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  • When I first started taking birth control at 17, it actually wasn't to avoid pregnancy. It was to treat my teen acne.


  • But as I grew up, started using the pill as a contraceptive, and became a scientist myself,


  • I started asking more questions about what exactly the pill is doing in our bodies. Because not only do I take it, but millions of other people around the world do too.


  • Now, there are a ton of different methods of birth control out there. We've got the hormonal ones, like the pill, IUDs, shots, implants,


  • and then the physical barriers like condoms and diaphragms. The list of choices is growing and frankly, it's kind of overwhelming.


  • So I figured we could focus on two of the most popular ones: the pill and the hormonal IUD,


  • both of which have a ton of interesting effects on the bodies of people who menstruate, some of which we're still figuring out.


  • Sometimes I think birth control can be a little bit of a mystery to some people.


  • About half of people who are on a birth control pill are on it for things other than pregnancy prevention.


  • When the birth control pill was first invented, part of its purpose was to be able to give the person


  • who was ovulating the power to decide what they wanted to do independent of their partner.


  • Dr. Stacy T. is right, this tiny but mighty pill prevents pregnancy, but it can also help the person taking it have more control over

    Stacy T.醫生是對的,這種微小但強大的藥丸可以防止懷孕,但它也可以幫助服用者更有效地控制

  • lots of other things to do with their sexual and reproductive health. So how exactly does it work?


  • There are lots of different formulations of the pill, but the most common is the combination pill. If you've watched my video on menstrual cycles,


  • which you can check out now, you'll remember that two of the important sex hormones that influence fertility are estrogen and progesterone.


  • The combination pill contains synthetic versions of both of those hormones: those are called ethinyl estradiol and progestin.


  • When you take both of these together, what it does is it suppresses ovulation.


  • There's a couple of other secondary factors that it does as well, it might alter motility of the tubes themselves, and it might thin out the lining of the uterus.


  • Basically the pill makes it so no baby-making equipment is up and running. On top of that, the progestin in the pill thickens the mucus of the cervix.


  • And yes, your cervix naturally produces mucus, it's totally normal and healthy and cool, and by making that thicker, it acts as a 'no sperm allowed' zone.

    是的,你的子宮頸會自然產生粘液,這完全是正常的、健康的、冷靜的,通過使粘液變稠,它可以作為一個 "不允許精子 "的區域。

  • So even if a sperm manages to get to the cervix, it would get stuck, kind of like a sticky trap for insects.


  • And yes. The pill does prevent pregnancy, but there are lots of other reasons to take the pill.


  • There are some other benefits and pleasant side effects that the pill can sometimes offer,


  • such as decreased bleeding with periods, decreased cramping with periods.


  • It can help treat acne, as my teenage self discovered, and in the long-term, research is also telling us that taking the pill can reduce our risk of


  • uterine, colon and ovarian cancers. And for those suffering from endometriosis or fibroids, conditions that cause really painful and really heavy periods,


  • the pill can provide relief by alleviating some of those symptoms.


  • Now, obviously, the birth control pill is not curing any of these conditions per se. It's meant to control symptoms.


  • Meaning, birth control isn't necessarily treating the root cause of an issue. And everyone is different.


  • So, while some people do get huge benefits out of taking it, the crappy side effects of birth control aren't talked about as much.


  • Things like headaches, breast tenderness, or nausea. And one reason why these side effects happen is the hormones in the medication are synthetic.


  • They mimic your natural ones, but they don't 100 percent match them. And that's why the pill's side effects are a little different


  • from the effects of, say, just the natural progesterone that your body produces.


  • And just by taking these synthetic hormones, the symptoms of your menstrual cycle may be amplified.


  • And in the long term, there are still some unanswered questions about birth control. Like what effect can these hormones have on mental health?


  • What effect does the pill have on our vaginal microbiome? And some of the side effects we do understand relatively well can be really serious,


  • like the increased risk of blood clots, but we'll get more into that later.


  • Because, to be most effective, the pill has to be taken daily around the same time so that the levels of these hormones in your body are kept nice and steady.


  • So what about the other popular contraceptive we mentioned?


  • The intrauterine device, or the IUD, is implanted directly into the uterus, which sounds a little intimidating


  • but IUDs fall under the category of LARCs, or Long-Acting Reversible Contraceptives. These little “t” shaped devices come in two main flavors: hormonal and copper.

