{"id":16898,"date":"2023-02-03T16:59:46","date_gmt":"2023-02-03T22:59:46","guid":{"rendered":"https:\/\/naturalwomanhood.org\/?p=16898"},"modified":"2025-02-10T08:46:56","modified_gmt":"2025-02-10T14:46:56","slug":"pas-de-cycle-avec-la-pilule","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/fr\/no-cycle-on-the-pill\/","title":{"rendered":"Les bases de la GPA : Vos hormones au cours d'un cycle naturel et vos hormones sous pilule"},"content":{"rendered":"\n
\n

\u201cThe average number of children U.S. adults think is ideal is 2.7. To achieve this family size, a sexually active woman must use contraceptives for roughly three decades<\/strong>.\u201d <\/p>\n<\/blockquote>\n\n\n\n

So reads a 2021 fact sheet<\/a> on contraceptive use from the Guttmacher Institute, Planned Parenthood\u2019s former research arm. <\/p>\n\n\n\n

Three decades of contraceptive use is a long time. It\u2019s a long time to expose oneself to the increased risks of both breast and cervical cancers<\/a> (and, yes, while oral contraceptive use is associated with decreased risk of uterine, ovarian, and colorectal cancer, you can read more about why that doesn\u2019t \u201cbalance out\u201d the increased breast and cervical cancer risk, here<\/a>). Likewise, three decades is a long time to negatively impact bone mineral density<\/a>, especially given that a woman\u2019s bone mineral density should be peaking during her teens and twenties<\/a>. And it\u2019s a devastating length of time to face increased risks for blood clots<\/a> and an array of autoimmune disorders<\/a> and mental health issues<\/a>. <\/p>\n\n\n\n

On the other side of the coin, thirty years is also a long time to miss out on the benefits of ovulation, a process which only occurs in healthy, naturally cycling women, as birth control functions primarily by preventing ovulation from happening. And ovulation is more than about the release of an egg each month\u2013it is essential for female bone<\/a>, breast<\/a>, brain<\/a>, heart<\/a>, and immune<\/a> health. Because women are often told by their doctors that birth control will \u201cregulate\u201d their cycles, many have no idea that they have no cycle on the Pill, and that the hormone withdrawal bleed they experience each month isn\u2019t the same thing as a period. Here, I\u2019ll cover the key hormonal difference between your natural cycle and your \u201ccycle\u201d on the Pill. <\/p>\n\n\n\n

This is what happens to your hormones during a natural ovulatory cycle   <\/span><\/h2>\n\n\n\n

Follicular phase<\/span><\/h3>\n\n\n\n

In the first part of the cycle, we have the follicular phase<\/a> (sometimes known as the proliferative phase), which starts towards the end of a woman\u2019s menstrual period. During this phase, follicle stimulating hormone (FSH) levels increase in a woman\u2019s brain, sending a message to one of her ovaries to recruit follicles (the structures surrounding each egg) to mature. The recruited follicles in the ovary start to grow and produce estrogen<\/a>. A woman using a fertility awareness method (FAM) has evidence of this increase in estrogen levels when she notices a change in sensation from dryness to moisture at the vaginal opening (that feeling of moisture is actually due to the presence of cervical mucus<\/a>).<\/p>\n\n\n\n

The selected follicles continue to produce more and more estrogen, which in turn causes the endometrial lining<\/a> to thicken and<\/em> causes the cervix<\/a> to open (just a little bit!) and secrete a \u201csperm friendly\u201d estrogenic, fertile mucus discharge. This is usually observed by the woman as a change in sensation from moist to slippery at the opening of the vagina.<\/p>\n\n\n\n

The rapid rise of estrogen levels, along with small increases in progesterone and inhibin<\/a>, signals the brain to decrease FSH. Peak estrogen levels typically produce an observable discharge around the time of ovulation that is clear and thin, like raw egg white (which is why other NW articles refer to this as egg-white cervical mucus, or EWCM). One follicle becomes \u201cdominant\u201d in this hormonal environment. This is the follicle that will release the egg at ovulation<\/a> (aka the main event of your cycle). <\/p>\n\n\n\n

