Correlation Between Contraceptive Pills and Hormone Imbalance

Eberi Uchenna Precious LASCOHET/PUBTECH/2022/024
LAGOS STATE COLLEGE OF HEALTH

TECHNOLOGY
DEPARTMENT: PUBLIC HEALTH TECHNOLOGY
COURSE: RESEARCH METHODOLOGY
COURSE CODE: GNS 218
GROUP NAMEs:
1. Eberi Uchenna Precious Lascohet/pubtech/2022/024
2. Abraham Florence Oluwapelumi. Lascohet/pubtech/2022/013
3. Aremu Waliyat Arike Lascohet/pubtech/2022/012
4. Adeoye Oluwadamilola Ganiyat Lascohet/pubtech/2022/002
5. Adegbite Rofiat Omotoyosi Lascohet/pubtech/2022/007
CLASS: 200L
LECTURER NAME: SAN OSHO S. A
TOPIC: CORRELATION BETWEEN

CONTRACEPTIVE PILLS AND
HORMONE IMBALANCE
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Table of Content
Introduction---------------------------------------------------------------------------------------------------------2-3
Mechanism of Action ----------------------------------------------------------------------------------4-5
Hormonal Changes and Balance ---------------------------------------------------------------------5-6
Side Effects and Hormonal Influences --------------------------------------------------------------7-8
Mood Changes -------------------------------------------------------------------------------------------9-10
Menstrual Changes-------------------------------------------------------------------------------------10-11
Regularization of Menstrual Cycle-----------------------------------------------------------------10-12
Individual Variations----------------------------------------------------------------------------------13-14
Health Considerations--------------------------------------------------------------------------------15-16
Consultation with Healthcare Professionals ----------------------------------------------------17-18
Long-Term Effects--------------------------------------------------------------------------------------18-19
Discontinuation and Hormonal Recovery--------------------------------------------------------20 -22
Reference-------------------------------------------------------------------------------------------------23--61
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Correlation between contraceptive pills and hormone imbalance

Introduction
Hormonal Components: Contraceptive pills contain synthetic hormones, typically estrogen and
progestin, which mimic the hormones naturally produced by the ovaries.
Mechanism of Action: These hormones work by suppressing ovulation, thickening cervical mucus,
and altering the endometrial lining, preventing pregnancy.
Hormone Imbalance and Contraceptive Pills:
Stabilizing Hormone Levels: Contraceptive pills are designed to create a stable hormonal
environment, preventing the natural hormonal fluctuations that occur during the menstrual cycle.
Potential for Hormone Imbalance: Prolonged use of contraceptive pills may, in some cases, lead to
hormonal imbalances when individuals discontinue the pills.
Menstrual Regulation:
Regular Menstrual Cycles: Contraceptive pills provide regular and predictable menstrual cycles by
suppressing ovulation and maintaining a consistent hormonal environment.
Potential Adjustment Period: Upon discontinuation, individuals may experience an adjustment

period as their bodies’ transition to the resumption of natural hormonal cycling.
Post-Pill Amenorrhea:
Temporary Absence of Menstruation: Some individuals may experience a temporary absence of

menstruation, known as post-pill amenorrhea, after discontinuing contraceptive pills.
Hormonal Rebalancing: This phenomenon is typically a result of the time it takes for the body to
rebalance hormone levels and resume normal menstrual function.
Ovulation and Hormonal Fluctuations:
Return to Ovulation: Discontinuation of contraceptive pills allows the resumption of ovulation,

leading to natural hormonal fluctuations.
Individual Variations: The time it takes for ovulation to resume varies among individuals, and
hormonal fluctuations during this period can contribute to a perceived imbalance.
Non-Contraceptive Benefits:
Management of Hormone-Related Conditions: Contraceptive pills are sometimes prescribed for non-
contraceptive benefits, such as managing conditions like acne, menstrual disorders, or polycystic
ovary syndrome (PCOS).
Continuation of Benefits: Individuals discontinuing pills for non-contraceptive benefits may continue
to experience the management of these conditions, as long as the underlying hormonal issues
persist.
Individual Responses:
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Varied Responses to Hormonal Changes: Individual responses to the discontinuation of

contraceptive pills can vary widely. Some individuals may experience a smooth transition, while
others may perceive changes in mood, energy, or other aspects.
Adjustment Period: It's common for individuals to go through an adjustment period as the body
adapts to the natural hormonal fluctuations.
Contraceptive Counselling:
Guidance on Hormonal Changes: Healthcare providers offer guidance and counselling on the
potential hormonal changes associated with discontinuing contraceptive pills.
Addressing Concerns: Individuals are encouraged to communicate any concerns or perceived

