Things you should know about taking the Contraceptive Pill


More and more of our clients are using contraception.

Whether it’s taking the pill, an IUD or injection or implant,

it’s important to know how these synthetic hormones act in

our body and how they can impact on the skin and various

skin conditions.


All pills have both estrogen and progestin, except for

the mini pill, which is just progestin; yes, not progesterone,

progestin. Progestin is a synthetic form of the body’s

natural hormone progesterone, which means the way it

interacts with the hormone receptors in your body is also

different. The progestins in hormonal birth control inhibit

ovulation and reduce the amount and stretchiness of

cervical mucus, making it unfriendly to sperm.


The chemical structure of progestins is different from

natural progesterone. Progestins were designed to interact

with progesterone receptors in the body in order to cause

progesterone-like effects. This means that they do some of

what the body’s natural progesterone does. For instance,

progestins can cause changes to the endometrium (the

lining of the uterus) that prevent it from proliferating

(building up) too much, and that can help it support

implantation and the continuation of an early pregnancy.

When progestins are combined with estrogens in

combined hormonal birth control, it is to make menstrual

bleeding predictable. Without the estrogen, progestin-only

methods commonly cause changes in menstrual bleeding.

Most progestins are created from testosterone, some from

progesterone, and one is a type of spirolactone (class of

synthetic hormones that can impact the body’s salt and

water balance).


HOW SYNTHETIC HORMONES WORK DIFFERENTLY

When your body produces hormones, they go to their

receptor. Synthetic hormones, such as progestins may

attach to more than just progesterone receptors in the body.

Progestins may also bind to receptors for:

» Androgens, so if this happens, this is when a client

can experience acne and facial hair. Androgen-like

side effects are more common in people taking the


mini pill, IUD, injections and the implant, which contain

no estrogen.

» Estrogens, the combined contraceptive pill can

sometimes make acne appear better because

the estrogen component suppresses the ovaries’

production of androgens and increases the amount of

a protein called sex hormone binding globulin (SHBG).

SHBG ties up androgens found in the blood and keeps

them from entering the cells in the skin and hair follicles.

» Other hormones, like mineralocorticoids, or

glucocorticoids (hormones produced by the adrenal

glands). Progestins that bind to mineralocorticoid or

glucocorticoid receptors can cause side effects related

to salt and water balance in the body. Mineralocorticoids

and glucocorticoids are hormones produced by the

adrenal glands, which sit on top of the kidneys. Progestins

that bind to glucocorticoid receptors and increase

glucocorticoid activity, can cause bloating.

If progestins bind to these receptors, they can cause

different side effects—depending on whether the progestin

activates or blocks the receptor. This is why the side

effects of the contraceptive pill can vary so much from

person to person. The side effects may not always

be straightforward or easy to predict, since the two

components can interact and sometimes counteract each

other.

So, you can see the side effects of contraception can

really vary in what effects clients will experience depending

on the dose and also which receptors it decides to bind

to, stimulate or inhibit. Also, progesterone our natural

hormone is very protective against breast cancer,

progestins, the synthetic form, are not.

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