HompesMethodPrac00onerTrainingLevelII

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Lesson Forty Five – The Contraceptive Pill

Introduc0on

•  Thisisnotapoli,calorsociologicaldebate.•  I’mnottakingmoralhighground.•  Itisadiscussiononphysiologicalconsequencesofthepillinwomen:–  Howthepillworks–  Theproblemsitcansolve–  Theproblemsitcancause

Whatisinthepill?

•  Therearefourtypesofcontracep,on:–  Hormonal:

•  Thepill•  Thepatch•  Theinjec,on

–  Barrier:•  Non-hormonalcoil•  Condoms

–  Intrauterine(insertedinsidetheuterus)–  Sterilisa,on

Whyisitused?

•  Birthcontrol(obvious)•  Alsofor“controlling”themenstrualcycle:–  Irregular,heavyanduncomfortablecycles–  Periodpains/menstrualcramps–  PMS/PMDD–  Hirsu,sm–  Acne–  PCOS–  Endometriosis

Atypicalstatement…

“TheoralcontracepPvepill,introducedintheUKin1961,hasbeenhailedasbeingoneofthemajormedicaladvancesofthe20thcentury.Itprevents

pregnancyinapproximately99%ofwomen(aslongasit’susedcorrectly).”

hRps://onlinedoctor.lloydspharmacy.com/uk/info/how-does-the-contracep,ve-pill-work

Howthepillworks

•  Birthcontrolpillspreventpregnancythroughseveralmechanisms,mainlybystoppingovulaPon.

•  Ifnoeggisreleased,thereisnothingtobefer,lizedbysperm,andthewomancannotgetpregnant.

Howthepillworks

•  Therearetwokindsofcontracep,vepills:–  Combinedpill

•  Containssynthe,cversionsofbothEandP–  Progesterone-onlypill(orminipill):

•  Containsonlysynthe,cprogesterone.

Howthecombinedpillworks

•  Synthe,cestrogenblocksFSHandLH–  Noeggisdeveloped/matured

•  Synthe,cprogesteronethickensmucusatwombentranceandthinsuterinelining–  Spermcan’tgetin–  Uterineliningcannotholdanegg

Howthepillworks

•  Withinthecombinedpilltherearetwosubcategories:monophasicandphasic.– Monophasicdeliversthesamedoseofsynthe,coestrogenandprogesteroneeveryday

–  Phasicpillstrytokeephormonelevelsconsistentbyalteringdosagethroughoutthemenstrualcycle.

•  Withbothtypes,thereisasevendaybreakevery21daystoallowmenstrua,ontooccur.

Howtheminipillworks

•  Mostoftheminipillsworkbythickeningthemucusatwombentranceandthinningtheuterinelining:–  Spermcan’tgetin–  Uterineliningcannotholdanegg

•  Ceraze<e,themostcommonlyusedminipill,alsoworksbypreven,ngovula,on.

Combinedpillbrandnames

•  Herearesomecommonlyprescribedcombinedpills:– Microgynon–  Cilest–  Rigevidon–  Yasmin– Marvelon

Minipillbrandnames

•  Therearetendifferentbrandsoftheprogesterone-onlypillavailableintheUK:–  CerazeRe–  Cerelle–  Micronor–  Norgeston–  Noriday–  Aizea–  Nacrez–  Desomono–  Desorex–  Zelleta

(Possible)Usesandbenefits

•  Preventsunwantedpregnancy;moreenjoyablesex•  Regula,onofmenstrualperiods•  Irregularperiods•  Menorrhagia(heavyperiods)•  Dysmenorrhea(painfulperiods)•  Endometriosis•  Premenstrualsyndrome(PMS)andpremenstrualdysphoric

disorder(PMDD)•  Acne,hirsu,sm(excesshairgrowth)andalopecia(hairloss)•  Decreasingtheriskofbreastcysts,ovariancysts,pelvic

inflammatorydisease(PID)andpregnanciesinthefallopiantubes*

–  *Hmmm:notnecessarily

Menstrualcycle

Menstrualcycleandthepill-problems

•  Majordisrup,ontoHPGaxis:–  FSHandLHaresuppressed–  OvulaPondoesnottakeplace–  Nonaturalprogesteroneisproducedbythecorpusluteum

•  Plentyofsynthe,chormonesfloataroundthebody–  Theyarenotthesameastheonesmadeinthebody–  Theyhavetobedetoxified–  Theyblockhormonereceptors