imbalances, and healthcare providers can offer support and address specific issues.
Health Monitoring:
Regular Check-ups: Regular health check-ups with healthcare providers allow for monitoring
hormonal changes, assessing any emerging health concerns, and making adjustments as needed.
Individualized Care: Healthcare providers offer individualized care based on factors such as health
history, reproductive goals, and the specific reasons for discontinuation.
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Mechanism of Action
Combined Oral Contraceptives (COCs): These pills contain synthetic estrogen (ethinyl estradiol) and a
synthetic progestin. They primarily prevent pregnancy by inhibiting ovulation, thickening cervical
mucus to impede sperm penetration, and altering the endometrial lining to reduce the likelihood of
implantation.
Progestin-Only Pills (POPs): Also known as mini-pills, they contain only a synthetic progestin. POPs
primarily work by thickening cervical mucus, making it more difficult for sperm to reach the egg.
The mechanism of action of contraceptive pills depends on whether they are combined oral
contraceptives (COCs) or progestin-only pills (POPs).
Combined Oral Contraceptives (COCs):
1. Suppression of Ovulation:
 The primary mechanism of COCs is the suppression of ovulation, preventing the release of
an egg from the ovary.
 Estrogen and progestin in COCs work together to inhibit the release of gonadotropins
(hormones that stimulate the ovaries), which, in turn, prevents the maturation and release
of an egg.
2. Changes in Cervical Mucus:
 COCs alter the cervical mucus, making it thicker and more hostile to sperm penetration.
 The thickened cervical mucus hinders the movement of sperm through the cervix and into
the uterus.
3. Changes in the Endometrium:
 COCs alter the endometrial lining, making it less receptive to a fertilized egg.
 If fertilization occurs, the altered endometrium makes it less likely for the fertilized egg to
implant successfully.
4. Inhibition of Sperm Function:
 The hormonal components of COCs may also affect sperm function, inhibiting their ability to
reach and fertilize an egg.
Progestin-Only Pills (POPs):
1. Thickening of Cervical Mucus:
 POPs primarily work by thickening the cervical mucus.
 The thickened cervical mucus acts as a barrier, making it more difficult for sperm to move
through the cervix and reach the egg.
2. Alterations in the Endometrium:
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 POPs may also induce changes in the endometrial lining, making it less receptive to a
fertilized egg.
3. Inhibition of Ovulation (Variable):
 While POPs are designed to primarily inhibit ovulation, they may not consistently suppress
ovulation in all cycles.
 In some women, POPs may prevent ovulation, while in others, they primarily act by
thickening cervical mucus.
Considerations:
1. Consistent Use is Crucial:
 For both COCs and POPs, consistent and correct use is crucial for effectiveness.
2. Immediate Protection:
 COCs and POPs provide immediate protection against pregnancy if started correctly.
However, it is recommended to use additional contraception methods for the first
seven days when initiating the pill.
3. Individual Variability:
 The efficacy of contraceptive pills can vary between individuals, and factors such as
missing pills or taking them at irregular times can affect their effectiveness.
4. Other Non-Contraceptive Benefits:
 Contraceptive pills, especially COCs, are sometimes prescribed for reasons beyond
contraception, such as managing menstrual disorders, acne, and symptoms of
polycystic ovary syndrome (PCOS).
It's important for individuals to discuss their health history, preferences, and any concerns with
healthcare professionals when considering contraceptive options. Healthcare providers can guide
individuals in selecting the most appropriate type of contraceptive pill based on individual needs and
health considerations. Regular follow-ups with healthcare providers are recommended to monitor
and adjust contraceptive methods as needed.
Hormonal Changes and Balance

Estrogen and Progestin Levels: COCs typically contain a combination of estrogen and progestin, and
they aim to maintain hormonal balance by providing a steady level of hormones throughout the
menstrual cycle. POPs, being progestin-only, have a more localized effect on cervical mucus and a
more variable impact on ovulation.
a. Estrogen and Progestin Levels:
 Combined Oral Contraceptives (COCs):
 Estrogen Component: COCs typically contain synthetic estrogen, often ethinyl

estradiol. The estrogen component helps regulate the menstrual cycle and stabilize
hormonal fluctuations.
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 Progestin Component: The progestin component provides contraceptive

effectiveness by inhibiting ovulation and influencing cervical mucus.
 Progestin-Only Pills (POPs):
 Progestin as the Sole Hormone: POPs contain only a synthetic progestin. Progestin
levels remain more consistent throughout the menstrual cycle.
 Impact on Menstrual Cycle: POPs provide contraceptive efficacy primarily by

thickening cervical mucus and, to a lesser extent, inhibiting ovulation.
b. Steady Hormone Levels:
 COCs: By providing a steady level of synthetic hormones throughout the menstrual cycle,
COCs help regulate hormonal fluctuations.
 POPs: While POPs do not consistently suppress ovulation in every cycle, they contribute to a
more stable hormonal environment compared to the natural menstrual cycle.
c. Feedback Mechanisms:
 COCs: The synthetic estrogen and progestin in COCs exert negative feedback on the pituitary
gland. This suppresses the release of gonadotropins (FSH and LH), leading to inhibition of
follicular development and ovulation.
 POPs: Progestin in POPs similarly exerts feedback on the pituitary, primarily inhibiting the
release of LH, which is crucial for ovulation.
d. Impact on Hormone-Related Symptoms:
 COCs: The steady hormonal levels in COCs can help alleviate hormone-related symptoms,
such as menstrual cramps, PMS (premenstrual syndrome), and acne.
 POPs: Some individuals may experience fewer hormonal fluctuations on POPs, potentially
leading to a reduction in hormone-related symptoms.
e. Continuous Hormone Delivery (Extended Regimens):
 COCs: Extended or continuous regimens involve skipping the placebo pills, resulting in a
more continuous hormone delivery. This can minimize hormonal fluctuations and reduce the
frequency of withdrawal bleeding.
 POPs: POPs are taken continuously without a break. This continuous hormone delivery
contributes to a more stable hormonal environment.
f. Individual Variability:
 Response to Hormones: Individual responses to hormonal contraceptives can vary. Some

individuals may experience side effects or changes in mood, while others may not notice
significant differences.
g. Return to Fertility after Discontinuation:
 COCs and POPs: Fertility generally returns promptly after discontinuing contraceptive pills.
The body resumes its natural hormonal fluctuations, and the menstrual cycle typically
normalizes.
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h. Monitoring and Adjustments:
 Healthcare Professional's Role: Healthcare providers monitor individuals using contraceptive

pills and may make adjustments based on individual responses, health considerations, and
any side effects.
Understanding the hormonal changes induced by contraceptive pills is essential for individuals
considering these methods. It emphasizes the importance of consulting with healthcare
professionals to find the most suitable contraceptive option based on individual health, preferences,
and lifestyle. Regular communication with healthcare providers allows for ongoing monitoring and
adjustments as needed.
Side Effects and Hormonal Influences

