One common thread for clients with hormone issues is post birth control syndrome that can rear it’s ugly head years later.
Wait… did you just say post birth control syndrome?
What the heck is that?!?!
It’s a very real issue that results from being currently on or having taken birth control pills (BCPs) — even if it was 10, 15 or 20 years ago!
What most people don’t know is that hormones (like estrogen) are detoxified by your liver to be removed from active circulation.
They also don’t realize that BCPs essentially shut down communication between your brain and your ovaries.
Because your body is ONE system, that single statement alone should grab your attention.
No doctor ever told me for the ten years that I took BCPs that I was effectively shutting down that very powerful and necessary hormonal feedback loop!
Since hormones aren’t my area of expertise, I reached out to my close friend — Dr. Jolene Brighten.
She knows her stuff and can go toe-to-toe (because she’s a total research geek) on all things hormones.
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How Post Birth Control Syndrome Affects Liver Detoxification Years Later with Dr. Jolene Brighten
Dr. Jolene’s Post-Birth Control Awareness Week (REGISTER NOW)
Beyond The Pill BOOK (coming in January 2019)
Jennifer: I have a very special episode for you today.
I know you are used to me talking all by myself, but I felt incredibly compelled today to have a guest join me.
In breaking the tradition of season four, I would love the opportunity to welcome Dr. Jolene Brighten. This is her first time ever to the Gluten Free School Podcast.
She is a functional medicine naturopathic medical doctor and the founder of Rubus Health, a women’s medical clinic that specializes in women’s hormones.
She is the number one expert in a condition called Post Birth Control Syndrome.
She also talks a lot about the long-term side effects associated with hormonal contraceptives.
Now here’s the thing — If you’re a man and you’re listening to this and you’re like, “What, post birth control syndrome? I’m out.”
You know what? You probably know a woman in your life who is experiencing this, and this could be really good information for her, and just also in general. There’s a lot of stuff going on with birth control that we need to be aware of, and the consequences down the road even when it’s long been in your rearview mirror.
But today I want to talk about how that directly affects estrogen metabolism. So Dr. Jolene, thank you so much for joining us!
Dr. Jolene: Hey there. Thanks so much for having me!
Jennifer: I don’t consider myself a hormone expert. I know that because you’re dealing with all of these issues, and birth control is essentially a way of shutting off the connection between your brain and your ovaries, correct?
Dr. Jolene: Totally. That’s the number one mechanism of action is to flood the system with so many hormones that your brain says, “Hey ovaries, we’re all good, so let’s not signal to them.”
So your brain and your ovaries stop talking. This means that there is no ovulation, which seems like a perfect solution if you don’t want to get pregnant. That’s until you find out that there’s a whole lot more to this story.
Lesser Known Liver Side Effects From Post Birth Control Syndrome
Jennifer: We know that birth control may be a factor for a lot of women. I have a lot of clients who they’ve either taken it in the past. Or they are still taking it now because they don’t want to get pregnant, but they’re in that committed relationship. So for anybody listening to this who’s like, “Are we talking about things that not might be cool for me?”
A lot of the women I work with are married, they’re in committed relationships, but they were told that having children now might not be a good idea because of having previous traumatic births in the past and other reasons.
But here’s the thing — How we metabolize estrogen is really important. Birth control pills especially mess with that, so can you talk to us a little bit about the role that estrogen plays and how the pill can really screw that up?
Dr. Jolene: I do want to say that if you’re a woman who’s using hormonal birth control, it’s not my aim to shame you or freak you out. But I think that you deserve all the information so you can care for your body.
It’s very much my philosophy that it’s not my body, it’s your body.
Whatever you choose, it’s my job as a physician to support that. And so here’s the really important thing to understand, and I thank you for starting this conversation, Jen. You said, “I want to talk about the liver” and here we are!
We did not diagnose liver tumors in women to the extent that we do now, not until the hormonal birth control was introduced did we start seeing lots of lumps on your liver, so benign liver tumors are actually very common. That’s a structural change happening to the liver because of being on hormonal contraceptives.
Now, your liver does so many wonderful things, and one of those things is detoxification, so your natural estrogen has to go through liver detoxification. Phase one and phase two detoxification, and there’s methylation required for all of that as well.
And so when you’re on hormonal birth control, any oral estrogen also has to pass through the same detox mechanisms. The problem is not their structural alterations — yes, these liver tumors are benign. We do see an increase in liver cancer, but, for the most part, the liver tumors are benign.
But, keep in mind, a structural change means this tissue is no longer working the way that it once was, so now we’ve inhibited detox capacity in that way.
In addition to that, these liver tumors rupture very easily.
Your liver is pumping so much blood that while a doctor may say it’s benign as in you don’t have cancer, it’s certainly not benign if you’re walking around taking the pill, you don’t know you have a liver tumor, you end up in a motor vehicle accident, or maybe you’re playing football.
