Does the Pill Shrink Vulvar Tissues? Examining the Clitoral Shrinkage Study | Ep. 604

Episode 604

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episode number six hundred and four
in today’s episode we are diving right into the controversy we are going to go over
what i consider one of the most controversial studies And if there was one time
that I’ve ever gone viral, this was many years ago, it was because of the study.
It was because I posted on social media about the study and the findings and I was
fully like attacked and it went like crazy because, you know, this sample size is
too small and you can’t use this and you’re going to scare women off of the pill
and all that stuff. So we’re going to go into why. So the title of the study is
super long, but the gist of it is that they’re looking at Vitoral vascularization
and sexual behavior in women who are using the pill, and they’re comparing a small
group of women who are using the pill to a small group of women who are using the
vaginal ring. There’s a couple of things I want to point out about the study right
off the bat that I will get to later on, and I think the most important thing to
keep in mind, even before we go into it, is that this study, while it was done
many years ago, it has never been repeated.
study different is that not only did it study the vulvar tissues, but it
specifically measured the size of the clitoris. Well, let me clarify what I mean by
that. It measured the size of the clitoris before the administration of any hormonal
contraceptive and after six months of it. And it compared the users of the pill,
the combined oral contraceptive pill as well as users of the vaginal ring. And so
that is what makes it one of the most controversial studies. And I would anticipate
that is why I wasn’t able to find a duplicate of the study. So there’s quite a
few studies that look at vulvar tissues and how the pill and other contraceptives
impact the vulver tissues. And there’s a pretty consistent finding that these hormonal
contraceptive options are shrinking vulvar tissues. And we’ll talk a little bit about
why that is and all of those things. So without further ado, let’s go ahead and
get into today’s study.
So a little bit of preamble to why studies like this are done and why this is
important. It kind of goes back to one of the big topics that I highlighted in my
first book, the fifth vital line, which is the impact that the pill has on sexual
function. So there’s a pretty significant body of research that does indicate that
the pill and other contraceptives can have a negative impact on sexual function. And
so a lot of studies have been done looking at a lot of different factors, whether
it’s self -reported satisfaction, whether it’s frequency of intercourse, whether it’s
frequency of orgasm, whether it’s sensation, whether it’s pain with sex. And some
studies actually measure physical attributes.
was shrinkage. And again, the study was never really replicated. And when you bring
it up, there’s often a lot of kind of like pushback about, yeah, really make any
conclusions based on this data, the sample size is do small. But what I’ve said for
many, many years is, well, where’s the follow -up, right? Like, why hasn’t this been
done? And obviously, the implications are there. If there’s a study showing that the
pill shrinks the toaurus, then who’s doing that follow -up? The drug companies are
paying for these studies to be done because they want people to use their products.
So if this type of result is being found, I mean, that would be all over the
internet, social media, and potentially could have a negative impact on their bottom
line. So I suspect that’s one of the reasons why we haven’t seen follow -up to the
study. Okay. So what did they do? So the sample size in the study is small.
So unlike last week’s study, if you remember last week, we looked at a study of
over 800 women, and it’s a totally different topic, but it was looking at how
ovulation may affect how attractive a woman feels and her interest in sexual
behavior. But in that study, one of the things that the researchers did is they
purposely aimed to get a large sample size because there had been previous research
in the past with smaller sample sizes, smaller groups. So they really wanted to kind
of see if there’s some legitimacy to this hypothesis by having a larger group. And
obviously that is one of the best ways to show if there’s anything there, right?
Like, is this going to reach statistical significance? Is this going to be
consistent? You do the smaller test study initially. It’s like a proof of concept.
But then when you continue to see these trends, eventually you move on to a larger
scale study so that you can have more solid data and information to really support
if this hypothesis is correct. So I’ll preface this by saying that yes, the sample
size is small, but I will tell you why we should still pay attention to the data,
even with a smaller sample size. So in this study, they actually had 40 women and
they were randomized into two groups. So one group received the oral contraceptive
and the other group received the vaginal ring. And the intention of the study,
the researchers, when you kind of look at why they chose to do this study, is
because they acknowledge right in their introduction, they’re talking about the
mechanics of sex and they’re talking about this kind of history of contraceptives
being linked to changes in sexual behavior, dissatisfaction, lower libido. And this is
a common thing. I mean, one of the running jokes about hormonal contraceptives is
that one of the reasons it works is because you don’t feel like having sex anymore.
