Reflecting over this past year of practice, I realized that I met several woman who shared a very similar story – which is that they all struggled to conceive a child after stopping the oral contraceptive pill (OCP). None of them were educated to the fact that the OCP use may have contributed to their fertility issue. Many were told that they were simply “anovulatory” (not ovulating) and were rushed into aggressive assisted fertility techniques (ART), many times unsuccessfully. In actuality all these women may have needed was simply a patient care provider who could suggest that they try for bit longer to achieve their pregnancy goal.
One of the woman whom I saw was put through 2 unsuccessful chlomiphene citrate cycles just eight months after stopping a 13 year long period of OCP use, with an unsuccessful IVF cycle right after that. The emotional tole these ART’s had taken on this woman were massive and actually lead to her being prescribed anti-anxiety medicines for the panic attacks she was having.
In a study published in the Journal of Human Reproduction, researchers showed that women who have been on the OCP may take longer to become pregnant after stopping them – roughly double the length than woman who had been using a condom as their previous birth control method before trying to conceive. In women with underlining menstrual issues, like irregularities before starting the OCP, the time to pregnancy being greater than 2 years was 2.5 times higher than had they never took the OCP in the first place.
The reason for the longer time it may take to achieve pregnancy is possible due to residual hormonal effects on the ovaries, leading to anovulation and continued ovarian suppression. Again time is a woman’s best friend in these situations, as it is time that is needed to allow the proper communication to once again commence between the brain and the ovary.
I firmly believe that two things have to take place out of this research:
1) Women need to be educated that before they take the OCP, particularly if they use it for more than 2 years duration, that their ability to become pregnant in the future may be reduced. That it may not be a “stop the birth control pill one month, pregnant then next month” type of scenario.
2) That for women coming off the OCP in order to conceive a child, that they may just have to wait a bit longer than normal. That their rates of fertility will be reduced than that of women who never took any OCP, particularly if they had a menstrual issue to begin with.
If women are at least educated that they may have to wait a while longer for their fertility to return to normal, they may be able to avoid the physical and emotional toll that ART can impose on them.
In my clinical practice at Acubalance Wellness Centre, I have found that for issues of anovulation, whether related to the post effects of OCP use or to conditions like polycystic ovarian syndrome, that both Chinese herbal medicine and/or acupuncture can be highly effective in restoring ovulation. This is probably because the focus of Chinese medicine is put on restoring internal balance rather than on suppression (which is how many drug therapies work).
I can still vividly remember Dr. Jeff Roberts of Pacific Coast Reproductive Medicine (PCRM) explaining to me how amazed he is when women come back to him with regular ovulating cycles after taking Chinese medicine for their previously very delayed anovulatory cycles. Dr. Roberts declared that in terms of western drug medicines, the only thing they have to help women attain regular cycles is the oral contraceptive pill. Which, as we all know, actually leads to anovulatory cycles through suppressing ovarian function – a situation that may far exceed its intended time of use.
Dr Trevor Erikson
Copyright © 2019 Dr. Trevor Erikson