Ovulation<\/span><\/h3>\n\n\n\n

Kisspeptin and Luteinizing hormone (LH)<\/span><\/h4>\n\n\n\n

Rapidly rising estrogen levels activate the hormone Kisspeptin in the brain (more on Kisspeptin and the surprising origin of its name, here!<\/a>). The Kisspeptinergic system is influenced by many different hormones, and is necessary for the onset of puberty and for reproductive function. Activation of Kisspeptin by the rapid rise in estrogen levels causes the brain to release a surge of luteinizing hormone (LH)<\/a>, which is necessary to trigger ovulation<\/a>. The released egg survives 12-24 hours if not fertilized, at which point it will break down and be resorbed by the woman\u2019s body. <\/p>\n\n\n\n

Corpus luteum<\/span><\/h4>\n\n\n\n

At the same time as the LH surge, the follicle secretes progesterone<\/a> to maintain LH levels, allowing for the formation of the corpus luteum<\/a> (or \u201cyellow body,\u201d which is covered at length, here<\/a>). This rise in progesterone just before ovulation is very important for the health of the corpus luteum. <\/p>\n\n\n\n

Luteal phase<\/span><\/h3>\n\n\n\n

The corpus luteum secretes progesterone (the dominant hormone during this phase of the cycle) and some estrogen to maintain an adequate luteal phase length. At this point, the thickening of the uterine lining (the endometrium<\/a>) slows down, and increased progesterone enriches it with blood vessels and nutrients in preparation for possible implantation of a fertilized egg (embryo). <\/p>\n\n\n\n

The mucus discharge secreted by the cervix changes from slippery and clear (estrogenic and fertile) to dry and thick (progestagenic and infertile) after ovulation. This blocks sperm from swimming through the cervix, acting as a biological valve. The corpus luteum lives 11 to 16 days (on average, 14) if the egg is not fertilized, and begins to shrink after about 6 days.  <\/p>\n\n\n\n

Menses \/ Your period<\/span><\/h3>\n\n\n\n

As the corpus luteum dissolves, about 14 days after ovulation, estrogen and progesterone levels drop, triggering the beginning of a new cycle with the sloughing of the endometrium. This is observed as vaginal bleeding or a \u201cperiod.\u201d <\/p>\n\n\n\n

Menstrual bleeding is an important external indicator of how balanced the prior <\/em>cycle\u2019s hormones were, and how healthy the ovulation was. Of note: the cyclical bleeding that occurs while taking the Pill is a result of hormone withdrawal, not ovulation. Oral contraceptive pills (OCPs) stop ovulation by suppressing<\/a> the hormonal communication between the brain and the ovaries [1].  <\/p>\n\n\n\n

Gonadotropin releasing hormone: the hormone that makes your entire cycle happen<\/span><\/h3>\n\n\n\n

Remember how I mentioned the \u201ckisspeptinergic system\u201d above? A healthy kisspeptinergic system in the brain supports Gonadotropin releasing Hormone (GnRH) function, and GnRH makes the whole hormonal process from the beginning of the follicular phase to the end of the follicular cycle happen. No GnRH means no menstruation, follicular phase, ovulation, or luteal phase. <\/p>\n\n\n\n

GnRH is produced by the hypothalamus in the brain, and is released in a pattern of continuous, pulsating waves that change in amplitude depending on where you are in your cycle. This continuous pulsating release allows for the necessary hormonal fluctuations required to achieve ovulation. Quite the intricate system, no? <\/p>\n\n\n\n

This is what happens to your hormones on the Pill (or any other form of hormonal contraception)<\/span><\/h2>\n\n\n\n