Now, that is not everyone’s experience. So before anyone wants to jump on me and
say, okay, I was on the pill and I want to have sex all the time. So obviously,
everyone’s experience on contraceptives isn’t the same. But when you look at the
research in terms of how the pill works, one of the ways it works is to shut down
ovulation. And When you shut down ovulation, you have a significant impact on the
natural hormone output. So we produce significantly less of our natural estradiol
progesterone, so our natural estrogens, we produce significantly less of that. But in
addition to that, when we’re on hormonal contraceptives, we also produce significantly
less testosterone. So our testosterone production drops by 50%,
but that’s not all. In addition to that, a hormone, SHBG, sex hormone binding
globulin, significantly increases as well. And when that increases, it actually absorbs
even more of the free testosterone. So the analogy I give in the fifth vital sign
is that SHBG is kind of like when you see those images of the iron filings and
like a magnet, and you see the magnet kind of like pulling up the filing so
they’re being drawn to it. So that’s essentially what this SHBG does.
So not only does it reduce the overall testosterone, but it actually also reduces
free testosterone by increasing the SHBG. So the bottom line is that regardless of
how you experience this individually. So you take 3 ,000 women on the pill,
and you could have all kinds of surveys about their energy levels and their libido
and all of these different things. Like you could look at all that. And of course,
there would be a lot of differences between how these women are actually experiencing
this. But if we look at the blood work, we’re going to see a significant reduction
in testosterone, free testosterone, because of the production and also because of this
increase in SHBG. So what I always say is that we have the kind of physiological
things that we know happen. And then the story of how this plays out for an
individual woman can be different. So some women may not really notice that they
have a change in their sexual function. One of the things that I often argue is
that women who are put on contraceptives at a very young age may not have a lot
of history about knowing themselves and knowing how they are sexually. So they may
not even have anything to compare it to. But then you’ll have other women who do
notice a drop in their libido or some women who maybe they weren’t even sexually
active before the pill said don’t really have like a background of what their sexual
activity was, but maybe they just think that they don’t have much of a libido. And
certainly many women come off of contraceptism, find that they do have more of the
libido than they did before. And then the other factor is that some women find that
sex is painful. They find that insertion is painful. And a lot of studies show that
a certain percentage of women will experience thinning.
well, we know what’s happening hormonally. We know that there’s going to be a
significant drop in testosterone for women who are using, especially these estrogen
-containing contraceptives, because you can read enough research papers to see that as
an effect. And then the question becomes, well, how is going to affect? So these
researchers are kind of acknowledging that this is an issue. And one of the reasons
they did this particular study is because they wanted to kind of test if there’s an
effect, not only just how women are experiencing it, but if there’s a physical
effect, right? So one of the quotes from the study, it’s a little technical, but it
says sex involves a successful integration between an intact neurovascular and muscular
circuitry, complex interactions between multiple neurotransmitter systems and critical
modulating influences from the endocrine system. So they’re kind of saying, in order
for sex to happen normally, there’s all of these different aspects of it, some which
are physiological. And so they also kind of describe that one of the earliest signs
of changes in the female sexual response is an increase in the vulvar,
clitoral, and vaginal blood flow. So they’re kind of looking at the specifics of
sexual function and the specifics of how that plays out in our sexual organs. And
they’re saying that we see blood flow, we see all of these different aspects of it.
So not only did they measure the
vulver tissues in a certain way, but isn’t necessarily this specific in terms of
measuring blood flow and measuring the actual glittoral volume.
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Okay, so we’ve got 40 women there between the ages of 18 to 35.
Now, they had women specifically that they chose for the study that were not on
contraceptives previously. So naturally cycling women in stable relationships, they said
non -smokers, so they had all these different criteria, but they were specifically
looking at non -users of contraceptives and then giving them contraceptives and
measuring before and after. And This took place over a six -month period.
And so it says a core measurements were focused on clitorial anatomy and blood flow.