But you have some kind of trauma to the abdomen, they can rupture and lead to a bleed.
Nutritional Concerns Resulting Even Though You Stopped The Pill
So that’s one way that the birth control can impact your liver, but in addition to that, you have to take enough estrogen to shut down the brain from talking to the ovaries. When you do that, you’re going to overwhelm the system with estrogen.
As you do that, the liver is going to struggle in other ways to be able to detoxify environmental toxins. So think about it. You’re walking around an environment that you don’t have full control over.
You already have xenoestrogens hitting you left and right. These are chemical compounds that are in our environment. They’re toxins that alter your hormonal function as it is, but also make extra work for your liver. These come in personal care products and receipts, and just about everywhere.
In addition to that, hormonal birth control is depleting nutrients.
The very nutrients you need to run your phase one and phase two liver detox, as well as run the COMT pathway which is a gene that helps with estrogen methylation.
Specifically, if you’re lacking magnesium, which just about everybody’s diet is lacking magnesium, hormonal birth control depletes magnesium, you can be in big trouble when it comes to that liver detoxification. I know that is a lot of information there, but does that make sense?
Jennifer: It does. And fortunately, I have recently shared in a podcast, I believe it’s one or two before this, so if you guys are listening sequentially, you have already heard all about the liver detoxification pathways — phase one and phase two — so you are familiar with what we are talking about. I’m really glad this is able to overlap.
I’m a little taken back, to be honest with you. I was on birth control pills for 10 years. I never knew that you could have these structural changes within your liver. That’s actually really alarming, and so anybody who’s listening to this, that’s, I guess that’s something really pretty serious you have to consider.
So if you go off the birth control, do they go away?
Dr. Jolene: I did the pill for 10 years too, by the way, that’s why I’m like, “Let’s not be shaming anybody.” But the thing about the liver is those hepatocytes, so the liver cells, they are amazing. They can regenerate themselves. It depends on underlying conditions, individualized factors like are you still having exposure to other elements, but yes, some of these tumors can go away.
The body over time can break them down and can heal. Things like milk thistle can certainly help. That’s an herb that helps the hepatocytes regenerate. We see that milk thistle can help in conditions like cirrhosis, which is due to alcoholism, so it is something that is very startling.
Why We Need More Research On How Birth Control Pills Affect Women
The research for women after stopping birth control pills isn’t the greatest. Researchers are not really looking at it like, “Oh, how long do these tumors take to resolve?” They’re more just documenting what happened.
We also have to understand that research is done through the lens of a healthy woman… not those who are sick.
Hormonal birth control was never designed for a diseased state to begin with. It was the first pharmaceutical introduced that you didn’t have to have a diagnosis. It was just you just had to be fertile.
With that, it was really designed for a healthy, fertile female, however we know that not everybody is made exactly the same.
Our genetics vary. We live in different environments.
And so that’s the other thing we have to respect and understand with regards to the literature, is that research studies will come out and they’ll say things like, “Oh this is a minimal risk,” or “Oh, it’s a low risk,” but is it true for you?
For example, the breast cancer risk association… they’re like, “Oh, it’s just a mild increase.” Yeah maybe, unless you’re somebody who has some genetic variations, you live in a very toxic environment, you have issues with your detox capacity.
There are other confounding variables that we really have to stand back and look at the individual.
The way it’s dispensed these days, you’re more likely someone will pass you the birth control pill over candy. Sugar is more of a villain than the birth control pill. I’m not saying that birth control pills or birth control is a villain, but it is a medication.
We have somehow lost sight that this is a medical intervention that’s designed to shut down your entire reproductive system. And P.S. — what affects your reproductive system affects everything in your body.
I just have to giggle that in medicine… the way that we teach medicine and learn medicine is a way that we can digest it as humans. But it’s like you have your rheumatologists, your endocrinologists, your gastroenterologists, and everybody’s separate and every system is separate.
But you know who doesn’t care? Your body. Your body does not care.
Your body doesn’t care whether the gastroenterologist thinks your gut is separate from your ovary. And it doesn’t get why the GI doc wants to send you over to the endocrinologist for your thyroid.
Your body knows, “I need these hormones in order to function optimally, and I need my gut. I need my liver. I need my skin. I need all of these things working in harmony if I’m going to be optimal.”
How Long Can Symptoms From Post Birth Control Syndrome Last?
Jennifer: If a woman, say, was on birth control 10 years ago, got off of it, is it possible that even now the effects could be lasting? Like you may still feel the repercussions of having been on birth control 10, 15 years ago?
Dr. Jolene: Oh absolutely. This is the thing that I have seen some people saying, like, “Post birth control syndrome only lasts about 6-12 months.”
And I’m like, “Well clinically, what I have seen and documented is that the side effects on hormonal birth control or a result of coming off, if you don’t do something about them. They don’t just go away.”
