September Monthly Muse: Dr Lara Briden
It is an honour to introduce this month’s muse, Dr Lara Briden, Naturopathic Doctor and author of The Period Repair Manual (a must-read for all women). Lara is not only an expert when it comes to period health and hormones but is also generous with her time, speaking at events internationally, featuring on podcasts and contributing to interviews such as this one in an effort to teach women about the importance of their cycle health.
Many Your Monthly clients have questions about contraception choices and feel that their worries are not always heard by their general physicians. Lara has contributed to what is known as the period revolutionary by professionals working in this space and inspires women to think beyond hormonal contraception by educating on how these medications work and what other options exist for women.
While this article is by no means intended to replace an appointment with your GP or Gynecologist, it is my hope that Lara’s wisdom gives you the confidence to advocate for yourself, your health and your monthly in your next appointment. Contraception should be an informed choice.
Lara, are you able to give a brief history of the development and mass prescribing of the oral contraceptive pill?
Contraceptive drugs were invented in the 1950’s for contraception and have been popular for that purpose. That makes sense.
What doesn’t make sense is:
1) the fact that it’s now 2019 and science has not yet come up with many (really, any) alternative methods of avoiding pregnancy, and
2) the fact that contraceptive drugs have become the standard way to “regulate” periods when they actually cannot do that.
What do you think is the most important thing women should know about hormonal birth control?
Contraceptive drugs work by suppressing ovarian function (and therefore suppressing the menstrual cycle) and then creating arbitrarily-timed “drug withdrawal bleeds” that have nothing do with the actual menstrual cycle.
In other words, the pill cannot “regulate” periods because pill-bleeds are not periods.
Are all hormonal contraception choices the same in terms of side effects or implications on cycle health? i.e. OCP versus implantation methods?
All hormonal methods except for the hormonal IUD work by suppressing ovulation and the menstrual cycle. In that way, all hormonal methods rob women of the benefits of progesterone (the hormone we make after ovulation). That is one of my biggest concerns with hormonal birth control because we need progesterone for general health, not just for making a baby! According to endocrinology professor Jerilynn Prior (who helped me with Period Repair Manual), progesterone can help to “prevent osteoporosis, stroke, dementia, heart disease, and breast cancer."
Beyond the very basic problem of suppressing ovulation and progesterone, the different types of hormonal birth control vary quite a bit in terms of side effects and risks. A lot of it depends on the exact dose of estrogen and also on the type of progestin. For example, some progestins such as levonorgestrel can cause hair loss because they are very similar to testosterone.
The hormonal IUD is different than other methods in that it can permit natural “ovulatory” menstrual cycles, which is a good thing. Also, the dose of the IUD’s drug (levonorgestrel) is lower and so slightly less likely to cause side effects.
What non-hormonal contraception options exist?
Currently, the three main methods of non-hormonal contraception are:
1) Fertility awareness methods (FAM), which are based on the fact that women are fertile only six days per cycle. FAM calculations can be done with a computer algorithm like the Daisy device, or with the correct training, they can be done manually.
2) The copper IUD.
3) Condoms.
There is a non-hormonal male method called Vasalgel that is currently under development and I hope will come to market one day soon!
Many women feel that they are not heard during GP appointments about their contraception choice (perhaps due to long term prescribing beliefs or practices). How can women advocate for themselves when it comes to discussing contraception?
Period Repair Manual includes a “How to speak to your doctor” section, with a list of questions and statements such as:
“I understand that the pill only masks the symptoms of PCOS and does nothing to correct the condition. I would prefer to use diet and lifestyle to try to reverse PCOS and return to having regular natural menstrual cycles. Can you support me in doing that?”
Do you believe that there are some client groups that may benefit from the use of hormonal contraception for a period of time due to complications (for example women with Endometriosis who experience debilitating pain during their cycles)?
Absolutely. Contraceptive drugs suppress the menstrual cycle which can be beneficial in more severe conditions such as endometriosis, adenomyosis, and very heavy periods.
I would consider Lara’s book a “must read” for all women (my copy is tattered and loved already!). You can purchase her book, The Period Repair Manual online and make sure to check out her blog and sign up to her newsletter for more information (including how you can work with Lara)