So they were doing ultrasound measurements of clitoral volume. And they were using a
Doppler to measure blood flow, essentially. And they also did different blood tests
to measure hormone levels. And they evaluated sexual function with questionnaires.
And then they also tracked specific behavior. So independent of their feelings in
terms of how they were answering these questions, they were also looking at frequency
of intercourse, orgasm, intensity, and pain. So they were looking at a broad variety
of factors. And this is one of the reasons why this study is something that while
people are quick to dismiss it because it had a small sample size, I think that
the design of it and the intention behind it is so specific and, like I said,
quite unique. And to me, I still, I’m waiting for the follow -up to this study with
a larger sample size. I don’t think it’s going to happen, honestly, but who’s
hoping, right? But like I said, I do think. And one thing interesting as well, like
they were serious about trying to understand how hormonal contraceptives could impact
sexual function outside of sexual activity. So they had strict protocols to avoid
things that could change the volume of the clitoris. So specifically, participants
were asked to refrain from sexual intercourse or masturbation 12 hours before when
they were being examined. And also to even avoid wearing tight clothing or crossing
their legs, like they were trying to get kind of like that objective, is this
affecting it and not having the interference? Because what they’re saying is during
times of sexual activity, you’re going to have more blood flow and some swelling and
things like that. So you don’t want that to be interfering with the data. So then
the main question becomes, what did they find? So when you kind of read through
what their expectations were, because I always find it interesting to see what they
thought was going to happen versus what happened. So they did expect that both types
of contraceptives were going to suppress the ovarian hormones, as we know, as we
talked about. So they do suppress estradiol, testosterone, progesterone, we’re not
producing significant progesterone or we’re not ovulating. And they did expect that
the hormonal suppression, and that’s how they termed it, but essentially when we’re
using hormonal contraceptives, it is a form of hormonal suppression because you’re
suppressing your natural hormones. So they expected that would lead to changes in
sexual response, including desire, orgasm, and lubrication. And of course, if you read
through the study, it’s because they have this body of research that shows that this
is a common response. You know, up to 50 % of women who are put on oral
contraceptives either switch or come off of it within the first year. So we know
something’s going on there. They also expected some possible differences in what they
called genital vascularization. So they expected some differences in the blood flow
because of the differences in hormones in terms of the profile of hormones with
these contraception. So they did anticipate the results that they found, maybe not
necessarily to the degree, but they did anticipate that. So what did they find? What
did this study reveal? Why is it so controversial? And why am I focusing on it
today? So the biggest, I think, and most controversial and, quote, scary finding was
that both types of contraceptives did result in a significant decrease in clitoral
volume over the six -month period. So for pill users, that reduction was just under
about 20%. And then with the vaginal ring users, it was about 12 to 13 % smaller.
And so ultimately, the line of the study, the title of the study could have been,
pill shrinks clitoris by nearly 20%. That could have been the title of the study.
So a significant reduction of clitoral volume was observed in both groups after six
months of treatment. So they’re telling us that we’re getting the average. So with
studies, they don’t always give you every single data point. Of course, that would
be so fantastic to get every single data point. And I’m always kind of wondering,
well, what was the range? Like the woman who had the most significant shrinkage,
like what was that percentage versus the women who had the lowest? But an average
of almost 20 % is quite significant. And over the years, when I share the study,
I’ll often say if there was something that was shrinking men’s penis or testicles by
up to 20%, right? We would be hearing a whole lot more about that, you know,
so something to be thinking about. And I guess one thing I can mention is that we
do know that men who use steroids similarly may experience a reduction in the size
of their testicles. That’s a pretty common knowledge thing. And so it’s interesting
because then we have that kind of mirror effect of adding artificial hormones. So
doing kind of hormone suppression. You’re suppressing your natural hormones when you’re
taking these artificial hormones. And therefore, it is having an impact. Okay.