Menstrualcycleandthepill-problems

•  It’shardtodefine“side-effects”inthiscontext.•  Isitasideeffectorjustadirectcause-effect?•  Problemscandevelopduringorafertakingthepill:–  Thesideeffectsvaryfromwomantowoman–  Someladiesfeelok–feelgreat,actually–  Somefeelnorealdifference–  Othersfeelterrible–  Somecannotregulatetheircycleoncetheystoptakingthepill

Menstrualcycleandthepill-problems

•  Mostcommonsideeffects:–  Intermenstrualspohng– Nausea–  Breasttenderness– Headaches– Weightgain– Moodchanges– Missedperiods– Decreasedlibido–  Vaginaldischarge–  Visualchangeswithcontactlenses

Problems-NHS

“Somedisadvantagesofthepillinclude:itcancausetemporarysideeffectsatfirst,suchasheadaches,

nausea,breasttendernessandmoodswings–ifthesedonotgoaferafewmonths,itmayhelptochangetoadifferentpill.itcanincreaseyourbloodpressure.”

hRp://www.nhs.uk/condi,ons/contracep,on-guide/pages/combined-contracep,ve-pill.aspx

Problems-Wikipedia

•  Nausea,vomi,ng,headache,bloa,ng,breasttenderness,swellingoftheankles/feet(fluidreten,on),orweightchangemayoccur.

•  Combinedoralcontracep,vesincreasetheriskofvenousthromboembolism(includingdeepveinthrombosis[DVT]andpulmonaryembolism[PE])

Problems-Wikipedia

•  COCpillswithmorethan50µgofestrogenincreasetheriskofischemicstrokeandmyocardialinfarc,onbutlowerdosesappearsafe.

•  Theserisksaregreatestinwomenwithaddi,onalriskfactors,suchassmoking(whichincreasesrisksubstan,ally)andlong-con,nueduseofthepill,especiallyinwomenover35yearsofage.

Problems-Individualised

•  Individualwomenwillresponddifferently,fordifferentreasons:–  Nutrientstatus–  Liver–  Alcoholintake–  Othermeds–  Stress–  Othertoxici,es

•  …etc.

Thebiggestproblem

•  Forme,themainproblemisthatwomenarenotproperlyeducated.–  It’snotjustabouttakingthepill,it’saboutcomingoffitaswell.

–  TheHPGaxiscantakealongPmetoresetwhenthepillisstopped,whichhasimplicaPonsnotonlyforsymptoms,butforferPlityaswell.

“Weareswimminginaseaof

estrogen!”

Estrogendominance

•  Thepillblocksovula,on–  Noprogesteroneisproduced–  Estrogendominancecandevelop

•  Bloa,ng,waterreten,on,weightgain,moodswings,etc.

•  EvenwhennaturalestrogenproducPoniscompromisedbythepill’seffectonthehypothalamus

Synthe0chormones

•  Synthe,chormonesdonotperformexactlythesamefunc,onsasnaturally-producedfemalehormones

•  Themoleculeshavesubtledifferences•  Sotheycanbepatented!

•  Naturalprogesteronepromotespregnancy;synthePcprogesPnusedinthemorningaferpillpreventspregnancy(Dr.KentHoltorf)

Hormonedetoxifica0on

•  Liverfunc,onisveryimportant:–  TheCYPenzymesmustbefunc,oningwell–  CYP1A1,CYP1B1,CYP3A4,COMT,SULT…

•  OtherxenoestrogenscancausefurtherEoverload:–  PUFA(esp.flax),soy(possibly)–  Alcohol:

•  IncreasesCYP19(aromatase),whichconvertsandrostenedioneandtestosteroneintoestrogens

–  BPA,pthalates,pes,cides,etc.

Hormoneelimina0on(estrogen)

•  Gutdysbiosiscanincreasebetaglucuronidaselevel:–  E.coli,Bacteroides,Clostridia,Staphylococcus–  …possiblyothers(Eubacterium,Peptostreptococcus,Ruminococcus)

•  Theenzymecleavesestrogen,causingittobereabsorbedintoentero-hepa,ccircula,on

•  Highlevelsareassociatedwithcolon,breastandprostatecancer(notiden,fiedascauseandeffectyet,asfarasIamaware)

Nutrientdeple0oncausedbythepill

•  Goingbacktothe1970’sitwasknownthatthepillcandepletethesenutrients:–  VitaminB2–  VitaminB6–  Folate(B9)–  VitaminB12–  VitaminC–  Zinc

•  Seeyourresources

Nutrientdeple0oncausedbythepill

•  B2,B6,B9,B12andzincareallmassivelyimportantforthemethyla,onandfolatecycles

•  TheyarethesubstratesandcofactorsfortheMTHFR,MTR/MTRRcomplex,andBHMTenzymes

•  Poormethyla,onandfolatecyclefunc,oningleadstofer,lityissuesandbirthdefects–  Arewomeneverwarnedaboutthis?

