I’ve had a lot of questions pop up about a really controversial video that a lot of our patients have seen regarding testosterone and birth control.
In the video a fitness trainer talked about how some of her patients had gotten much better results at the gym when they had stopped their birth control pills. She went on to say that the results were due to the fact that while on birth control you have a lower testosterone level and when you stop taking the pills your testosterone (and your fitness results) increase. I wanted to respond in order to help our patients figure out if this is something that they need to be worried about or not. Watch the video below.
First, let me say yes, that being on the birth control pill, lowers your free testosterone levels as well as your total testosterone levels.
Women have testosterone that comes mostly from our ovaries, but also our adrenal glands and some various organs in our endocrine system.
When we are on birth control, our ovaries don’t make the high levels of our usual hormones that we have throughout our menstrual cycle. Our estrogen, our progesterone and yes, our testosterone levels are all decreased as a production factor at the ovary, because birth control puts our ovaries to sleep.
Our brain works on this thing that we call a negative feedback loop. So the stimulating hormones that come from our brain that talk to our ovaries and tell them to make hormones are basically turned off when we’re on birth control pills, because we get this low, steady dose of hormone throughout the whole time that we’re there. So as that fact happens, our production of testosterone slightly decreased.
Free testosterone levels and total testosterone levels are two different things.
Total testosterone, it was all the testosterone in our body. While free testosterone is the testosterone that is able to act and produce effects in our body.
The other thing that birth control does to drive down testosterone effects, is increasing a protein that comes from our liver called sex hormone binding globulin. This is why, our acne clears up when we’re on the birth control pill, because less oil in our face less testosterone effect, less acne.
So what does this mean? If you are a star athlete who is in a fitness competition or you’re really trying to build up your muscle mass, could this affect your performance?
It is possible that it could.
If that’s bothersome to you, then come talk to us about it because there are other birth controls that we can prescribe that do not affect your serum testosterone levels.
What we don’t want you to do is to stop your birth control without having an alternative contraception in place.
IUDs are great option, so is the NuvaRing or the patch These are what we call transdermal or absorbed forms of hormones. These are not going to bump your sex hormone binding globulin levels like an oral pill. They avoid what we call first pass metabolism. They’re metabolized differently in the body and are not going to decrease the testosterone as much.
Some practitioners, providers and OB/GYNs will prescribe testosterone supplements to people who are on birth control if they have concerns about muscle wasting and things like that.
These are so many great options available so don’t hesitate to come in and have a conversation with your FĒNOM doc about finding the best solution for you. What we don’t ever want you to do is just stop your birth control cold turkey with no plan in place. We are here for you and committed to your well-being. We love talking to you guys and want to work with you to find what is right for you.