Full Transcript Introduction to contraception concerns 0:02 If this were your 19-year-old daughter, 0:02 If this were your 19-year-old daughter, would you knowingly give her a drug that 0:04 would you knowingly give her a drug that 0:04 would you knowingly give her a drug that chemically shuts down her reproductive 0:06 chemically shuts down her reproductive 0:06 chemically shuts down her reproductive system? That may sound extreme, but that 0:09 system? That may sound extreme, but that 0:09 system? That may sound extreme, but that is exactly what happens with medications 0:11 is exactly what happens with medications 0:11 is exactly what happens with medications commonly and incorrectly called hormonal 0:15 commonly and incorrectly called hormonal 0:15 commonly and incorrectly called hormonal contraceptives. Today, I want to talk 0:17 contraceptives. Today, I want to talk 0:17 contraceptives. Today, I want to talk about contraception from a holistic and 0:19 about contraception from a holistic and 0:19 about contraception from a holistic and integrative medical perspective. Not 0:22 integrative medical perspective. Not 0:22 integrative medical perspective. Not religious, not political, just biology, 0:25 religious, not political, just biology, 0:25 religious, not political, just biology, psychology, and long-term health. I'm 0:28 psychology, and long-term health. I'm 0:28 psychology, and long-term health. I'm Dr. Fred Bloom, and I practice 0:30 Dr. Fred Bloom, and I practice 0:30 Dr. Fred Bloom, and I practice integrative and holistic medicine. What 0:32 integrative and holistic medicine. What 0:32 integrative and holistic medicine. What shapes my perspective is simple. I don't 0:35 shapes my perspective is simple. I don't 0:35 shapes my perspective is simple. I don't just see what these medications do in 0:36 just see what these medications do in 0:36 just see what these medications do in the short term. I see what they do years 0:39 the short term. I see what they do years 0:39 the short term. I see what they do years later. Women come into my office with 0:42 later. Women come into my office with 0:42 later. Women come into my office with anxiety, fatigue, infertility, and a 0:44 anxiety, fatigue, infertility, and a 0:44 anxiety, fatigue, infertility, and a hormone resistance. And one sentence I 0:47 hormone resistance. And one sentence I 0:47 hormone resistance. And one sentence I hear over and over again is this, "I was 0:50 hear over and over again is this, "I was 0:50 hear over and over again is this, "I was fine before I went on birth control." A 0:52 fine before I went on birth control." A 0:53 fine before I went on birth control." A patient recently asked me what I would 0:54 patient recently asked me what I would 0:54 patient recently asked me what I would recommend for her 19-year-old daughter. 0:56 recommend for her 19-year-old daughter. 0:56 recommend for her 19-year-old daughter. My answer surprised her. Let me explain
Why the language around birth control matters 0:59 My answer surprised her. Let me explain 0:59 My answer surprised her. Let me explain why. Before we talk about contraception 1:01 why. Before we talk about contraception 1:01 why. Before we talk about contraception options, we need to fix the language. 1:04 options, we need to fix the language. 1:04 options, we need to fix the language. Oral contraceptives are often called 1:07 Oral contraceptives are often called 1:07 Oral contraceptives are often called hormonal contraceptives. 1:09 hormonal contraceptives. 1:09 hormonal contraceptives. That term is medically misleading. These 1:13 That term is medically misleading. These 1:13 That term is medically misleading. These medications contain no human hormones at 1:16 medications contain no human hormones at 1:16 medications contain no human hormones at all. 1:17 all. 1:17 all. They contain synthetic 1:18 They contain synthetic 1:18 They contain synthetic hormone-disrupting chemicals, foreign 1:21 hormone-disrupting chemicals, foreign 1:21 hormone-disrupting chemicals, foreign compounds designed to override, 1:24 compounds designed to override, 1:24 compounds designed to override, suppress, and block normal endocrine 1:27 suppress, and block normal endocrine 1:27 suppress, and block normal endocrine signaling. They're not bioidentical, 1:29 signaling. They're not bioidentical, 1:29 signaling. They're not bioidentical, they're not physiologic, and they do not 1:32 they're not physiologic, and they do not 1:32 they're not physiologic, and they do not support natural hormone rhythms. 