a. Mood Changes:
COCs: Some individuals may experience mood swings or changes in mood due to hormonal
fluctuations, especially during the hormone-free interval (placebo week) when estrogen levels drop.
POPs: Progestin-only pills, which provide a more consistent hormonal environment, may have a
lower likelihood of causing mood swings.
b. Breast Tenderness:
COCs: Breast tenderness can occur as a side effect of the hormonal changes in COCs, particularly in
response to the synthetic estrogen component.
POPs: Progestin-only pills may have a milder impact on breast tenderness since they lack the
estrogen component.
c. Nausea:
Common Initial Side Effect: Nausea is a common side effect, especially when starting a new type of
contraceptive pill. It often improves with continued use as the body adjusts to the hormones.
Reduced Nausea in POPs: Progestin-only pills, with a more stable hormonal profile, may be
associated with reduced nausea compared to combined pills.
d. Changes in Libido:
COCs: Changes in libido can occur as a result of hormonal fluctuations, but the impact can vary
among individuals.
POPs: Progestin-only pills, with a more steady hormonal profile, may have a lesser impact on libido.
e. Menstrual Changes:
COCs: While COCs aim to regulate the menstrual cycle, some individuals may experience
breakthrough bleeding or spotting, especially during the initial months of use or if pills are missed.
POPs: Progestin-only pills can lead to changes in menstrual bleeding patterns, including irregular
bleeding or amenorrhea (absence of menstruation).
f. Individual Variability:
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Body Response: Individual responses to hormonal contraceptives can vary. Some individuals may
tolerate hormonal changes well, while others may experience side effects.
Switching Pills: If side effects are problematic, switching to a different formulation or type of
contraceptive pill may be considered.
g. Non-Contraceptive Benefits:
COCs: Beyond contraception, combined pills are sometimes prescribed to address non-contraceptive
issues such as acne, menstrual disorders, and polycystic ovary syndrome (PCOS).
POPs: Progestin-only pills may be preferred for individuals sensitive to estrogen or for those with
contraindications to estrogen-containing contraceptives.
h. Health Monitoring:
Regular Check-ups: Healthcare providers monitor individuals using contraceptive pills, assessing side
effects, and ensuring overall health.
Communication with Healthcare Provider: Open communication with healthcare providers is crucial
to address any concerns, side effects, or changes in health status.
i. Impact on Bone Health:
Ongoing Research: Some studies have explored the potential impact of long-term contraceptive pill
use, especially those containing estrogen, on bone health. Ongoing research is conducted to
establish definitive conclusions.
Understanding the potential side effects and hormonal influences of contraceptive pills is essential
for informed decision-making. Healthcare providers play a central role in guiding individuals through
the selection of the most suitable contraceptive method, considering individual health factors and
preferences. Regular check-ups and communication with healthcare providers ensure ongoing
monitoring and adjustments as needed.
Mood Changes
Some individuals may experience mood swings or changes in mood.
a) Combined Oral Contraceptives (COCs):
b) Estrogen Influence: COCs, which contain synthetic estrogen (ethinyl estradiol), can influence
mood. Estrogen has been associated with neurotransmitter regulation, including serotonin
and dopamine, which play roles in mood.
c) Hormone-Free Interval: Mood changes are more commonly reported during the hormone-
free interval (placebo week) when estrogen levels drop. Some individuals may experience
mood swings, irritability, or mild depressive symptoms during this time.
d) Progestin-Only Pills (POPs):
e) Steady Hormonal Levels: POPs, being progestin-only, provide a more consistent hormonal
environment. They may have a lower likelihood of causing mood changes compared to
COCs.
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f) Lack of Estrogen Influence: Since POPs lack the estrogen component, they may have a
reduced impact on mood during the hormone-free interval.
g) Individual Variability:
h) Body Response: Individual responses to hormonal contraceptives vary. While some

individuals may not notice significant mood changes, others may be more sensitive to
hormonal fluctuations.
i) Adjustment Period: Mood changes, if experienced, may occur in the initial months of
starting a new contraceptive pill. This is often a period of adjustment as the body adapts to
the hormonal changes.
j) 4. Addressing Mood Changes:
k) Consultation with Healthcare Provider: If mood changes are significant or bothersome,

individuals are encouraged to discuss these concerns with their healthcare provider.
l) Switching Formulations: Healthcare providers may consider switching to a different

formulation of contraceptive pill, adjusting the hormone dosage, or exploring alternative
contraceptive methods based on individual needs and responses.
m) Non-Contraceptive Benefits:
n) COCs: Beyond contraception, COCs are sometimes prescribed for non-contraceptive

benefits, such as managing symptoms of premenstrual dysphoric disorder (PMDD), which is
characterized by severe mood changes.
o) Individualized Approach: The choice of contraceptive pill may be influenced by non-

contraceptive benefits, and healthcare providers consider individual health factors and
concerns.
p) Monitoring and Open Communication:
q) Healthcare Provider's Role: Regular check-ups with healthcare providers allow for the
monitoring of mood changes and overall well-being.
r) Open Communication: Open communication with healthcare providers is crucial for

addressing any concerns or changes in mood and ensuring that the chosen contraceptive
method aligns with an individual's overall health goals.
s) Lifestyle Factors:
 Additional Factors: Lifestyle factors, stress, and underlying mental health conditions can also
contribute to mood changes. It's important to consider these factors in conjunction with
contraceptive choices.
Understanding the potential impact of contraceptive pills on mood changes underscores the
importance of individualized care and open communication between individuals and healthcare
providers. This ensures that contraceptive methods align with individual health needs and
preferences. If mood changes are a concern, discussing alternatives and exploring different
formulations under the guidance of a healthcare professional is recommended.
Fluctuations associated with contraceptive pills can influence neurotransmitters and, in turn, mood.
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Breast Tenderness: Hormonal changes, particularly the increase in breast tissue sensitivity to
estrogen, can lead to breast tenderness.
Nausea: Nausea is a common side effect, especially during the initial months of starting a new
contraceptive pill. It may be related to the introduction of synthetic hormones.
Changes in Libido: Hormonal fluctuations can impact sexual desire, and some individuals may
experience changes in libido.
Menstrual Changes
a. Combined Oral Contraceptives (COCs):
 Regulation of Menstrual Cycle: COCs are often prescribed to regulate the menstrual cycle. By
suppressing ovulation, they provide a more predictable and consistent menstrual cycle.
 Reduced Menstrual Flow: Some individuals on COCs may experience lighter and shorter
menstrual periods. The hormonal control provided by COCs influences the endometrial
lining.
b. Progestin-Only Pills (POPs):
 Variable Menstrual Effects: POPs may have variable effects on the menstrual cycle. While
they aim to provide contraceptive efficacy through thickened cervical mucus, their impact on
ovulation can vary among individuals.
 Irregular Bleeding: Some individuals on POPs may experience irregular bleeding or spotting,
especially if pills are taken at different times each day.
c. Amenorrhea (Absence of Menstruation):
 COCs and POPs: Both COCs and POPs may lead to amenorrhea (absence of menstruation) in
some individuals. This is not harmful, and the absence of menstruation is often due to the
hormonal control provided by the contraceptive pill.
d. Breakthrough Bleeding:
 COCs and POPs: Breakthrough bleeding or spotting may occur, especially during the initial
months of starting a new contraceptive pill or if pills are missed.
 Consistent Pill Use: Consistent and correct pill use is crucial for minimizing breakthrough
bleeding.
e. Manipulation of Menstrual Timing:
 Extended Regimens: Both COCs and POPs can be used in extended regimens to manipulate
the timing of menstruation. This involves skipping the placebo pills (hormone-free interval)
to reduce the frequency of withdrawal bleeding.
f. Non-Contraceptive Benefits:
 COCs: Beyond contraception, COCs are often prescribed to address non-contraceptive issues,
such as managing menstrual disorders, reducing menstrual cramps, and improving
symptoms of conditions like polycystic ovary syndrome (PCOS).
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 POPs: POPs may be preferred for individuals who are sensitive to estrogen or have
contraindications to estrogen-containing contraceptives.
g. Consultation with Healthcare Provider Health Considerations: Individuals with specific health
considerations, such as irregular menstrual cycles or heavy menstrual bleeding, should discuss these
with healthcare providers to determine the most appropriate contraceptive method.
h. Return to Fertility:
 COCs and POPs: Fertility generally returns promptly after discontinuing contraceptive pills.
The menstrual cycle resumes its natural pattern, and individuals can conceive when ready.
i. Monitoring and Adjustment:
 Regular Check-ups: Regular check-ups with healthcare providers allow for the monitoring of
menstrual changes and overall reproductive health.
 Adjustment as Needed: If menstrual changes are a concern or if irregular bleeding persists,