Trytogetacopy…

•  TheBi<erPill–Dr.EllenGrant,M.D.–  Afascina,ngexplora,onofhowthepillwasdevelopedintheUK,alongwiththedisturbingside-effectsthatcame–ands,llcome–alongwithit.

Summary

•  Usedforcontracep,onandcycleregula,on•  Effec,veforcontracep,on•  Helpsregulatethecycleandbenefitssomewomen•  ScramblesHPGaxis•  Preventsovula,on•  Createsanar,ficialhormonebalance(imbalance)•  Progesteronecannotoffsetestrogens•  Cancauseproblemsduringorafercessa,on•  MayincreaseriskforCVD,clohngandcancer•  Effectswillbeindividualised•  ThereisliRle-to-noeduca,on

Thanksandnextup

•  Thanksforwatchingorlistening.Nextup,we’lllookattheotherchemicalcontracep,ves–thepatch,pillandhormonecoil.

hRps://en.wikipedia.org/wiki/

Estradiol

hRp://journal.fron,ersin.org/ar,cle/10.3389/fendo.

2014.00192/full

hRp://www.medscape.com/viewar,cle/523196_3

hRps://en.wikipedia.org/wiki/

Estradiol

hRps://www.researchgate.net/figure/7360494_fig1_The-estradiol-metabolic-pathway-Estradiol-is-synthesized-from-cholesterol-in-a-series-of

hRp://catsfork.com/Health-Metabolism/

Hormones-Female.html

hRps://clinicalgate.com/adrenal-exhaus,on/

MyTopResources

•  I’vereaddozensofbooksabout“hormonebalance”inmy,meands,llhavefewontheshelfthathaveasyetgoneunopened.

•  Onthefollowingpagesyou’llfindmytopthreeorfourpicks.

•  I’veprovidedplentyofvideosandar,clesinyourresourcessec,on,aswell.

MyTopResources

•  NaturalHormoneBalanceMadeSimple–JohnLee,M.D.–  Oneofthepioneersinthefieldofprogesteronetherapy,thisbooksummarizesDr.Lee’sworknicely.

–  Dr.KalishlearnedagreatdealfromDr.Lee.

MyTopResources

•  TheNaturalSuperwomanbyUzziReiss,OBGYN.–  Quitesimplyabrilliantbookwhenitcomestohormoneeduca,on;Dr.Reisshasbeenhelpingwomenbalancetheirhormonesformorethanthirtyyears.

MyTopResources

•  StayYoungandSexywithBioidenPcalHormoneReplacement–JonathanWright,M.D.–  Dr.Wrightwastheguywhoeffec,velybroughtbioiden,calsintoprac,ce.Thisbookcarriesawealthofscien,ficevidencesuppor,nghormonetherapy.

MyTopResources

•  DiscoverYourMenopauseTypebyJosephCollins,N.D.–  Thisisasuperbbookthatbreaksmenopausesymptomsdownintodifferenttypesandtreatments.

MyTopResources

•  TheBi<erPill–Dr.EllenGrant,M.D.–  Afascina,ngexplora,onofhowthepillwasdevelopedintheUK,alongwiththedisturbingside-effectsthatcame–ands,llcome–alongwithit.

MyTopResources

•  Menopause–ASpiritualRenaissance–HeleneB.Leoneh,M.D.–  LovelybookbyaladyI’vehadthefortunetointerview.

MyTopResources

•  BHRTWorldSummit–Various;hostedbyJoelYaffa,M.D.:–  Excellentsummitwithopinionsfromvariousleadingexperts.Givesagoodspreadofopinion.

MyTopResources

•  Therearesomeothersuperbresources,andI’llmen,onthemaswegoalongaswellaslis,ngthemonaresourcesheetforyou.

ThankYou!

•  Thanksamillion!Inthenextlessonwe’lllookatthespecifichormonesinvolvedinthemenstrualcyclesowecanthendiveintowhatcangowrong.