1:34 support natural hormone rhythms. 1:35 support natural hormone rhythms. Instead, they shut down the body's own 1:37 Instead, they shut down the body's own 1:37 Instead, they shut down the body's own hormone production. These chemicals 1:39 hormone production. These chemicals 1:39 hormone production. These chemicals suppress ovulation, shut down the 1:42 suppress ovulation, shut down the 1:42 suppress ovulation, shut down the hypothalamic-pituitary-ovarian 1:44 hypothalamic-pituitary-ovarian 1:44 hypothalamic-pituitary-ovarian axis, reduce estrogen, progesterone, and 1:47 axis, reduce estrogen, progesterone, and 1:47 axis, reduce estrogen, progesterone, and testosterone signaling, and alter 1:49 testosterone signaling, and alter 1:49 testosterone signaling, and alter cortisol, thyroid, and insulin pathways. 1:53 cortisol, thyroid, and insulin pathways. 1:53 cortisol, thyroid, and insulin pathways. From a physiologic standpoint, this is 1:55 From a physiologic standpoint, this is 1:55 From a physiologic standpoint, this is best described as temporary chemical 1:59 best described as temporary chemical 1:59 best described as temporary chemical castration. That term is intentionally
How hormonal contraceptives affect the body 2:02 castration. That term is intentionally 2:02 castration. That term is intentionally uncomfortable. In most cases, it does 2:04 uncomfortable. In most cases, it does 2:04 uncomfortable. In most cases, it does not mean permanent sterility. It means 2:06 not mean permanent sterility. It means 2:06 not mean permanent sterility. It means intentional chemical suppression of 2:09 intentional chemical suppression of 2:09 intentional chemical suppression of reproductive function. That is biology, 2:11 reproductive function. That is biology, 2:12 reproductive function. That is biology, not ideology. A 19-year-old woman is 2:14 not ideology. A 19-year-old woman is 2:14 not ideology. A 19-year-old woman is still developing. 2:16 still developing. 2:16 still developing. The brain, especially areas responsible 2:19 The brain, especially areas responsible 2:19 The brain, especially areas responsible for judgment, impulse control, and 2:21 for judgment, impulse control, and 2:21 for judgment, impulse control, and emotional regulation, continues 2:23 emotional regulation, continues 2:23 emotional regulation, continues developing into the mid-20s. At the same 2:26 developing into the mid-20s. At the same 2:26 developing into the mid-20s. At the same time, the endocrine system is still 2:29 time, the endocrine system is still 2:29 time, the endocrine system is still establishing lifelong signaling 2:31 establishing lifelong signaling 2:31 establishing lifelong signaling patterns. Introducing hormone-disrupting 2:33 patterns. Introducing hormone-disrupting 2:33 patterns. Introducing hormone-disrupting chemicals during this window can have 2:36 chemicals during this window can have 2:36 chemicals during this window can have lasting effects. 2:38 lasting effects. 2:38 lasting effects. These drugs can alter baseline hormone
Developmental risks for young women 2:40 These drugs can alter baseline hormone 2:40 These drugs can alter baseline hormone set points, affect mood and anxiety 2:43 set points, affect mood and anxiety 2:43 set points, affect mood and anxiety regulation, reduce libido and sexual 2:45 regulation, reduce libido and sexual 2:45 regulation, reduce libido and sexual responsiveness, and disrupt future 2:48 responsiveness, and disrupt future 2:48 responsiveness, and disrupt future fertility signaling. 2:50 fertility signaling. 2:50 fertility signaling. Often subtly at first, 2:52 Often subtly at first, 2:52 Often subtly at first, often showing up years later. Women 2:55 often showing up years later. Women 2:55 often showing up years later. Women don't come in saying, "This is because 2:57 don't come in saying, "This is because 2:57 don't come in saying, "This is because of birth control." They say their 2:59 of birth control." They say their 2:59 of birth control." They say their anxiety started in college. Their libido 3:01 anxiety started in college. Their libido 3:01 anxiety started in college. Their libido never came back. They stopped ovulating. 3:04 never came back. They stopped ovulating. 3:04 never came back. They stopped ovulating. They can't get pregnant. Or their 3:06 They can't get pregnant. Or their 3:06 They can't get pregnant. Or their hormones don't respond anymore. 3:09 hormones don't respond anymore. 3:09 hormones don't respond anymore. And very often, the timeline includes 3:11 And very often, the timeline includes 3:11 And very often, the timeline includes years of chemical hormone suppression 3:14 years of chemical hormone suppression 3:14 years of chemical hormone suppression early in adulthood. Not always, but 3:17 early in adulthood. Not always, but 3:17 early in adulthood. Not always, but often enough that ignoring it is 3:19 often enough that ignoring it is 3:19 often enough that ignoring it is irresponsible. There's another piece we