healthcare providers may consider adjusting the type or formulation of contraceptive pills.
Understanding the potential effects of contraceptive pills on the menstrual cycle is crucial for
individuals making contraceptive choices. Healthcare providers play a central role in guiding
individuals through these choices, considering individual health factors, preferences, and non-
contraceptive benefits. Regular communication with healthcare providers allows for ongoing
monitoring and adjustments as needed.
Regularization of Menstrual Cycle

Regularization of Menstrual Cycle:
a) 1. Combined Oral Contraceptives (COCs):
b) Suppression of Ovulation: COCs primarily work by suppressing ovulation, preventing the

release of an egg from the ovary.
c) Consistent Hormonal Levels: By providing a consistent level of synthetic hormones (estrogen

and progestin) throughout the menstrual cycle, COCs help regulate hormonal fluctuations.
d) Predictable Menstrual Cycle: The absence of ovulation and the consistent hormonal levels
contribute to a predictable and regular menstrual cycle.
e) 2. Progestin-Only Pills (POPs):
f) Variable Suppression of Ovulation: POPs aim to suppress ovulation, but their effectiveness in
consistently preventing ovulation can vary among individuals.
g) Thickening of Cervical Mucus: POPs primarily work by thickening cervical mucus, making it
more difficult for sperm to reach the egg.
h) Influence on Menstrual Regularity: While POPs may contribute to menstrual regularity in

some individuals, irregular bleeding or spotting can occur due to the variability in ovulation
suppression.
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i) 3. Benefits of Regular Menstrual Cycle:
j) Predictability: A regular menstrual cycle provides predictability, allowing individuals to plan

for menstruation and associated events.
k) Management of Menstrual Symptoms: Regular cycles may assist in managing menstrual

symptoms such as cramps, bloating, and mood changes.
l) Tracking Ovulation: For individuals not using contraceptive methods for family planning, a
regular menstrual cycle can facilitate tracking ovulation and identifying fertile periods.
m) Irregular Bleeding:
n) COCs and POPs: While both COCs and POPs aim to regulate the menstrual cycle, irregular
bleeding or spotting may occur, especially during the initial months of use or if pills are
missed.
o) Consistent Pill Use: Consistent and correct use of contraceptive pills is essential for
minimizing irregular bleeding.
p) Non-Contraceptive Benefits:
q) COCs: Beyond contraception, COCs are prescribed for various non-contraceptive benefits,
including the management of irregular menstrual cycles, polycystic ovary syndrome (PCOS),
and endometriosis.
r) POPs: Progestin-only pills may be recommended for individuals who are sensitive to
estrogen or have contraindications to estrogen-containing contraceptives.
s) Health Considerations:
t) Individual Health Factors: Individual health factors, such as pre-existing menstrual disorders,
heavy menstrual bleeding, or irregular cycles, should be discussed with healthcare providers.
u) Tailoring Contraceptive Choices: Healthcare providers can tailor contraceptive choices based
on individual health considerations and the desired outcomes related to menstrual
regularity.
v) Return to Fertility:
w) COCs and POPs: Fertility typically returns promptly after discontinuing contraceptive pills.
The menstrual cycle resumes its natural pattern, and individuals can conceive when ready.
x) Monitoring and Adjustment:
y) Regular Check-ups: Regular check-ups with healthcare providers allow for the monitoring of
menstrual regularity and overall reproductive health.
z) Adjustments as Needed: If irregular bleeding persists or if there are concerns about

menstrual regularity, healthcare providers may consider adjustments to the type or
formulation of contraceptive pills.
a. Ensuring a regular menstrual cycle is often a key consideration for individuals

choosing contraceptive methods. Healthcare providers play a crucial role in guiding
individuals through these choices, taking into account individual health factors and
preferences. Regular communication with healthcare providers allows for ongoing
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monitoring and adjustments as needed to align contraceptive choices with individual

health goals.
b. Contraceptive pills are often prescribed to regulate the menstrual cycle. By

suppressing ovulation, they provide a more predictable menstrual cycle.
c. Irregular Bleeding: Some individuals may experience breakthrough bleeding or
spotting, especially when starting a new type of contraceptive pill.
Individual Variations
a. Response to Hormones:
 Differing Sensitivity: Individuals may vary in their sensitivity to synthetic hormones in

contraceptive pills. Some may experience noticeable changes in mood, libido, or other side
effects, while others may have a more muted response.
 Individualized Adjustments: Healthcare providers consider individual responses when

prescribing contraceptive pills and may adjust formulations or types based on individual
needs.
b. Menstrual Changes:
 Variability in Bleeding Patterns: Responses to contraceptive pills, especially in terms of