With the exception of the copper IUD and some progestin-only pills (sometimes called \u201cmini Pills,\u201d) all forms of contraception contain a combination of synthetic estrogens and progestins. The Pill (and other forms of hormonal contraception) works in 3 main ways to \u201cflatline\u201d your hormone levels (which we\u2019ll discuss below), which stops your natural cycle altogether. That\u2019s right: if you are on hormonal birth control,<\/strong> you do not have a cycle<\/strong>. <\/p>\n\n\n\n

#1 Preventing ovulation by blocking the HPO feedback loop<\/span><\/h3>\n\n\n\n

The Pill\u2019s primary mechanism of action for preventing conception is preventing ovulation by blocking the communication pathway of hormones between the brain and the ovaries. This \u201cpathway\u201d is known scientifically as the hypothalamic-pituitary-ovarian (HPO) feedback loop. This lowers the body\u2019s natural estrogen and progesterone, to levels below which ovulation cannot occur. Concerningly, research suggests that women who have been on the Pill have lower blood levels <\/a>of naturally occurring estrogen and progesterone, even after stopping the medication, than women who aren\u2019t on hormonal contraception [2].<\/p>\n\n\n\n

Dr. Juan Pablo Del Rio and colleagues\u2019 description of the \u201covulatory continuum\u201d provides a compelling visual of this medically-induced hormonal imbalance. You can think of the normal hormonal variance observed in healthy, natural, ovulatory cycles as being like a normal cardiac rhythm electrocardiogram (EKG) tracing, with the up and down representing the \u201club-dub\u201d of a heartbeat. As you can see below, the Pill induces a \u201cflatline\u201d for FSH, LH, estrogen and progesterone.  See Figure 1<\/a>. from Del Rio et. al. [3]. <\/a><\/p>\n\n\n\n

<\/span><\/h3>\n\n\n\n

#2 Thickening and drying up cervical mucus by blocking the effects of your body\u2019s estrogen<\/span><\/h3>\n\n\n\n

The Pill also prevents conception by thickening and drying up cervical mucus. The synthetic progesterone (progestin) in the Pill counteracts the effects of the body\u2019s natural estrogen,  preventing the production of the slippery mucus (also known as \u201cegg-white\u201d mucus) necessary for sperm survival. Sperm survives only minutes to hours in a thickened mucus environment, and thickened mucus likewise forms a barrier that prevents sperm from ever reaching the mature egg (should the Pill\u2019s primary mechanism of action fail, and ovulation still occur\u2013a phenomenon known as breakthrough ovulation). The increased risk of cervical cancer<\/a> associated with the Pill is attributed to this action [4]. <\/a><\/p>\n\n\n\n

#3 Thinning the uterine lining (endometrium) by suppressing the body\u2019s own natural estrogen and progesterone <\/span><\/h3>\n\n\n\n

The third way the Pill works to prevent pregnancy* is by thinning the endometrium<\/a>. The Pill prevents the thickening of the uterine lining that naturally occurs before<\/em> ovulation, as well as the nourishment provided by the corpus luteum after<\/em> ovulation. <\/p>\n\n\n\n

In other words, the Pill is designed to keep the endometrium thin and flat, under 7 millimeters<\/a>, typically between 2.5mm and 5.7 mm. The normal thickness<\/a> of an endometrium after ovulation is 9-12mm, increasing to up to 16mm before shedding as one\u2019s period. Optimum endometrial thickness <\/a>associated with live births in patients undergoing in-vitro fertilization (IVF) was between 8.7 and 14.5mm [5]. This effect also explains the lighter bleeding and the decreased risk of endometrial cancer<\/a> associated with the Pill. <\/p>\n\n\n\n

Your \u201ccycle\u201d on the Pill isn\u2019t a cycle at all<\/span><\/h2>\n\n\n\n

