The pill's trade-offs: benefits, underappreciated risks and what it means for fertility
Sharon Malone walks through birth control's benefits, its myths and the return of the rhythm method, Sara Gottfried weighs real benefits against underappreciated risks and discusses oral contraceptives and the copper IUD, Natalie Crawford explains what birth control does and does not do to fertility, Kyle Gillett discusses oral contraceptives alongside PCOS, Stacy Sims covers birth control with iron and blood tests, Rena Malik takes up contraception, and Andrew Huberman describes how the pill interacts with odor and ovulation in attraction. Comparing these views helps women weigh contraception choices with the full set of effects in mind.
Why doesn't the combined pill cause infertility, according to Crawford? Show answer
It doesn't change how quickly eggs leave the ovary's vault; it stops the brain's FSH signal, so each month's group dies without ovulating.
How does Malone compare the pill's clot risk with pregnancy's? Show answer
The pill raises clot risk two to three times, while pregnancy raises it six times.
Why does Malone say natural cycle tracking is poor contraception? Show answer
Temperature rises after ovulation, not before, so tracking is useful in hindsight or when trying to conceive, not for preventing pregnancy.
How does the pill lower libido in some women? Show answer
It raises sex hormone binding globulin (SHBG), which binds testosterone and makes it less available.
How long does SHBG stay raised after stopping the pill? Show answer
Malik says at least four months, Gillett says it can last quite some time, and Gottfried cites limited data showing it still elevated a year later.
How much does the pill lower ovarian cancer risk? Show answer
About 50% after about five years in Gottfried's account, and more than 90% after ten years in Crawford's.
What does Crawford advise if AMH tests low while a woman is on the pill? Show answer
Stop the pill for a few months and retest, since the pill can lower AMH by up to 30% and the effect is reversible.
Who should avoid the pill, according to Crawford? Show answer
Anyone who tests positive for a clotting disorder such as factor V Leiden; smokers and people with high blood pressure need extra caution.
How far ahead should Depo-Provera be stopped before trying to conceive? Show answer
One and a half to two years, Crawford says, since it can suppress ovulation for up to 18 months.
Why does Gottfried prefer the copper IUD? Show answer
It is non-hormonal, as effective as getting your tubes tied, and can last 10 years.
What did a 2024 study Sims mentions find about the pill and the brain? Show answer
Changes in the amygdala that increased fear and made women less willing to take chances; reversible in adults, unknown in developing girls.
What happens to attraction across the cycle when women take the pill, in the studies Huberman describes? Show answer
The peak around ovulation flattens: men no longer perceive a peak in women's attractiveness, and women no longer prefer the scent of more symmetrical men.