menstrual changes, can vary. While some individuals may experience lighter and more
regular periods, others may have irregular bleeding or spotting.
 Adjustments for Irregularities: Healthcare providers may recommend adjustments, such as

changing the type of pill or formulation, to address menstrual irregularities.
c. Side Effects:
 Diverse Reactions: Side effects such as nausea, breast tenderness, or mood changes can vary
widely among individuals. Some may tolerate contraceptive pills well, while others may find
certain side effects problematic.
 Switching Formulations: In cases of intolerable side effects, healthcare providers may

explore alternative formulations or types of contraceptive pills.
d. Health Considerations:
 Underlying Health Conditions: Individual health considerations, such as a history of blood

clots, migraines, or certain medical conditions, can influence the suitability of specific
contraceptive pills.
 Contraindications: Healthcare providers carefully assess individual health factors to ensure

that the chosen contraceptive method aligns with the individual's overall health.
e. Non-Contraceptive Benefits:
 Diverse Treatment Goals: Beyond contraception, individuals may seek contraceptive pills for
non-contraceptive benefits, such as managing acne, improving menstrual symptoms, or
addressing conditions like polycystic ovary syndrome (PCOS).
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 Individualized Approach: Healthcare providers take an individualized approach to address

both contraceptive and non-contraceptive goals.
f. Lifestyle Factors:
 Adherence to Pill Schedule: Individual adherence to the pill schedule is crucial for
contraceptive effectiveness. Variations in lifestyle, routine, or memory may impact
adherence.
 Guidance on Pill Use: Healthcare providers provide guidance on consistent and correct pill
use, taking into account individual lifestyle factors.
g. Fertility and Pregnancy Plans:
 Varied Plans: Individuals have diverse plans regarding fertility and pregnancy. Some may
seek contraception temporarily, while others may consider it as part of family planning.
 Guidance for Pregnancy Planning: For individuals with plans for future pregnancy, healthcare
providers offer guidance on the resumption of fertility after discontinuing contraceptive pills.
h. Communication with Healthcare Provider:
 Open Dialogue: Open communication between individuals and healthcare providers is

crucial. Individuals are encouraged to share their preferences, concerns, and experiences to
guide healthcare providers in recommending the most suitable contraceptive option.
 Regular Check-ups: Regular check-ups allow healthcare providers to monitor individual

responses and make any necessary adjustments.
i. Switching Contraceptive Methods:
 Changing Preferences: Individual preferences may change over time. Some individuals may
choose to switch from contraceptive pills to other methods based on lifestyle changes, side
effects, or contraceptive needs.
 Exploring Alternatives: Healthcare providers discuss alternative contraceptive methods and

assist individuals in transitioning to a method that aligns with their current preferences and
lifestyle.
Recognizing and addressing individual variations is central to the provision of personalized and
effective contraceptive care. Healthcare providers work collaboratively with individuals to tailor
contraceptive choices based on their unique needs, preferences, and health considerations. Regular
communication and follow-ups ensure ongoing support and adjustments as needed.
Body Response: Individual responses to contraceptive pills can vary. What works well for one person
may not be suitable for another. It may take some time to find the most appropriate formulation.
Health Considerations
Health Considerations in Contraceptive Pill Use:
a. Cardiovascular Health:
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b) Blood Clot Risk: Contraceptive pills, especially those containing estrogen, may increase the
risk of blood clots. Individuals with a history of blood clots, deep vein thrombosis (DVT), or
pulmonary embolism may have contraindications to estrogen-containing pills.
c) Individual Assessment: Healthcare providers conduct individual risk assessments,

considering factors such as age, smoking status, and pre-existing cardiovascular conditions.
a. Migraines:
d) Migraine Types: Individuals with a history of migraines, particularly migraines with aura, may
have an increased risk of stroke when using contraceptive pills.
e) Alternative Contraceptive Options: Healthcare providers may recommend progestin-only

pills or non-hormonal methods for individuals with specific migraine types.
a. Hypertension:
f) Blood Pressure Monitoring: Contraceptive pills can potentially increase blood pressure.
Regular blood pressure monitoring is essential, and individuals with uncontrolled
hypertension may be advised against certain formulations.
a. Smoking:
g) Increased Cardiovascular Risk: Smoking while using contraceptive pills, especially for
individuals over 35 years old, can significantly increase the risk of cardiovascular events.
h) Smoking Cessation Support: Healthcare providers may encourage smoking cessation and
discuss alternative contraceptive methods for individuals who smoke.
a. History of Breast Cancer:
i) Individual Assessment: The relationship between contraceptive pill use and breast cancer
risk is complex. Healthcare providers conduct individual assessments, considering factors
such as family history and personal risk factors.
a. Liver Health:
j) Liver Function Tests: Contraceptive pills are metabolized in the liver. Individuals with liver
conditions or impaired liver function may require careful monitoring or alternative
contraceptive methods.
k) Contraindications: Severe liver disease may be a contraindication to certain formulations.
a. History of Stroke or Heart Disease:
l) Individual Assessment: Individuals with a history of stroke or heart disease may require
individualized assessments to determine the suitability of contraceptive pills.
m) Alternative Methods: Healthcare providers may explore alternative methods, such as non-
hormonal options, for individuals with specific cardiovascular histories.
a. Diabetes:
n) Blood Sugar Monitoring: Contraceptive pill use can affect blood sugar levels. Individuals with
diabetes may require careful monitoring, and adjustments to diabetes management may be
needed.
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a. Age and Reproductive Stage:
o) Perimenopause and Menopause: For individuals approaching menopause, contraceptive

needs may change. Healthcare providers discuss appropriate contraceptive methods based
on age and reproductive stage.
a. Overall Health Status:
p) Comprehensive Assessment: Healthcare providers conduct a comprehensive health

assessment, taking into account overall health status, medical history, and any pre-existing
conditions.
q) Shared Decision-Making: The decision to use contraceptive pills is a shared one between the
individual and healthcare provider, considering both contraceptive goals and overall health.
a. Monitoring and Follow-up:
 Regular Check-ups: Regular check-ups with healthcare providers are crucial for ongoing
monitoring of health status, addressing any emerging health concerns, and making
adjustments to contraceptive choices as needed.
Individual health considerations play a pivotal role in the decision-making process when choosing
contraceptive methods. Healthcare providers assess individual health factors to ensure the safety
and suitability of contraceptive pills, and they work collaboratively with individuals to find
contraceptive options that align with their overall health and lifestyle. Regular communication and
follow-ups contribute to a comprehensive and personalized approach to contraceptive care.
Underlying Health Conditions: Certain health conditions may influence the choice of contraceptive
pills. For example, women with a history of blood clots may be advised against estrogen-containing
pills.
Consultation with Healthcare Professionals