So interestingly, there were some differences that they found between the pill and
the ring. And they theorized that the differences were because of the mode of
delivery. But they did find that the pill, in this case, impaired clitoral blood
flow where they did not have that finding with the vaginal ring. And so that did
show that there was actually changes to blood flow. And so if we’re finding that
women who are using contraceptives are reporting changes in their sexual function,
then this study kind of gives even more credence to that in the sense that it’s on
in your head. We’re actually seeing changes in how blood flow is delivered to the
clitoris, which is an important part of sexual function. And so when they measured
hormonal shifts, they found that the estradiol, so the estrogen levels dropped more
sharply in pill users compared to ring users. So they did find some changes
hormonally there. And they did find that both groups had significantly suppressed
testosterone and increased SHBG, which lowers free testosterone. So that was what I
was talking about before. So often some of these sexual side effects are linked to
the significant degrees in testosterone. So as women, we make 90 % less testosterone
than our male counterparts, but even though we make a lot less of it, it is
essential for sexual function. And so when we’re significantly decreasing testosterone,
that is one of the factors that correlates to this change that we see in sexual
function. So in addition to those findings, they found that sexual desire and orgasm
frequency decreased in both groups, more in pill users. So pill users had significant
drops in the frequency of intercourse, orgasm frequency, orgasm, intensity, and sexual
satisfaction. And again, just to kind of reiterate this, so this was a group of
previously they were not on contraceptives and then they were put on contraceptives.
So again, this study is really interesting because it’s specifically trying to say,
okay, so when we put women on the pill who weren’t previously on it, or have women
use the vaginal ring who previously were just cycling naturally, what is the
difference that we’re seeing here? Also, pain during intercourse increased, but only
in the pill group. So they reported more pain with sex after the six -month period.
Lubrication reduced significantly in the pill group, while ring users did not have
that negative effect. So the women who were on the pill reported that they had less
natural lubrication. Then one of the questions is kind of like, well, so because
they were looking at the difference between pill users and the ring users, what was
going on there. So just to kind of go through how they interpreted this change.
So both of these modes of contraceptives, there were similar effects.
Both groups had lower testosterone levels. Both groups had clitoral shrinkage,
although the ring users to a lesser degree, so there was a lot of overlap and a
lot of similarity. But the pill seemed to have a more pronounced negative effect on
sexual function. So why is it? So one of the reasons that they suggested is because
of the way that it’s delivered. So the researchers argued that the pill caused more
sexual side effects and impaired clitoral blood flow because the oral estrogen spikes
SHBG and suppresses free testosterone more dramatically. So they were arguing that
because the ring gives this kind of steady hormone delivery that that’s one of the
reasons it has more stable delivery. So maybe that’s one of the reasons why it had
fewer of those negative effects or the negative effects to a lesser degree.
But keep in mind, both of the types of contraceptive methods did reduce the clitoral
size, and both of them did have an impact, but interestingly, the ring fared better.
So what do we do with this information? What does this all meet? And why is it so
controversial? And why has a follow -up study not been done? So, I mean, if I
summarize the information in the study into a little package for you. We do know
that both the pill and the ring were associated with pretty significant clitoral
shrinkage. So that’s the big takeaway of that. And the pill also significantly
decreased clitoral blood flow. The pill disrupted hormones more dramatically than the
vaginal ring did, especially in terms of its effect on free drone and estrogen.
Sexual function declined in both groups. So both groups did report a drop in sexual
desire and having sex less frequently, fewer orgasms, etc. But of course,
the pill did have a more pronounced effect. And there was kind of a question around
the deliverability of the ring versus the pill showing that maybe that reduced some
of these effects to some point. So then the ring had a better sexual side effect
profile. So it’s like both of them are kind of negative, but the ring was less
negative, right? And I think ultimately, I have several takeaways from the study.
I think the big one is that it really helps to validate the lived experience of
women who have taken contraceptives and have noticed a shift in their libido. or
maybe, like I said, if they weren’t sexually active prior to using the pill and
they still had some of these effects, maybe not knowing that it’s not normal to
have pain with sex or it’s not normal to not lubricate or it’s not normal to kind
of not have a strong of a sex drive, I feel like it really helps to normalize and
put that information out there. When women are going on the pill, we’re not really
counseled and told that it can have a negative effect on sexual functional libido.
The line that is repeated over and over and over again is that the pill is a
reversible contraceptive. It’s perfectly safe. It’s widely used.
