Fact: Unfortunately, it does not. What is more, you will not have a natural menstrual cycle at all. By supplying a woman’s body with synthetic hormones, certain areas of the brain responsible for stimulating the production of natural hormones are “tricked.” The woman’s body is put into a kind of dormant state, and instead of the natural hormonal balance a so-called “hormonal prosthesis” is introduced – synthetic hormones.

When using hormonal contraception, the natural hormonal and menstrual cycle is replaced by an artificial cycle, dependent on the dose and composition of the pills taken. The bleeding that occurs while using hormonal contraception is not a true menstrual period. It is caused by withdrawal from the pills or removal of the patch and the resulting drop in hormone levels. Its regularity therefore depends on the number of pills in a blister pack and has nothing to do with regulating the natural cycle. On the contrary, after stopping this “treatment”, cycles are often just as irregular – or even more irregular – than before.

With intrauterine devices commonly called “coils”, bleeding often occurs irregularly and is difficult to predict (the so-called unpredictable bleeding profile associated with hormonal inserts). It is frequently heavier or prolonged (persistent spotting). Additional bleeding can also occur with oral contraceptives – often as so-called breakthrough bleeding – caused by shedding of the thickened upper layer of the uterine lining. In some women, hormonal contraception does not completely block ovulation; ovarian follicles continue to grow and produce estrogen, leading to proliferation of the endometrium, which then sheds under the atrophying effect of the progestogen contained in the pill.

The situation is even more problematic with injectable contraception, because the body receives such a large dose of synthetic hormones that the natural hormonal system can be suppressed for several months or even longer, and the effects of such an injection may be felt for years. The return of fertility in this case is a lengthy process and often requires additional treatment.

Fact: Hormonal contraception is indeed quite effective at preventing pregnancy – depending on the method, the Pearl Index (the number of pregnancies per 100 women per year) ranges from 0.2 to 4.0 [1]. However, none of these methods is 100% effective:

• combined oral contraceptives: PI from 0.2 to 3.0;
• progestin-only pills: PI from 0.3 to 4.0 (with a potential anti-implantation effect on the embryo!);
• contraceptive patches: PI from 0.2 to 0.8;
• hormonal intrauterine devices (IUDs): PI from 0.6 to 0.8 (also with a possible anti-implantation effect!);
• hormonal implants and injections: PI from 0.3 to 1.0 (again with a possible anti-implantation effect; the index increases toward the end of their duration of action!).

Barrier methods alone have a much less encouraging Pearl Index, ranging from 3.0 to 15.0 (!).

The synthetic hormones contained in contraceptives are intended to block the secretion of a woman’s natural hormones and thus inhibit ovulation and follicular development, slow down tubal transport, prevent proper development of the uterine lining, and alter the properties of cervical mucus – all in order to prevent fertilization or the implantation of a fertilized egg in the uterus.

However, it has recently been widely discussed that ovulation can still occur despite the regular use of contraceptive pills. According to Grimes, Godwin, and Rubin [2], ovulation may occur in about 5% of users of combined oral contraceptives and in as many as 40% of users of progestin‑only (so‑called low‑dose) pills. This means that fertilization can indeed take place, while other mechanisms of hormonal contraception then prevent the further development of pregnancy.

Are there natural methods that are as effective as the most effective hormonal pills? Yes! Multi-indicator fertility awareness methods (such as the Rötzer method) have an excellent Pearl Index (≤ 0.2), and even with typical user error it is around 1.6. Studies conducted in 2007 by researchers from the Department of Gynecological Endocrinology and Fertility Disorders at Heidelberg University [3] confirmed over 99% effectiveness of multi-indicator methods (PI = 0.4). At the same time, natural fertility awareness methods are completely safe for health, do not interfere with the natural hormonal cycle, and have no side effects.

Unfortunately, it cannot be said that hormonal contraception is the safest method of preventing pregnancy – quite the opposite. Hormonal contraception poses significant health risks.

It increases the risk of cervical cancer, breast cancer, venous thromboembolism, pulmonary embolism, liver tumors, pancreatitis, and hypertension (these risks are openly listed in manufacturers’ information leaflets).