Consultation with Healthcare Professionals:
a. Informed Decision-Making:
b) Education on Contraceptive Options: Healthcare professionals provide comprehensive

information on various contraceptive methods, including contraceptive pills, ensuring
individuals are aware of the benefits, risks, and alternatives.
c) Informed Consent: Individuals are actively involved in the decision-making process,

providing informed consent based on their understanding of contraceptive options.
a. Personalized Health Assessment:
d) Individual Health Factors: Healthcare professionals conduct a personalized health

assessment, considering factors such as medical history, current health status, lifestyle, and
reproductive goals.
e) Identification of Contradictions: Contradictions, such as a history of blood clots or certain

medical conditions, are identified through thorough assessments.
a. Contraceptive Goals and Preferences:
17
f) Family Planning Objectives: Healthcare professionals discuss individuals' family planning

goals, whether it involves short-term contraception, long-term planning, or considerations
for future pregnancies.
g) Preferences and Lifestyle: Individual preferences, lifestyle factors, and considerations for
method adherence are taken into account when recommending contraceptive options.
a. Evaluation of Menstrual History:
h) Menstrual Regularity: The assessment includes an evaluation of menstrual history to

determine if an individual seeks contraceptive pills for menstrual regulation or other non-
contraceptive benefits.
i) Addressing Menstrual Symptoms: Contraceptive pills may be recommended to address

symptoms such as irregular bleeding, menstrual cramps, or premenstrual symptoms.
a. Addressing Non-Contraceptive Benefits:
j) Non-Contraceptive Goals: Individuals may seek contraceptive pills for non-contraceptive

benefits, such as acne management, treatment of menstrual disorders, or addressing
conditions like polycystic ovary syndrome (PCOS).
k) Balancing Contraceptive and Non-Contraceptive Objectives: Healthcare professionals help

individuals balance both contraceptive and non-contraceptive goals in choosing the most
suitable method.
a. Detailed Discussion on Contraceptive Pills:
l) Explanation of Hormonal Components: Healthcare professionals explain the hormonal

components of contraceptive pills, including synthetic estrogen and progestin, and how they
work to prevent pregnancy.
m) Mechanism of Action: Individuals are informed about the mechanism of action, involving the
suppression of ovulation, thickening of cervical mucus, and alterations in the endometrial
lining.
a. Assessment of Cardiovascular Risk:
n) Cardiovascular Health: Considering the potential impact on cardiovascular health, healthcare

professionals assess risk factors such as smoking, hypertension, and a history of blood clots.
o) Selection of Appropriate Formulation: Based on cardiovascular risk factors, healthcare

providers may recommend specific formulations or alternative contraceptive methods.
a. Discussion of Potential Side Effects:
p) Common Side Effects: Healthcare professionals discuss potential side effects of

contraceptive pills, including nausea, breast tenderness, mood changes, and irregular
bleeding.
q) Addressing Concerns: Individuals are encouraged to express concerns about potential side
effects, and healthcare providers provide guidance on managing or mitigating these effects.
a. Guidance on Pill Schedule and Adherence:
18
r) Consistent Pill Use: Healthcare professionals emphasize the importance of consistent and
correct pill use for optimal contraceptive efficacy.
s) Pill Schedule and Routine: Guidance is provided on the pill schedule, including taking pills at
the same time each day, and integrating pill-taking into daily routines.
a. Monitoring and Follow-up:
t) Scheduled Follow-ups: Healthcare professionals schedule regular follow-ups to monitor

individuals' experiences with contraceptive pills, assess any side effects, and make
adjustments as needed.
u) Ongoing Support: Individuals are encouraged to communicate openly about their

experiences, and healthcare providers offer ongoing support to address any emerging
concerns.
a. Shared Decision-Making:
 Collaborative Approach: The decision to use contraceptive pills is a collaborative effort

between individuals and healthcare professionals.
 Respecting Individual Choices: Healthcare professionals respect individuals' choices and

work together to find a contraceptive solution aligned with their health goals and
preferences.
Consultation with healthcare professionals ensures a thorough understanding of individual health

needs, contraceptive goals, and preferences. This collaborative approach enables informed decision-
making, personalized contraceptive care, and ongoing support for individuals throughout their
contraceptive journey. Regular follow-ups contribute to a dynamic and responsive healthcare
relationship, allowing for adjustments and adaptations as needed.
Healthcare Provider's Role: Healthcare providers play a crucial role in guiding individuals through the
selection of an appropriate contraceptive method. They consider individual health history,
preferences, and potential side effects.
Long-Term Effects
Long-Term Effects of Contraceptive Pill Use:
a. Bone Health:
b) Calcium Metabolism: Long-term use of contraceptive pills, particularly those with synthetic
estrogen, may influence calcium metabolism. Some studies suggest a potential small
decrease in bone density, but the clinical significance is unclear.
c) Impact on Bone Mineral Density: Research on the impact of contraceptive pills on bone
mineral density has shown mixed results, and any potential effect is generally considered
reversible upon discontinuation.
a. Reproductive Health After Discontinuation:
d) Return to Fertility: One of the notable long-term effects is the rapid return to fertility after
discontinuing contraceptive pills. Menstrual cycles typically resume their natural pattern,
allowing individuals to conceive when ready.
19
e) Normal Ovulation: Ovulation resumes promptly after discontinuation, and the ability to
conceive is not compromised by previous contraceptive pill use.
a. Cancer Risk:
f) Breast Cancer: Studies on the long-term risk of breast cancer associated with contraceptive
pill use have shown varying results. The relationship is complex and may involve factors such
as age, duration of use, and individual risk factors.
g) Ovarian and Endometrial Cancer: Long-term use of contraceptive pills has been associated
with a reduced risk of ovarian and endometrial cancers. The protective effect may persist
even after discontinuation.
a. Cardiovascular Health:
h) Risk of Blood Clots: The long-term use of contraceptive pills, especially those containing
estrogen, may be associated with a small increase in the risk of blood clots. This risk is
generally considered higher in the first year of use and decreases with continued use.
i) Individual Cardiovascular Risk: Individual cardiovascular risk factors and health

