations like this, because if other people and medical professionals are not making those connections for us, some of us are very fortunate to go to a doctor who’s aware or go to a professional who’s aware, and at least just say that, put that little thing in your head, but most of us are going through life experiencing whatever we’re experiencing and not making that connection because we’ve never even heard it, it’s always like a midnight internet search that leads you to this, as you mentioned, it was literally like I’m following some new people on Instagram.

Yeah, and I was researching about me, I mean like I was jumping into it because of my experience, but if I hadn’t even experienced this, I would have never looked for the information or wouldn’t have followed the Instagram account or anything, it’s just because of me, and that I found out all of this. And now I do plan to practice as a clinician eventually, so I do consider, I will definitely consider taking this into consideration, I mean for sure, if I am going to start working with women, it would be just an obvious, it’s like a tick in a box on an intake form.

Literally, I mean, it’s so interesting, I’m sure we could talk about this all day, but certainly from that clinical perspective, because there are certainly health professionals listening to the podcast, anyone who is a health professional or anyone at all is kind of nodding their head thinking, well actually that makes sense, because when you go to a new practitioner you usually do intakes, and it would make sense if there was more of an awareness of what types of factors. But again, there’s that stereotype, as women, that we are emotionally unstable and we are the weaker sex or whatever, and so legitimately it actually makes sense why it’s not thought to potentially be a result of medication and side effects, right. So hopefully we will just smash that foolishness.

So as we bring our conversation to an end today, I think we touched on it, but what would you want, so for the woman who’s listening, because she is on birth control and she’s kind of doing what you were doing, she’s just looking at her options, this is all kind of new, she just discovered fertility awareness, she never really had any particular issues, like for that woman on the pill, what, if anything, would you want her to know?

Well, first, that it’s okay if they are not ready to go off the pill, I know it’s a big step, especially if you’ve been on it for a long time and you’re just used to it, I mean it takes a long time to just forget about the time you have to take the pill, and just to get over like, oh, it’s past eight, oh my god, I missed my time. So I would say that it’s a scary road at first, well, the very beginning it’s confusing, and you’re not very sure what you’re going to do and what’s going to happen, and definitely I was scared that I would get pregnant while getting off the pill, and I was like, okay, so I got off the pill, but I don’t have any other methods, I don’t want any other synthetic hormones getting into my system, so what are my options, I don’t trust condoms, I’m sorry. So I was not very sure about what I was going to do, so I had my grace period to just gather my thoughts and just try to find the way for me. And it’s okay to be afraid, it’s okay to be confused, and what I can say is that I feel like we are a very empathetic community, like when you start talking and learning about fertility awareness, it’s like a big discovery, and I don’t know about other women, but at first I got mad, I was like I felt like I’ve been cheated on, and I felt like my whole life was a lie, but then I was thankful that I was able to find information, and I understood that I was privileged to be able to reach that information, because well, first, most of the information is in English, so being able to understand it was a big advantage for me. Here in Costa Rica there’s not a lot of information or channels, I do know a couple of people that work from that perspective, but it’s not a lot of information we have over here, and it’s something that we need to start talking about. Definitely every language needs to have available information, but I would say just, it’s okay to be scared, it’s okay to be confused, it’s okay if you need to ask a lot of questions, it’s okay if you need a lot of explanations, that’s fine, sometimes it’s a lot to take. It’s okay to have a conversation with your partner, it’s okay just to let them know, okay, I’m not comfortable with this, I don’t know what to do, but I’m not comfortable with this, so you can both find a way or find something that works for both of you. So yeah, it’s okay to be scared, but just keep going, and if you want to get off the pill, do it when you feel ready, it doesn’t have to be the same story for all of us.

Well, I love that. I think it’s really important to just approach this issue with compassion, like this is, it’s hard to convey, but by doing this series it’s not meant to be all or none, you know, and I have actually gotten flack from people before when they find out that I don’t tell women not to take the pill, they’re kind of like, how could you, how could you ever suggest the pill, and I mean, obviously I’m not running around suggesting the pill, but with that said, I acknowledge the fact that the pill is there for a reason, and at different points in our life the pill might be the exact right thing that you need. And so what I always say is, and this is like a broken record, I feel like women fall into three categories when they’re fully informed about the pill, and category one is some women are going to say, oh wow, you know, I don’t even take Tylenol, I’m not, so obviously there’s those folks, right. And then there’s some women who are going to hear about it but they’re still going to take it, but they would modify their use, so it’s kind of like, if they had the information maybe when they’re 19 and in college they’re definitely going to use it, but when they find themselves in a more stable relationship, knowing all of the information, they may modify, so instead of using it for 15 years they may end up using it for three or five. And then there are women who are going to use it just as long, and you know, when I get flack about that, like, how could you ever say that, blah blah blah, it’s like, well, women smoke, right, people smoke, people drink alcohol, people do drugs, like the difference is that when you buy a pack of cigarettes, because I don’t smoke, but in Canada it comes with the pictures on the front of the cigarette package, like teeth black, lungs black, all that kind of stuff, and so the difference is that when you buy a pack of smokes you know that it has a black label warning, like, you know that, and you know the side effects because it’s literally on the box. Like when you get a package of the pill it’s like pink and pretty, they don’t have images of people dying of strokes on it, so it’s a different kind of thing.

Yeah, it sounds like you’re going to have a better hair, clear skin.