According to the package inserts of various hormonal contraceptives, very common side effects (affecting 1 or more in 10 users) include: abdominal pain, menstrual disorders, nausea, vomiting, fatigue, headaches and dizziness, breast tenderness, painful and heavy bleeding, and mood changes. Less common effects (1 or more in 100) include: depression, anxiety symptoms, decreased libido, visual disturbances, insomnia, hot flashes, diarrhea or constipation, acne, rash, frequent urination, genital pain, abnormal vaginal discharge, and appetite changes. Rare effects (1 or more in 1,000) include: hypertension, thrombosis with embolism, concentration problems, drowsiness, dizziness, swelling of the sinuses, nosebleeds, gastroesophageal reflux, kidney stones, kidney pain, changes in urine color, rupture of ovarian cysts, infections and inflammation, fever, chills, erythema or melasma, tooth pain, inner ear disorders, breast discharge, and dehydration.

Is this what we can really call safety?

Fact: Perhaps for many people today, especially young people, contraception is associated with freedom. But is this really so in practice? Based on the accounts of women who use contraception and their partners, who often come to me with doubts, I must say that it certainly is not.

Contraception often means fear of one’s own decisions and actions, and an unwillingness to take responsibility for them. It can be difficult to accept that sexual intercourse is intrinsically linked to its procreative function.

Who uses hormonal contraception?

Unfortunately, among very young people, an increasingly common motive for using the “benefits” theoretically associated with contraception is the progressive change in social norms, a complete lack of a sense of responsibility, the trivialization of relationships between women and men, an inability to commit, the separation of sex from love, and the reduction of sex to a purely physiological need. How can one even think about the possibility of pregnancy if one only wants “to have some fun”, “to try what making love is like”, “to feel good for a moment”, “to boost one’s self-esteem”, “to relax”, “to have an adventure”, or “to satisfy one’s needs”, etc. (authentic quotations from online statements). One can only wonder how such an approach relates to the spread of HIV and other sexually transmitted diseases.

Another group using contraception consists of today’s thirty-somethings – often single, focused on their careers, with little time for emotional commitment or planning a family. An unintended child would mean several years of giving up professional advancement and possibly irreparable losses on the job market. To avoid pregnancy, they therefore reach for every possible method, even if this may one day result in permanent infertility.

For me, the saddest group using synthetic hormones are women aged 45 and over, who no longer plan to have children but lack the motivation to seek healthier and safer methods of preventing pregnancy. Many of them are already experiencing the first symptoms of the perimenopausal period, and the only form of help offered by doctors is artificial hormones in the form of contraception.

Doubts of women using hormonal contraception:

Many women who use hormonal contraception in the form of pills, patches, rings, intrauterine devices, implants, or injections do not feel this supposed “freedom” at all. On the contrary, they increasingly feel dependent on these methods, fear their failure and their harmful effects on health, and worry about their possible impact on a child who might be conceived despite their use. Not infrequently, they also harbor resentment toward their partner or husband, because the entire responsibility for “protection,” remembering about contraception, and bearing the health consequences rests on them. Added to this is the fear of what will happen if contraception fails. Where, then, is the “joy of sex” and the “sense of freedom”?

It is encouraging that something is also beginning to change in men’s awareness. An increasing number of men read package leaflets, take an interest in the subject, and are aware of the side effects of hormonal contraception. After all, frequent bleeding and spotting, headaches, abdominal pain, irritability, depressive states, drowsiness, or nausea in their partner also affect them.

Constant doubts and anxiety in both women and men are related to:

• uncertainty about substances (herbs, juices, weight-loss products) that may weaken the effectiveness and absorption of contraception;
• uncertainty about taking medications for illness or colds that may reduce contraceptive effectiveness;
• absorption problems due to digestive disorders, diarrhea, or vomiting, for example during travel or after alcohol consumption;
• missed or delayed doses, late application or accidental detachment of patches, problems with inserting or replacing vaginal rings, irregular pill-taking, and the resulting need for additional hormone doses or backup contraception.

Additional consequences of a lifestyle based on contraception include:

• decreased libido and loss of interest in sex;
• growing distrust toward one’s partner;
• so-called “abortion-minded” thinking;
• routine and boredom in sexual relations, with a constant search for new sensations and experiences;
• a demanding and selfish attitude.

Fact: Not necessarily. Even the information leaflets of contraceptive products warn that one should wait at least three months before trying to conceive, and preferably six. Ovulation may indeed return quite soon after stopping the pill or patches – sometimes as early as the first cycle, though often only after a markedly prolonged estrogen phase (the so‑called repeated attempts at ovulation). However, the mere return of ovulation does not mean that everything has returned to normal. The most common consequence of long-term use of hormonal contraception is so-called luteal phase deficiency, i.e. insufficient production of natural progesterone. This makes conception more difficult and is a major cause of early and recurrent miscarriages, preterm birth, and problems with carrying a pregnancy to term. In such cases, close cooperation with a physician and appropriate treatment are necessary.