considerations are assessed by healthcare providers to determine the appropriateness of
long-term use.
a. Non-Contraceptive Benefits:
j) Management of Menstrual Disorders: Long-term use of contraceptive pills can provide

ongoing management of menstrual disorders, such as irregular bleeding, heavy periods, and
menstrual cramps.
k) Treatment of Acne and PCOS: For individuals using contraceptive pills for non-contraceptive
benefits, such as acne management or the treatment of polycystic ovary syndrome (PCOS),
the benefits may be sustained with long-term use.
a. Menstrual Regularity:
l) Continued Menstrual Regularity: Individuals using contraceptive pills for menstrual

regulation may experience continued regularity in their menstrual cycles with long-term use.
m) Endometrial Protection: The consistent hormonal environment provided by contraceptive

pills helps protect the endometrial lining and reduces the risk of conditions such as
endometrial hyperplasia.
a. Individualized Considerations:
n) Health Monitoring: Long-term users of contraceptive pills are advised to undergo regular
health check-ups, including blood pressure monitoring and assessments of cardiovascular
health.
o) Individual Risk-Benefit Assessment: Healthcare providers conduct ongoing risk-benefit

assessments, taking into account individual health factors, age, and the specific goals of
contraceptive use.
a. Bone Mineral Density:
p) Reversibility of Changes: Any potential decrease in bone density associated with

contraceptive pill use is generally considered reversible upon discontinuation.
20
q) Weight-Bearing Exercise and Nutrition: Encouraging weight-bearing exercise and adequate

calcium intake can contribute to bone health for individuals using or considering long-term
use of contraceptive pills.
a. Menopausal Transition:
r) Transition to Menopause: For individuals approaching menopause, healthcare providers may

discuss the transition to non-hormonal methods or the discontinuation of hormonal
contraceptives.
a. Monitoring and Adjustments:
 Regular Check-ups: Long-term users of contraceptive pills benefit from regular check-ups to
monitor overall health, assess any emerging concerns, and make adjustments to
contraceptive choices as needed.
 Open Communication: Ongoing communication between individuals and healthcare

providers allows for addressing any changes in health status, preferences, or contraceptive
goals.
The long-term effects of contraceptive pill use involve a complex interplay of individual health
factors, reproductive goals, and potential non-contraceptive benefits. Healthcare providers play a
vital role in guiding individuals through these considerations, conducting risk assessments, and
offering ongoing support for informed and personalized contraceptive choices. Regular health check-
ups contribute to a dynamic and responsive approach to long-term contraceptive care.
Bone Health: There have been discussions about the potential impact of long-term contraceptive pill
use on bone health. Some studies suggest a correlation, but more research is needed to establish
definitive conclusions.
Discontinuation and Hormonal Recovery

Discontinuation and Hormonal Recovery after Contraceptive Pill Use:
a. Rapid Hormonal Reversibility:
b. Prompt Return to Natural Hormonal Levels: One of the notable aspects of discontinuing
contraceptive pills is the rapid hormonal reversibility. The synthetic hormones (estrogen and
progestin) introduced by the pills are metabolized and eliminated from the body, allowing
natural hormonal levels to resume promptly.
a. Resumption of Ovulation:
c. Quick Return to Fertility: Ovulation, the release of an egg from the ovary, typically resumes
quickly after discontinuation of contraceptive pills.
d. Return to Menstrual Cyclicity: The menstrual cycle returns to its natural pattern, and
individuals regain the ability to conceive when they are ready.
a. Menstrual Changes After Discontinuation:
21
e. Irregular Bleeding: Some individuals may experience irregular bleeding or spotting after
discontinuing contraceptive pills. This is often a temporary phenomenon as the menstrual
cycle readjusts.
f. Timing of Menstrual Resumption: The timing of the first menstrual period after
discontinuation can vary among individuals, with some experiencing a return to regular
cycles sooner than others.
a. Non-Contraceptive Benefits:
g. Continuation of Non-Contraceptive Benefits: For individuals using contraceptive pills for non-
contraceptive benefits, such as the management of acne, menstrual disorders, or polycystic
ovary syndrome (PCOS), the benefits may persist after discontinuation.
h. Individualized Considerations: Healthcare providers assess individual health goals and

preferences to determine the most appropriate post-discontinuation plan.
a. Fertility and Pregnancy Planning:
i. Preparation for Pregnancy: Discontinuing contraceptive pills allows individuals to prepare for
pregnancy if desired. Ovulation resumes, and fertility is restored.
j. Conception Timing: Some individuals may conceive soon after discontinuation, while others
may take longer based on individual factors.
a. Monitoring and Health Check-ups:
k. Post-Discontinuation Health Check-ups: Healthcare providers may recommend post-

discontinuation health check-ups to monitor the resumption of natural hormonal patterns,
assess any changes in menstrual regularity, and address any emerging health concerns.
l. Individualized Follow-up: The frequency and nature of follow-up appointments are

individualized based on factors such as health status, reproductive goals, and any specific
concerns.
a. Contraceptive Counselling:
m. Exploring Alternative Methods: Individuals discontinuing contraceptive pills may discuss

alternative contraceptive methods with healthcare providers based on changes in
reproductive goals or preferences.
n. Transition to Non-Hormonal Methods: For individuals transitioning to non-hormonal

methods, healthcare providers provide guidance on suitable options.
a. Return to Natural Menstrual Patterns:
o. Natural Hormonal Cycling: Discontinuation of contraceptive pills allows the body to return to
its natural hormonal cycling, with the menstrual cycle regulated by the body's endogenous
hormones.
p. Individual Variations: The time it takes for the menstrual cycle to stabilize varies among
individuals, and some may experience a period of irregularity before achieving regular
cycles.
a. Lifestyle and Reproductive Planning:
22
q. Adjustments Based on Lifestyle Changes: Individuals may discontinue contraceptive pills due
to lifestyle changes, reproductive goals, or other personal considerations.
r. Open Communication: Ongoing communication with healthcare providers allows for