Yeah, and it’s not, again, it’s not even just because people would still take it, but it’s just to say, like, yeah, we should, so anyway, so for anyone who’s kind of like that, although I think we’re in a friendly environment here.

Yeah, I just tell it like it is, and then you get to make your decision, and I think that’s what it means to be grown up, and I feel like that’s the way the world should work, and that’s all I’m going to say about that.

Just, here you go, the information, it’s up to you if you want to take it or not, but here you’ve got the facts, just go ahead.

Well, thank you so much, Gabby. So I am, when, as we’re recording this, I was saying to you before we started, to hit the record button, that my kids are outside making snow angels and they’re building a snowbank out there, and you’re in beautiful sunny Costa Rica, so I hope that you enjoy some of that wonderful sun and vitamin D, for me because I get my vitamin D bottle currently until the sun comes back. But thank you so much for being here with us today.

Thank you so much for having me, I really appreciate this opportunity, and well, I hope my experience can help other people and other women to feel like they’re not alone in this experience and it’s okay.

Thank you for listening. If you enjoyed today’s show please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/361. I hope that you enjoyed today’s episode, certainly hearing these stories over the years has changed me, I feel like I’ll never be the same again after hearing so many women share their experiences with hormonal birth control. And I always try to make my stance real clear, so for those of you who’ve listened to the podcast for a while, I’m sure that I come across as a person that would be very anti-pill, but I think of myself as pro-information. I mean I know what it is and that’s that kind of thing, so I recognize that there are a lot of women who have negative effects, and many of them have no idea that it’s related, or haven’t necessarily heard that the particular effects that they’re having can be related to birth control. And a big reason for that is because the most common issues with hormonal contraceptives are mood issues, so depression, anxiety, and low libido, you know, in terms of having the pill affect your sexual function, so whether that is your desire to have sex with your partner, or whether it’s the actual sensation being dimmed, the ability to orgasm, or even pain, you know, even changing or thinning the lining in the vulva region and causing sex to be more painful. But certainly mood changes and sexual side effects are among the most common side effects, and often we haven’t necessarily heard about them, so the women who I’ve interviewed, many of them had no idea that the anxiety, the depression, those feelings that they were experiencing, could have anything to do with it. And so of course some women experience a lot of anxiety where they’re actually having panic attacks and literally in therapy, and the therapist, as in the interview today, I always wonder about that, if there are any therapists listening, is there anything we can do here to change the way that therapists are trained, I mean are they aware that the birth control pill could significantly alter a woman’s mood, to the point that if you’re actually seeking therapy for it, it should be on the questionnaire, you know, have you started taking birth control recently, are you on birth control, how long have you been on birth control, did your symptoms start around the time you started on birth control. And even if they didn’t start when you were on the birth control, I’ve also interviewed women who started having panic attacks repeatedly, but it was kind of like five, six years into their use, and of course if something like that happens you’re not necessarily going to think, hey, could this be my contraceptive, because if you’ve been on it for five years already then it wouldn’t make sense while suddenly it could be contributing to panic attacks when it wasn’t before. And again, that could potentially be a result of the accumulation of deficiencies that happens over time and that’s exacerbated with long-term use. But either way, if we have any therapists listening, I always wonder about things like that, because if you didn’t know you wouldn’t know, and I’m sure some start to see the pattern, I’m sure that there are many therapists out there that have started to see the pattern and kind of have that as something that they’re looking into. But either way, that’s why I continue to do this, so I’m sure I come off as very anti-pill, but ultimately it’s about informed consent, because ultimately if you know that the pill could contribute to anxiety and depression and panic attacks and things like that, and you go on it, then at least if you start experiencing those symptoms you have in the back of your mind, like, oh yeah, someone told me that this could happen, so that you don’t have to go through months or years of therapy, you know, medication, to think that there’s something fundamentally wrong with you, when legitimately it’s a side effect of your birth control, right, like it just, come on. So that’s why I continue to share these experiences, because as much as I’ve been hearing these types of experiences for decades now, certainly the average woman still doesn’t really know, and so I guess it’s just up to me and up to all of you to just keep putting the information out there and keep talking about it, so that more and more women can really make these informed decisions. And again, it doesn’t mean that if the pill is right for you at a certain time of your life, it doesn’t mean that you shouldn’t consider it as an option, but certainly there are ways to use it, and if you do end up being not a good candidate, because at the end of the day too, some women just aren’t good candidates for it, so there’s some women who go on it and they don’t necessarily have that type of experience, so even though it changes the hormones for everybody, everyone’s testosterone is way lower, certainly their natural estrogen and progesterone, so everyone experiences the hormonal shifts, but obviously there are some of us who would be more sensitive in certain ways. So not everyone who goes on the pill is going to have painful sex and a real issue with sexual function, but plenty of women do. Not every woman who goes on the pill necessarily experiences depression and anxiety and things like that, but many do, and you don’t necessarily know how it’s going to respond in you, that’s that kind of bio-individuality angle. So with that said, some food for thought, I suppose, I hope you have a wonderful week or weekend, whenever you tune into the show. If this episode kind of struck you as something that a friend of yours could really benefit from hearing, then definitely share the link to the episode, it’s fertilityfriday.com/361. And yeah, so I will let you go, have a wonderful week or weekend, whenever you’re tuning into the show, and of course, as always, until next time, be well and happy charting.