And of course, that’s marketing. And if you want to find out more of the side
effect profile, you would have to go online and search for the prescribing
information, which isn’t hard to do. If you currently are taking contraceptives or
someone who is, you just type in the brand name and then you would put in the
prescribing information and you should be able to find literally like the PDF online.
They’re typically available. But unless someone tells you that or unless someone goes
through it with you, especially if you’re like 13 or 14 or 15 when you start
taking it, I mean, I’ve had many conversations with adults who are in their 20s,
30s, 40s who are taking medications and it’s me that’s suggesting that they search
for that or go to their pharmacists and ask for that because it never even occurred
to them. So we certainly live in a time where we are kind of used to taking
medications and we’re not necessarily used to looking deeper into what those side
effects are. But the information is available. But I would say most women who I’ve
ever spoken to who’ve been put on contraceptives, it’s not necessarily discussed. And
maybe some of the side effects are discussed at some point, but the low libido
sexual side effects aren’t necessarily front of the line, I guess you could say.
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So I would say that what this study did do is it points to the fact that it’s
not just in someone’s head. It’s not just emotional. It’s not just like hormones or
just this kind of concept that is in the air or something and it’s not really a
tangible thing. You know, when people say, oh, it’s your hormones. We kind of think
that it’s like this force or something. This study shows that there are specific
measurable physiological effects that hormones have on our sexual organs specifically.
And So if you’re experiencing changes in sexual function when you’re using these
products, it is not just in your head. We can actually measure. We can measure
changes in hormone levels. We can measure the thickness of your vulvar tissues.
We can measure the volume of your clitoris. We can measure the degree to which
these medications are changing the blood flow to said sexual organs.
And these researchers did. And the results are very striking. So some of the
criticisms, obviously then, especially the blowback that I’ve had at times when I’m
sharing about this, is that the sample size is so small. You can’t draw conclusions
based on a sample size of 40 women. And so there’s a couple things that I just
want to say to that. So obviously, when we have data like this, it’s not as strong
as it would be if we had data on a thousand or 2 ,000 women, obviously. But when
you have a study that’s showing such specific results that the researchers expected
because previous research has shown that this is a common effect of said medication,
and when you have a situation where all of the participants experienced shrinkage
with an average of just under 20 % for those who were the pill users, then I don’t
think we can just ignore it. So I find it just so interesting. Like there’s this
touch of like hysteria when studies like this are so damning for birth control for
various reasons. Of course, pharmaceutical companies don’t want to dissuay women from
using it because that’s going to affect their bottom line. We often have women who
are concerned about the availability of contraceptives. They don’t want people to bash
contraceptives, so to speak. I don’t think it’s bashing. I honestly think it’s
reading the paper and like sharing the research. I feel like it’s important for us
to have important consent I always have. So I don’t think that actually just telling
women what studies have shown is bashing. I think that’s just providing information,
but to each their own, right? But there are, of course, women who don’t like when
we highlight these types of issues because it’s like, well, then you’re going to
make all these women not want to use it. And potentially, it could mean that
they’re going to pull it. Well, no, they’re not going to pull contraceptives. It’s a
30 plus billion dollar industry. So I don’t think we’re ever going to lose our
access to conscience. Maybe I’m naive by saying that, but honestly, 30 billion dollar
industry. There’s a lot invested in making sure that contraceptives never go away. So
if they’re not going away, we need to be able to talk about, not that I’m asking,
I don’t want them to go away. I’m not saying that’s what I want either. I’m just
saying that as a response to that common critique. But I guess what I’m saying is
we have them, they’re available. So then the next step would be, well, what can we
do to reduce the side effects? So the first thing we have to do is actually study
them. So again, going back to what I said at the very beginning, when I started
recording, this study initially came out in 2014.
So that’s 11 years ago. And that’s a long time in research land. There are so many
studies of contraceptives. If you’ve never looked at studies on contraceptives, have a
look. The pill first came out in 1960. That was 65 years ago.