addressing any changes in health status, reproductive plans, or contraceptive needs.
a. Individualized Approach:
 Tailoring Post-Discontinuation Care: Healthcare providers take an individualized approach to

post-discontinuation care, considering factors such as health history, menstrual patterns,
and fertility goals.
 Addressing Concerns: Individuals are encouraged to communicate any concerns or questions

about the post-discontinuation period, and healthcare providers provide guidance and
support as needed.
Discontinuation of contraceptive pills marks a transition period for individuals, involving the
resumption of natural hormonal patterns and reproductive planning. Healthcare providers play a
crucial role in supporting individuals during this transition, providing guidance on fertility, monitoring
health changes, and addressing any specific concerns or goals. Regular communication and follow-
ups contribute to a comprehensive and individualized approach to post-discontinuation care.
Return to Fertility: After discontinuing contraceptive pills, hormonal levels typically return to normal,
and fertility can be restored.
It's important to highlight that contraceptive pills are generally safe and effective when used as
prescribed. However, individual responses can vary, and healthcare providers play a key role in
monitoring and adjusting contraceptive methods based on individual health considerations. Regular
check-ups and open communication with healthcare professionals are crucial for ensuring the most
suitable contraceptive approach for each individual.
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Keywords: hormonal contraceptives, brain, neuroimaging, MRI, PET, EEG
Citation: Brønnick MK, Økland I, Graugaard C and Brønnick KK (2020) The Effects of Hormonal
Contraceptives on the Brain: A Systematic Review of Neuroimaging Studies. Front. Psychol.
11:556577. doi: 10.3389/fpsyg.2020.556577
Received: 28 April 2020; Accepted: 25 September 2020;
Published: 27 October 2020.
Edited by:
Simona Raimo, University of Campania Luigi Vanvitelli, Italy
Reviewed by:
59
Federica Galli, European Institute of Oncology (IEO), Italy
Silvia Picazio, Santa Lucia Foundation (IRCCS), Italy
Copyright © 2020 Brønnick, Økland, Graugaard and Brønnick. This is an open-access article
distributed under the terms of the Creative Commons Attribution License (CC BY). The use,
distribution or reproduction in other forums is permitted, provided the original author(s) and the
copyright owner(s) are credited and that the original publication in this journal is cited, in
accordance with accepted academic practice. No use, distribution or reproduction is permitted
which does not comply with these terms.
*Correspondence: Marita Kallesten Brønnick, mk.bronnick@gmail.com
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Correlation Between Contraceptive Pills and Hormone Imbalance

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Correlation Between Contraceptive Pills and Hormone Imbalance

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Eberi Uchenna Precious LASCOHET/PUBTECH/2022/024

LAGOS STATE COLLEGE OF HEALTH

LECTURER NAME: SAN OSHO S. A

TOPIC: CORRELATION BETWEEN

Mechanism of Action ----------------------------------------------------------------------------------4-5

Hormonal Changes and Balance ---------------------------------------------------------------------5-6

Side Effects and Hormonal Influences --------------------------------------------------------------7-8

Mood Changes -------------------------------------------------------------------------------------------9-10

Regularization of Menstrual Cycle-----------------------------------------------------------------10-12

Consultation with Healthcare Professionals ----------------------------------------------------17-18

Discontinuation and Hormonal Recovery--------------------------------------------------------20 -22

Correlation between contraceptive pills and hormone imbalance

Hormone Imbalance and Contraceptive Pills:

Potential Adjustment Period: Upon discontinuation, individuals may experience an adjustment

Temporary Absence of Menstruation: Some individuals may experience a temporary absence of

Ovulation and Hormonal Fluctuations:

Return to Ovulation: Discontinuation of contraceptive pills allows the resumption of ovulation,

Varied Responses to Hormonal Changes: Individual responses to the discontinuation of

Addressing Concerns: Individuals are encouraged to communicate any concerns or perceived

Combined Oral Contraceptives (COCs):

2. Changes in Cervical Mucus:

3. Changes in the Endometrium:

4. Inhibition of Sperm Function:

Progestin-Only Pills (POPs):

1. Thickening of Cervical Mucus:

 POPs primarily work by thickening the cervical mucus.

2. Alterations in the Endometrium:

3. Inhibition of Ovulation (Variable):

1. Consistent Use is Crucial:

4. Other Non-Contraceptive Benefits:

Hormonal Changes and Balance

a. Estrogen and Progestin Levels:

 Combined Oral Contraceptives (COCs):

 Estrogen Component: COCs typically contain synthetic estrogen, often ethinyl

 Progestin Component: The progestin component provides contraceptive

 Progestin-Only Pills (POPs):

 Impact on Menstrual Cycle: POPs provide contraceptive efficacy primarily by

b. Steady Hormone Levels:

d. Impact on Hormone-Related Symptoms:

e. Continuous Hormone Delivery (Extended Regimens):

 Response to Hormones: Individual responses to hormonal contraceptives can vary. Some

g. Return to Fertility after Discontinuation:

h. Monitoring and Adjustments:

 Healthcare Professional's Role: Healthcare providers monitor individuals using contraceptive

Side Effects and Hormonal Influences

i. Impact on Bone Health:

a) Combined Oral Contraceptives (COCs):

d) Progestin-Only Pills (POPs):

h) Body Response: Individual responses to hormonal contraceptives vary. While some

j) 4. Addressing Mood Changes:

k) Consultation with Healthcare Provider: If mood changes are significant or bothersome,

l) Switching Formulations: Healthcare providers may consider switching to a different

n) COCs: Beyond contraception, COCs are sometimes prescribed for non-contraceptive

o) Individualized Approach: The choice of contraceptive pill may be influenced by non-

p) Monitoring and Open Communication:

r) Open Communication: Open communication with healthcare providers is crucial for

b. Progestin-Only Pills (POPs):

c. Amenorrhea (Absence of Menstruation):

e. Manipulation of Menstrual Timing:

i. Monitoring and Adjustment:

 Adjustment as Needed: If menstrual changes are a concern or if irregular bleeding persists,

Regularization of Menstrual Cycle

a) 1. Combined Oral Contraceptives (COCs):