So since we’re keeping this conversation very liver focused because your people are in the know, there’s another change that happens within the genetics of your liver.
When you take hormonal birth control, it changes the genetic expression of a protein called sex hormone binding globulin. This is why you lose your libido on birth control, and it doesn’t come back when you stop.
That is something that research has looked at and said even five years after stopping hormonal birth control, the genetic alterations persist and that woman has higher levels of sex hormone binding globulin than a woman who has never used hormonal birth control.
This is really important to understand. It alters the genetics in your liver. This much we know. The question remains — what other genetics are birth control pills altering?
Because we don’t know as much as we would think we do in medicine. Clinically, I found this to be true.
I’ve had women who were on the pill for 10 years. And even for like 30, 40 years, which is crazy because it’s not how they were designed to be used.
If you think about shutting down your reproductive tract for 30-40 years, that’s gonna have some impacts.
But I’ve seen these women come in and I’ve had women off of hormones for five years, 10 years, 15 years, and their sex hormone binding globulin, sure enough, is elevated.
These women have done the work in bringing down their sex hormone binding globulin and bringing their libido back. It speaks volumes to epigenetics and what you can do with the right supplements, the right food, and the right lifestyle factors.
I want to see so much more research on women’s medicine altogether, but this is something that I wonder in these studies, were these women eating a standard American diet? What was going on for them that that sex hormone binding globulin persisted?
I have seen women who are “eating a clean diet and they’re doing everything right” and they’re still having these issues years later after being off of hormonal birth control.
A lot of that comes down to that’s where you need the medical Sherpa because we don’t fix people. I think it’s so disempowering to act like, “Oh I’m a doctor. I fix people.”
The reality is that I solve people’s puzzles. I outline the path and I basically am like, I mean I’m old enough to remember maps, like legit maps that you drew on and been like “This is how we’re gonna get from point A to point B.”
That’s my job — to show YOU that.
But it’s really our patients and our clients who do the work, who take the step every day.
The most powerful thing you can do is choose wisely with what you put at the end of your fork, and your doctor is not there doing that with you, so that’s just my little soapbox moment, to be like, “Women heal themselves, okay?”
Diving Deeper Into Post Birth Control Syndrome
Jennifer: I agree with you wholeheartedly. Okay, so first everybody, you can check out Dr. Jolene’s amazing guide on her website.
Number two, her book coming out called Beyond The Pill is amazing. It’s a really worthwhile read and I would encourage all of you to go grab a copy. It is available to purchase right now. It’s not out yet. It will be out in January 2019. I am so excited for this book.
Then she also has an amazing event coming up that … Tell us a little bit about it because it’s a BIG deal (and YES, I’m a part of it which is such a deep honor)!
Dr. Jolene: Yeah, so we are launching the first ever Post-Birth Control Syndrome Awareness Week.
We are aiming to raise awareness around hormonal contraceptives and the impacts that they have on women’s bodies, and help them stay safe and understand how they can safeguard against some of these negative side effects.
For every woman who has come into my medical practice and said, “My doctor laughed at me. My doctor said I was in my head. My doctor told me just to go back on birth control, that I was broken, that I would never fix my period, I would never be able to fix my mood or any of this without hormonal birth control.”I really want to raise awareness that this condition is real. It is not in your head, and there’s a whole lot that you can do about it.
We’re bringing in a myriad of experts which are really the trailblazers and the thought leaders together because of this Awareness Week.
You’re actually gonna get access to information that’s not even in medical textbooks yet! And it’s also for the clinicians who are on the ground, doing the work, reading the research, and working with people one on one, bringing the most practical and tangible information.
It is now at this time 2018, and I feel like everybody’s just starting to catch on to what women have been complaining about forever which is medical gender bias.
We know that it’s us ladies who are dismissed at a higher rate.
We are told that symptoms are in our head and we’re given very few options in medicine in terms of what do you get, hormonal birth control, IVF, hysterectomies, and all those things have a time and a place, but it’s time that we transform women’s medicine for the better.
The way that I see that we’re going to do that is by taking the medicine and putting it in the patient’s hand so that they can go to their provider and they can ask for better and they can make that partnership with their provider. I think we’re gonna make some big changes in women’s medicine.
Jennifer: HERE is the link to sign up for this event! It’s completely free to attend.
It is going to be an incredible opportunity for you to really dive into this whole area and get information. I just want to thank you so much for your time in joining us on the podcast. You’re my first guest ever for season four and I’m really glad to have you here.
Dr. Jolene: I’m so honored. You broke your streak and brought me in…
Jennifer: I know. I had to! You’re too brilliant of a guest! I just had to do it.
Dr. Jolene: Well thank you, I appreciate that. No one can see me blushing except you right now.
Jennifer: All right, well thank you for tuning in. I will put all those links in the show notes, and I will see you the next time.