So we have a lot of research about the pill, which is so fortunate. We live in an
amazing time where we can actually look at it. And so what’s incredible to me is
that this study had such damning and specific negative results and it has not been
touched since then. And part of that, I think, is that it allows the marketing to
kind of say, well, the sample size was small. We can’t really draw conclusions about
that. We just don’t have enough data. So it allows them to kind of continue to
say, like, we just don’t have enough data. We just don’t have enough data. Whereas
really and truly, this should have been an alarm, right? To say, oh, my goodness,
this is shrinking the clitoris. It’s dramatically changing sexual function. It’s
changing the blood flow that is being distributed to the clitoris, right? And there’s
plenty of other research studies that show the shrinkage of the vulver tissues, a
thinning of the vulver tissues and the association with I’m
scary stat from the fifth vital sign. Like there’s like two stats that like have
people stopped in their tracks. And one of them is the it could shrink your
clitoris by up to an average of 20%. And then the other stat is it shrinks the
ovaries by about 50%. Right. So ultimately this artificial hormone replacement,
it suppresses our natural hormone production. And then that has a tangible physiologic
effect on the body. And, you know, my question is, like, A, why can’t we talk
about this more? B, where’s the follow -up? Research, right?
Like, where’s the research follow -up to this study? So I will leave those thoughts
with you. I just wanted to share this. And before I wrap up, though, I don’t want
to just leave it there because the one thing, I think, the one issue about bringing
up this information is that it terrifies people. Because, again, The pill is one of
the most widely used medications on earth. Over 100 million women are estimated to
have used it, including myself. I was a pill user when I was a teenager, so I
would have experienced some of these effects as well. And so what we know about the
pill is that the research does not suggest that these effects are permanent. But
with that said, we don’t really have the research then after the women come off to
see how long it takes the size of the clitoris to return back to normal. Of
course, that study isn’t done, right? Because we have barely gotten this study to
begin with. So we don’t really have actual research to say how long does it take
for those tissues to return back to normal. But with that said, the research that
we do have on ovarian function and sexual function, it does suggest that over time,
the SHBG levels do return a normal, although it can take many years for the SHBG
levels to normalize. We do see that the estrogen, progesterone, testosterone do
normalize at some point. We have our post -pill studies that show that typically
cycles return to normal. Within about six to 12 months, I think for most
contraceptive methods, though, the caveat about the shot is that it does have a more
pronounced negative effect. And the time to pregnancy and the time for the cycles to
return to normal for women who’ve used the shot in particular, is longer. So more
like 18 months to two years before we’re seeing full normalization of hormones and
cycles off the shot. But what we do know is the research shows us that there is a
post -pill transition period and it lasts a minimum of six to 12 months, but it can
be longer depending on the situation. So we don’t have any research to suggest that
this is a permanent thing, that this is a kind of a temporary effect from the
exposure to the artificial hormones for the duration that we’re using it. And the
research would also indicate that when women are using these effects for long term,
which in most studies is kind of like two years or more. So long term use, this
tends to be associated then with a bit of a longer delay. So again, in that six
to 12 month timeframe. So that’s what we know. And so I don’t share this
information as a scare tactic to say no one should ever use the pill. But this
research, like I said,
that they’re more lubricated and whatever the case is. Some women do find that maybe
it takes a bit of time or maybe that painful sex persists. And so there’s an
episode that I shared a few years ago with a client who had this experience and
she ended up having to use testosterone replacement cream. That was the thing that
finally helped to relieve the pain that was associated with insertion. And again,
likely due to pill use in her case. And of course, one other thing I’ll say is
that every woman doesn’t have the same experience. So not everybody who uses a pill
is going to have painful sex. Just like not everybody who uses a pill is going to
report the same side effects. There’s quite a wide side effect profile. And
obviously, everybody doesn’t experience the same thing. But as with anything, in order
for us to have informed consent, we need to know, we need to understand. And if
you happen to experience one of these side effects, I think the most important
empowering thing about this conversation is that it’s better to at least know what
the side effects are. Because the number of women who experience negative side
effects, it’s not like 1%. There is a decent percentage of women who are
experiencing side effects of hormonal birth control. And so if you happen to
experience a side effect that is particularly negative, it’s way better that you
actually know that is a side effect of birth control. Because a number of women
that I’ve spoken to over the years who were having to kind of do a midnight
Googling situation to try to figure out what was going on with them, that’s just
unacceptable, right? We need to be aware when we’re being put on these medications,
what some of those side effects are. So if you do experience like a drop in your
libido or if sex becomes painful or you notice a change in your sexual function, if
you do notice that you are starting to have anxiety, panic attacks, mood changes.