When you\u2019re on the Pill or another form of hormonal contraception, your natural cycle is paused altogether (except for when breakthrough ovulation occasionally occurs), tricking your body<\/a> not into \u201cthinking it\u2019s already pregnant,\u201d as you may have heard, but into thinking it\u2019s already ovulated. But because your body hasn\u2019t actually ovulated while on the Pill, you miss out on the health benefits<\/a> of ovulation and<\/em> incur multiple health risks<\/a> at the same time. <\/p>\n\n\n\n

Fortunately, fertility awareness methods (FAM) offer women ways to prevent pregnancy, plan families, and address reproductive health issues that maintain, support, and even restore the body\u2019s natural hormonal patterns and fertility health. Women\u2019s bodies were incredibly designed, and FAMs respect that design rather than overriding the system as hormonal birth control does. Side effects need not apply. Best of all, FAMs and methods of Natural Family Planning (NFP) are just as effective as many of the most common contraceptives available on the market (don\u2019t believe it? Read more on FAM effectiveness, here<\/a>.) <\/p>\n\n\n\n

*Note that we specified that the endometrial-thinning action of the Pill does not function to prevent conception, but pregnancy (which is defined as beginning only when an embryo implants within the endometrium). Should the primary and secondary mechanisms of action fail to prevent conception (prevention of ovulation and thickening of cervical mucus, respectively), this tertiary mechanism is intended to prevent implantation of the newly conceived embryo. <\/em><\/p>\n\n\n\n

References:<\/p>\n\n\n\n[1] Westhoff CL, Heartwell S, Edwards S, Zieman M, et al. Oral contraceptive discontinuation: do side effects matter? Am J Obstet Gynecol. 2007 Apr;196(4):412.e1-6; discussion 412.e6-7. doi: 10.1016\/j.ajog.2006.12.015. PMID: 17403440; PMCID: PMC1903378.<\/p>\n\n\n\n[2] Fleischman, D. S., Navarrete, C. D., & Fessler, D. M. T. (2010). Oral Contraceptives Suppress Ovarian Hormone Production. Psychological Science, 21(5), 750\u2013752. <\/em>https:\/\/doi.org\/10.1177\/0956797610368062<\/em><\/a>. <\/p>\n\n\n\n[3] Del R\u00edo JP, Alliende M I, Molina N, et al. \u201cSteroid Hormones and Their Action in Women’s Brains: The Importance of Hormonal Balance.\u201d Front. Public Health,  vol. 6 (2018). https:\/\/doi.org\/10.3389\/fpubh.2018.00141<\/a><\/p>\n\n\n\n[4] Guven, Suleyman et al. \u201cThe underlying cause of cervical cancer in oral contraceptive users may be related to cervical mucus changes.\u201d Medical hypotheses<\/em> vol. 69,3 (2007): 550-2. doi:10.1016\/j.mehy.2007.01.051.<\/p>\n\n\n\n[5] Shaodi, Zhang et al. \u201cThe effect of endometrial thickness on pregnancy outcomes of frozen-thawed embryo transfer cycles which underwent hormone replacement therapy.\u201d PloS one<\/em> vol. 15,9 e0239120. 24 Sep. 2020, doi:10.1371\/journal.pone.0239120.<\/p>\n\n\n\n

Additional Reading:<\/p>\n\n\n\n

FAM Basics: What is the luteal phase of the menstrual cycle?<\/a><\/p>\n\n\n\n

FAM Basics: What is the follicular phase of the menstrual cycle?<\/a><\/p>\n\n\n\n

FAM Basics: Ovulation, aka “the main event of your cycle”<\/a><\/p>\n\n\n\n

FAM Basics: Estrogen<\/a><\/p>\n\n\n\n

FAM Basics: Progesterone<\/a><\/p>\n\n\n\n

FAM Basics: What is cervical mucus?<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"\"Le nombre moyen d'enfants que les adultes am\u00e9ricains consid\u00e8rent comme id\u00e9al est de 2,7. 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