Long-term effects on mood, fertility, and attachment 3:21 irresponsible. There's another piece we 3:21 irresponsible. There's another piece we rarely talk about. Sexual intimacy 3:24 rarely talk about. Sexual intimacy 3:24 rarely talk about. Sexual intimacy releases oxytocin, which promotes 3:26 releases oxytocin, which promotes 3:26 releases oxytocin, which promotes emotional bonding and trust. It also 3:29 emotional bonding and trust. It also 3:29 emotional bonding and trust. It also releases dopamine, which reinforces 3:31 releases dopamine, which reinforces 3:31 releases dopamine, which reinforces pleasure and reward-based learning, and 3:34 pleasure and reward-based learning, and 3:34 pleasure and reward-based learning, and vasopressin, which contributes to 3:36 vasopressin, which contributes to 3:36 vasopressin, which contributes to long-term attachment. 3:38 long-term attachment. 3:38 long-term attachment. In young women especially, repeated 3:40 In young women especially, repeated 3:40 In young women especially, repeated sexual intimacy can wire emotional 3:43 sexual intimacy can wire emotional 3:43 sexual intimacy can wire emotional attachment before emotional maturity is 3:46 attachment before emotional maturity is 3:46 attachment before emotional maturity is fully developed. When intimacy occurs 3:49 fully developed. When intimacy occurs 3:49 fully developed. When intimacy occurs without safety, stability, and genuine 3:52 without safety, stability, and genuine 3:52 without safety, stability, and genuine commitment, it can strengthen attachment 3:55 commitment, it can strengthen attachment 3:55 commitment, it can strengthen attachment to unhealthy partners, make it harder to 3:58 to unhealthy partners, make it harder to 3:58 to unhealthy partners, make it harder to leave unsafe relationships, and blur 4:00 leave unsafe relationships, and blur 4:00 leave unsafe relationships, and blur chemistry with real connection. This is 4:03 chemistry with real connection. This is 4:03 chemistry with real connection. This is not religion. This is neurobiology. 4:06 not religion. This is neurobiology. 4:06 not religion. This is neurobiology. Pregnancy prevention dominates the 4:08 Pregnancy prevention dominates the 4:08 Pregnancy prevention dominates the conversation, but it is not the only 4:11 conversation, but it is not the only 4:11 conversation, but it is not the only risk that matters. Barrier methods 4:13 risk that matters. Barrier methods 4:13 risk that matters. Barrier methods reduce STD risk, but they do not 4:16 reduce STD risk, but they do not 4:16 reduce STD risk, but they do not eliminate it. Protection is not 100% 4:19 eliminate it. Protection is not 100% 4:19 eliminate it. Protection is not 100% breakage,
Barrier methods and social dynamics 4:20 breakage, 4:20 breakage, slippage, inconsistent use, and 4:23 slippage, inconsistent use, and 4:23 slippage, inconsistent use, and skin-to-skin transmission all matter. 4:25 skin-to-skin transmission all matter. 4:25 skin-to-skin transmission all matter. When pregnancy risk is chemically 4:27 When pregnancy risk is chemically 4:27 When pregnancy risk is chemically removed, social dynamics can shift. Some 4:30 removed, social dynamics can shift. Some 4:30 removed, social dynamics can shift. Some women feel pressured to engage sexually. 4:33 women feel pressured to engage sexually. 4:33 women feel pressured to engage sexually. Boundaries can erode. Power imbalances 4:36 Boundaries can erode. Power imbalances 4:36 Boundaries can erode. Power imbalances can emerge. 4:38 can emerge. 