These are things that have been linked in research to the pill. If you notice
symptoms of depression, that’s also a very common response to birth control.
And that can be a result of a combination of the way the pill changes, how we
process our nutrients, particularly B6, vitamin B6, B12, and also the drop in
testosterone. There’s a lot of research that we have. But if we are not provided
with that information, it’s harder for us to make an informed decision. And I’ll
conclude with this for anyone who has not heard what I say about birth control. So
for anyone who’s wondering about my personal opinion about birth control, my opinion
is that we should just be aware of the side effects. And I think that when we
educate and empower women, just giving them the information about it, then they get
to make a decision. And I think that many women fall into one of three categories.
So category one, it’s like, okay, so I’m happy that I know this information. You’ve
told me what the side effects are. So I’m going to use it now, but then it gives
me the option if something does come up, at least I know about it, and then I can
decide what I’m going to do about it then, whether it’s switched to a different
brand or maybe try something else. There’s a second group of women who, when they
learn about the side effects, they may say, okay, you know what? I’m glad that I
know about the side effects. And so while I need to use this now, maybe instead of
being on it for 20 years, maybe I would shorten how long I use it. And I think
there’s a third category of women who are going to hear about the side effects, and
they’re going to say, you know what, this isn’t for me. But I don’t think every
single woman who learns about the side effects is going to say, this isn’t for me,
or we wouldn’t have 100 million women worldwide using it. And we wouldn’t have a
$30 dollar industry. So I don’t actually think that educating women about the side
effects is going to destroy the industry and make everyone just not take it anymore.
But I think we would have a more informed population and we would have women who
would be using it more mindfully. And some women don’t have a lot of negative
experiences on it. Over the years, I’ve worked with countless women who used
contraceptives and they didn’t have the negative side effects. And I’ve also worked
with countless women who they went on it and they felt completely crazy and they
had to come off immediately or they felt fine for the first few years and then all
of a sudden they started to have all these side effects and they had to come off.
And the things that they were experiencing stopped when they came off. So ideas for
future research, I mean, I have a gazillion, but what I would love is I would love
for the industry to care enough about women to not only do research in general,
but get to the point where we’re doing such specific research where we can actually
try to identify, okay, we have some women who are just like they go on it and
they’re just like roller coaster crying, laughing, and immediately have to come off.
We have some women who are going on it and the side effects kind of just increase
over time or just start to happen more and more after they’ve used it longer. And
we have other women who say they’re totally happy with it and don’t really report
negative side effects. What if we figure out why that is? And who’s more prone to
side effects so that we can maybe gear the women who are more likely to have the
negative side effects to other methods that might not, right? I feel like if we
actually cared about the women who are using these products, then we could get
where. But I think we’re currently in a time, or at least historically, we’ve been
in a time where when women bring up side effects, we’re just dismissed, we’re
gaslighted, we’re told this in our head, and we can’t get anywhere if we’re doing
that. If we’re not listening to the people using the products and we’re not hearing
what they’re saying, we’re not researching more deeply, then we’re not going to make
any progress. So those are some thoughts I wanted to leave with you today. Like I
said, this study I always find really interesting and I always like to share about
it whenever I have an opportunity. And I always want to leave with that question of
like, it’s been 11 years. Like, why is it that this is the only study about this
topic that I’ve seen publicly? And if it has been done, take me on Instagram at
Fertility Friday because I would love to do an episode on the follow -up study to
this.
If you found today’s episode particularly interesting, and you can think of somebody
who absolutely needs to hear about it, make sure to share. You’ll find the show
notes page at fertility friday .com slash 604, and that is the same link you can
use to share this episode. So with that said, I hope you have a wonderful week
weekend whenever you’re tuning into the show. And of course, as always, until next
time, be well, and happy charting.
And that’s a wrap. If you’ve been loving the podcast,
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