    但宮內節育器屬於LARC的範疇,即長效可逆避孕藥。這些 "t "形的小裝置有兩種主要類型:荷爾蒙和銅。

  • And it's a favorite for those who want a more low maintenance option. Because once it's in the uterus, you can keep it there for years,


  • depending on which one you get, and you don't really have to give it much thought. The hormonal IUD's lifespan can be anywhere from 3 to 7 years,


  • depending on the brand. And apart from abstinence, LARCs are one of your best non-permanent bets to avoid pregnancy,


  • because they have more than 99% efficacy rate.


  • So how exactly does it work? The hormonal IUD is constantly releasing a small amount of progestin into the uterus


  • while it's chillin' up there, so it's a localized hormone delivery as opposed to the pill, which is releasing its hormones system-wide via your bloodstream.


  • And like the pill, the IUD's progestin thickens the mucus of the cervix. The hormonal IUD does also come with a “funarray of side effects:

    和避孕藥一樣,宮內節育器的孕激素會使子宮頸的粘液變稠。荷爾蒙宮內節育器也有一系列 "有趣 "的副作用。

  • things like irregular bleeding patterns, headaches, cramping, bloating


  • but typically, these are supposed to go away about 3-6 months after insertion.


  • There are also very rare cases of complications, like the device causing damage to the uterus, or your body can choose to just expel the IUD entirely


  • like, just yeet it out of your uterus, but again, these are very rare.


  • So as you can see, these two popular choices, the IUD and the pill, are far from perfect.


  • And remember that increased risk of blood clots? Here's the sitch on that.


  • We know that the increased risk of blood clotting is mostly from the estrogen components, because estrogen is thought to be what we call pro-thrombotic.


  • That essentially means that your blood is more likely to clump together into clots. And these can be dangerous because


  • they can block blood flow to other parts of your body. Research suggests that the synthetic estrogen in the pill is what's increasing


  • certain blood clotting factors, while also decreasing anticoagulants, or the substances that can thin out your blood,


  • all of which together makes a big, blood, roadblock more likely.


  • So the higher estrogen state, the higher that risk is. So when birth control pills were first invented, and the dosages were significantly higher,


  • that risk was much higher. And as we've moved down those dosages, that risk has become lower.


  • There are also cases where some kinds of progestin have been linked to blood clots, but we still need more research into that.


  • Like Dr. Staci said, those cases are rare, but this is why it's really important to be aware of the risks before choosing a birth control method,


  • especially within the context of your personal health history, because some individuals may have a higher baseline risk to begin with.


  • And how about the long-term impact of taking synthetic hormones?


  • I think a common misconception about birth control pills, in general, is that it can affect long term health overall.


  • Most of the risks and side effects involved are more immediate when you're taking it and for some of them, for the short period after you're taking it.


  • I think it's important to take a minute here and recognize that while birth control has changed the world and so many individual lives for the better


  • it's not as good as it could be. And yes, it lets those of us who ovulate have more bodily autonomy. We get to decide if and when we get pregnant


  • which is arguably one of the most important decisions for our lives and our health, and one that used to be much more out of our hands.


  • But the burden of birth control, the cost, the responsibility, and certainly the health risks, still mostly rests on the shoulders of the person


  • who can get pregnant, and they might be left with lots of questions, or stuck between choices that may not be quite right for them.


  • Because aside from the pill and the IUD, there are a ton of other options out there, and each comes with their own pros and cons.


  • One of the most common questions that I get all the time, is what is the best form of birth control?


  • And that question is really difficult because it's different for each individual person, because everyone has different priorities.


  • Everyone has a different health background.


  • Everyone has different ideas of if they want to prevent pregnancy, or if they want to treat symptoms of something else.


  • So best is not really a generalizable thing. It is what is best for you and your personal priorities.


  • My hope is that the more we talk about our existing birth control options, like which parts work and which parts don't,


  • and ask for more research into some of the side effects we still don't have a clear picture on, then the science world may be motivated


  • to come up with better and better options. And who knows, male birth control may become a reality sooner rather than later, and that would be rad!


  • The upshot is, I hope learning more about the ins and outs of your own bodily cycles and how birth control works within those


  • can give you the power to take your time. Talk to your healthcare provider, ask questions, do your own research, and make informed decisions


  • about what's best for you and your goals. Good luck out there.


  • I know it's tough but now at least you have some info to get you started.


  • Thanks for watching Seeker's new series Body Language. I hope you've enjoyed this video.


  • And if there's another women's health topic you want us to cover, leave us a comment. I'll see you next time!


When I first started taking birth control at 17, it actually wasn't to avoid pregnancy. It was to treat my teen acne.



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節育對身體有什麼影響? (What Does Birth Control Do To The Body?)

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    Summer 發佈於 2021 年 07 月 13 日