National Post (National Edition)
‘Post-birth control syndrome’ isn’t a real thing, doctors say
Doctors are calling out the latest unsubstantiated health advice aimed at women — naturopaths claiming they can “recover” women from “postbirth control syndrome,” and Gwyneth Paltrow’s new “Madame Ovary” dietary supplement for menopause.
According to U.S. naturopath Jolene Brighten — a self-described leading expert on post-birth control syndrome and host of an “awareness week” featuring Canadian naturopaths and chiropractors — the phenomenon arises within the first four to six months after going off the pill, the patch or other hormonal options, “and can be as drastic as total loss of your period.” Women can also experience symptoms such as hair loss, libido loss, insomnia, leaky gut, heavy periods, painful periods or irregular or nonexistent ones, Brighten says, adding that the syndrome is “100 per cent reversible,” given the right diet, lifestyle and supplement therapy.
However, according to Dr. Dustin Costescu, an assistant professor and family planning specialist at Mcmaster University, there is “absolutely no evidence” for post-birth control syndrome, post-amenorrhea (when a woman’s period doesn’t come back after stopping the pill) “or any long-term consequences related to reproduction and birth control use.”
Still, the Ontario doctor says he’s sympathetic to women.
“I think that symposia like this highlight the fact that in general, women are not given access to (credible) information about their bodies and what’s normal and not normal,” Costescu said.
“You can see where the demand comes from, which is people trying to understand their bodies, trying to get accurate information, trying to get better and perhaps dissatisfaction with the status quo .... We know in gynecology that women often suffer for months if not years for conditions like endometriosis because women are not believed about their symptoms.”
But the post-pill “detoxes” and hippy Goop advice frustrate doctors.
In an interview, Brighten admitted that post-birth control syndrome isn’t a recognized medical diagnosis,
nor is there any research to support it, “although there is plenty of research to support all of the symptoms” that go along with it.
“We’re flooded with comments right now” from women who came off the pill who lost their period and stopped ovulating, Brighten said. “There are other
women who had clear skin — they never had acne until they discontinued hormonal birth control. And now they have things like cystic acne.”
But doctors say these “post-pill” symptoms may just be a woman’s natural state — conditions for which the pill may have been prescribed in the first place.
Stop taking it, and the symptoms return. That’s not a syndrome, they say.
“I don’t think what people realize is that when you stop your hormonal contraception, you are what you would be without it,” said Dr. Amanda Black, a professor of obstetrics and gynecology at the University of Ottawa.
“Within a week, most of them have left the system and you’re back to your baseline... And your baseline might be that you don’t have regular periods or you don’t have periods at all, or you do have problems with acne.”
While there are some risks associated with using hormonal birth control — including blood clots, heart attacks and stroke — they are rare.
“Scaring women is completely antithetical to the goal of furthering and improving the lives of women and their families,” Costescu said.
Brighten said she is “proinformed consent” and insisted “we are not scaring women off birth control whatsoever. We have lots of classes that are just for women who want to remain on hormonal birth control.”
Costescu said some women do experience side effects when they come off hormonal birth control, like pre-menstrual syndrome. But side effects usually abate within a month, “because by then the body will resume its normal cycling again — that is, releasing an egg and having a period thereafter.”
For her part, Paltrow says Goop’s Madame Ovary, which costs US$90 for a month’s supply, is intended for women right before, during and after menopause and is designed to provide support for the thyroid, as well as things like mild hot flashes, mood shifts and fatigue. Inside every daily packet is a multivitamin with phytonutrients, omega-3 fish oils and herbs like black cohosh, a natural estrogen.
The problem with a natural estrogen is that it stimulates the lining of the uterus, and without progestin it could grow unopposed.
“Yes, it helps treat your hot flashes if you’re perimenopausal, but at the risk of potentially giving you endometrial cancer,” Black said. “There’s always a concern when people are using naturopathic things that aren’t regulated, aren’t tested.”
But she, too, gets the frustration women might be feeling. For example, with birth control, myths and misperceptions prevail, not just among women, but healthcare providers.
“I give lectures at huge conferences to dispel myths about contraception,” Black said. For example, hormonal birth control doesn’t cause weight gain, you don’t have to take a break from the pill to reset your biological clock, you don’t have to give birth before you can get an IUD implanted and you don’t need to wait until your next period to start on birth control.
“There are a lot of things that we as health-care providers say and do that create barriers to access. And we perpetuate some of those myths that are out there.”