4:38 can emerge. So, what do I actually recommend? My 4:40 So, what do I actually recommend? My 4:40 So, what do I actually recommend? My priorities are preserving endocrine 4:42 priorities are preserving endocrine 4:42 priorities are preserving endocrine health, 4:43 health, 4:43 health, minimizing long-term harm, and 4:45 minimizing long-term harm, and 4:45 minimizing long-term harm, and supporting emotional and physical 4:47 supporting emotional and physical 4:47 supporting emotional and physical safety. From a medical standpoint, 4:50 safety. From a medical standpoint, 4:50 safety. From a medical standpoint, abstinence carries zero pregnancy risk, 4:53 abstinence carries zero pregnancy risk, 4:53 abstinence carries zero pregnancy risk, zero STD risk, and zero hormonal 4:56 zero STD risk, and zero hormonal 4:56 zero STD risk, and zero hormonal disruption. It remains the lowest risk 4:58 disruption. It remains the lowest risk 4:59 disruption. It remains the lowest risk option. If a young woman chooses to be
Medical alternatives and informed consent 5:01 option. If a young woman chooses to be 5:01 option. If a young woman chooses to be sexually active, I would recommend 5:03 sexually active, I would recommend 5:03 sexually active, I would recommend barrier methods: condoms, diaphragms, or 5:06 barrier methods: condoms, diaphragms, or 5:06 barrier methods: condoms, diaphragms, or the FemCap. They avoid hormone 5:08 the FemCap. They avoid hormone 5:08 the FemCap. They avoid hormone disruption, preserve natural cycles, 5:11 disruption, preserve natural cycles, 5:11 disruption, preserve natural cycles, offer partial STD protection, and are 5:14 offer partial STD protection, and are 5:14 offer partial STD protection, and are immediately reversible. They're not 5:17 immediately reversible. They're not 5:17 immediately reversible. They're not perfect, but they respect physiology. We 5:20 perfect, but they respect physiology. We 5:20 perfect, but they respect physiology. We also need to talk about longer-acting 5:21 also need to talk about longer-acting 5:21 also need to talk about longer-acting devices because they are often presented 5:23 devices because they are often presented 5:23 devices because they are often presented as set-it-and-forget-it solutions. 5:25 as set-it-and-forget-it solutions. 5:25 as set-it-and-forget-it solutions. Copper IUDs are non-hormonal, but they 5:28 Copper IUDs are non-hormonal, but they 5:28 Copper IUDs are non-hormonal, but they can increase bleeding, cramping, 5:30 can increase bleeding, cramping, 5:30 can increase bleeding, cramping, inflammation, and discomfort in some 5:32 inflammation, and discomfort in some 5:32 inflammation, and discomfort in some women. IUDs that release 5:33 women. IUDs that release 5:33 women. IUDs that release hormone-disrupting chemicals, such as 5:35 hormone-disrupting chemicals, such as 5:35 hormone-disrupting chemicals, such as Mirena, cause lower systemic exposure 5:37 Mirena, cause lower systemic exposure 5:37 Mirena, cause lower systemic exposure than oral contraceptives, but they still 5:39 than oral contraceptives, but they still 5:39 than oral contraceptives, but they still suppress normal hormone signaling. They 5:42 suppress normal hormone signaling. They 5:42 suppress normal hormone signaling. They are still associated with mood changes, 5:44 are still associated with mood changes, 5:44 are still associated with mood changes, reduced libido, anxiety, and many other 5:47 reduced libido, anxiety, and many other 5:47 reduced libido, anxiety, and many other side effects in some women. Implantable 5:49 side effects in some women. Implantable 5:49 side effects in some women. Implantable arm devices like Nexplanon continuously 5:52 arm devices like Nexplanon continuously 5:52 arm devices like Nexplanon continuously release hormone-disrupting chemicals. 5:54 release hormone-disrupting chemicals. 5:54 release hormone-disrupting chemicals. They strongly suppress ovulation. They 5:56 They strongly suppress ovulation. They 5:56 They strongly suppress ovulation. They are frequently associated with mood 5:58 are frequently associated with mood 5:58 are frequently associated with mood changes, anxiety, depression, weight 6:00 changes, anxiety, depression, weight 6:00 changes, anxiety, depression, weight gain, irregular bleeding, reduced 6:02 gain, irregular bleeding, reduced 6:02 gain, irregular bleeding, reduced libido, and many other side effects as 6:04 libido, and many other side effects as 6:04 libido, and many other side effects as well. These devices are not benign. They 6:07 well. These devices are not benign. They 6:07 well. These devices are not benign. They may be appropriate in select cases, but 6:09 may be appropriate in select