Time is also needed for the uterus to regenerate after the use of intrauterine devices. It should be remembered that IUDs are not recommended for women who have never given birth, because of the risk of damage to the uterine wall caused by the device.

In the case of hormonal injections (so-called “pregnancy shots”), the return of fertility may take even several years, and additional treatment is often required.

Fact: According to Dr. Maciej Barczentewicz, a specialist in obstetrics and gynecology, “using contraceptives as treatment proves that the doctor does not know how to treat in any other way (…) Such management does not remove the cause, but only masks the symptoms” [4].

A similar view is expressed by Prof. Bogdan Chazan, MD, PhD, who states: “Contraceptives are overused, not only for contraception but also in the 'treatment' of various gynecological conditions (…) This creates the desired impression for the doctor that he is treating the disease, and the patient feels better. But I emphasize that the disease is not actually being treated – it is only symptomatic management, and side effects of contraceptives appear as well” [5].

By administering hormonal contraceptives, the natural functioning of the hypothalamic–pituitary–ovarian axis is suppressed, and thus the cyclic activity of the ovaries and the endometrium in the uterus ceases. The true cause of the complaints usually remains undiagnosed, while the symptoms it produces are merely suppressed by switching off the cycle and the natural hormonal balance.

Effective treatment – including hormonal therapy – should be tailored to the individual woman’s menstrual cycle. This means that exactly those hormones that are lacking should be given, and precisely at the time when they are lacking [4].

Fact: Hmm… There are no scientific studies that confirm this! On the contrary, almost every leaflet of hormonal contraceptives mentions the possible occurrence of acne and skin changes as side effects. Despite this, many gynecologists prescribe contraceptive pills for this very purpose – and sometimes they do seem to work… but what happens when we want to stop taking them? We can never be sure how a given preparation will affect us; often a doctor selects a product by “trial and error,” observing how successive pills work in a particular patient. Some women also report breast enlargement while taking contraceptive pills. And here, too, the leaflet provides a clue under “side effects”: “increased breast swelling and tenderness”. This idea of “speeding up adulthood” already appeals to 12-13-year-old girls. We should also think about our future and remember the increased risk, for example, of breast cancer associated with the use of hormonal contraception.

Hormonal contraceptives are not vitamins! By taking them, regardless of the form, we primarily affect the highest centers of our brain, and this influences not only our fertility but also our entire organism.

Fact: The first contraceptive pills were developed at roughly the same time and based on the same scientific discoveries as… fertility awareness methods.

Both are easy to use and do not require great effort; choosing either of them is a matter of lifestyle, worldview, personal responsibility, and self-acceptance.

One option involves dealing with more or less troublesome side effects, awareness of potential harm to health, and reliance on a substance or device. The other requires effort in acquiring knowledge, systematic observation of one’s own body, making one’s own decisions, and trusting oneself.

In the first case, the woman bears the main responsibility for their use and for remembering to take, apply, or replace them regularly, and she also carries most of the anxiety about the consequences if they fail. In the case of natural methods, cooperation between the woman and the man is necessary, and the consequences of decisions belong to both partners.

Modern contraception today should not be harmful to health, should not interfere with the human body, should not be unnatural, and certainly should not cause side effects (bleeding, spotting, pain, nausea, swelling, reduced libido, depression) or even a shadow of risk of life-threatening diseases.

Today, “modern” should mean convenient, painless, healthy, natural, and safe – something that allows independent thinking and personal freedom of choice. A modern woman is someone who knows her body well, is aware of her femininity, confident, capable of making decisions, and attentive to her own well‑being and health. Being modern also means thinking about the future.

Based on:

[1] Prof. J. Guillebaud, "Contraception – questions and answers", Medycyna Praktyczna, 2nd ed., Kraków 2005.

[2] D.A. Grimes, A.J. Godwin, A. Rubin, “Ovulation and follicular development associated with the low-dose oral contraceptives: a randomized controlled trial”, Obstetrics and Gynecology, No. 83, 1994, pp. 29–34.

[3] P. Frank-Herrmann et al., “The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study”, Human Reproduction, Vol. 22, No. 5, pp. 1310–1319.

[4] “Tailor-made therapy”, interview by E.M. Prokop with M. Barczentewicz, IMAGO No. 8–9 (3–4/2012), p. 12.

[5] Lecture by Prof. B. Chazan, “Natural Family Planning in Contemporary Medicine”, Symposium “Natural Family Planning or Contraception,” Kraków 2011.