cases, but 6:09 may be appropriate in select cases, but they require real informed consent 6:11 they require real informed consent 6:11 they require real informed consent before any young woman starts 6:13 before any young woman starts 6:13 before any young woman starts contraception. True 6:19 what is actually happening. These drugs 6:19 what is actually happening. These drugs contain no human hormones. They suppress 6:22 contain no human hormones. They suppress 6:22 contain no human hormones. They suppress ovulation and shut down normal endocrine 6:24 ovulation and shut down normal endocrine 6:24 ovulation and shut down normal endocrine signaling. They can affect mood, libido, 6:27 signaling. They can affect mood, libido, 6:27 signaling. They can affect mood, libido, anxiety, attachment patterns, fertility 6:28 anxiety, attachment patterns, fertility 6:29 anxiety, attachment patterns, fertility recovery, and long-term hormone 6:30 recovery, and long-term hormone 6:30 recovery, and long-term hormone responsiveness. Copper IUDs may increase 6:32 responsiveness. Copper IUDs may increase 6:32 responsiveness. Copper IUDs may increase pain and bleeding. Mirena-type IUDs may 6:35 pain and bleeding. Mirena-type IUDs may 6:35 pain and bleeding. Mirena-type IUDs may still cause systemic effects. Implants 6:37 still cause systemic effects. Implants 6:37 still cause systemic effects. Implants like Nexplanon carry significant 6:39 like Nexplanon carry significant 6:39 like Nexplanon carry significant neurohormonal risks. Declining,
Final warning on synthetic hormones 6:41 neurohormonal risks. Declining, 6:41 neurohormonal risks. Declining, delaying, or discontinuing contraception 6:44 delaying, or discontinuing contraception 6:44 delaying, or discontinuing contraception is a legitimate medical choice. 6:46 is a legitimate medical choice. 6:46 is a legitimate medical choice. Protecting natural hormone function is 6:48 Protecting natural hormone function is 6:48 Protecting natural hormone function is not irresponsible. It is informed. That 6:52 not irresponsible. It is informed. That 6:52 not irresponsible. It is informed. That is what true informed consent looks 6:54 is what true informed consent looks 6:54 is what true informed consent looks like. Not persuasion, not fear, just 6:58 like. Not persuasion, not fear, just 6:58 like. Not persuasion, not fear, just clarity. 6:59 clarity. 6:59 clarity. The real question is not what's easiest. 7:02 The real question is not what's easiest. 7:02 The real question is not what's easiest. The real question is what best protects 7:05 The real question is what best protects 7:05 The real question is what best protects her long-term biology, emotional health, 7:08 her long-term biology, emotional health, 7:08 her long-term biology, emotional health, and future fertility. Synthetic 7:10 and future fertility. Synthetic 7:10 and future fertility. Synthetic hormone-disrupting chemicals may prevent 7:12 hormone-disrupting chemicals may prevent 7:12 hormone-disrupting chemicals may prevent pregnancy, but they also silence normal 7:15 pregnancy, but they also silence normal 7:15 pregnancy, but they also silence normal hormonal communication during a critical 7:17 hormonal communication during a critical 7:17 hormonal communication during a critical developmental period. That deserves 7:20 developmental period. That deserves 7:20 developmental period. That deserves honesty before the prescription, not 7:22 honesty before the prescription, not 7:22 honesty before the prescription, not after the consequences. 7:24 after the consequences. 7:24 after the consequences. If you're a parent, a young woman, or a 7:26 If you're a parent, a young woman, or a 7:27 If you're a parent, a young woman, or a clinician, 7:28 clinician, 7:28 clinician, were you ever told these drugs contain 7:30 were you ever told these drugs contain 7:30 were you ever told these drugs contain no actual hormones? Were you told they 7:33 no actual hormones? Were you told they 7:33 no actual hormones? Were you told they function through chemical castration? 7:36 function through chemical castration? 7:36 function through chemical castration? Would that knowledge have changed your 7:38 Would that knowledge have changed your 7:38 Would that knowledge have changed your choices? Let's talk about it in the 7:40 choices? Let's talk about it in the 7:40 choices? Let's talk about it in the comments.
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