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Navigating Birth Control | Dr. Sophia Yen

This is the first post in a series of three about birth control. It became apparent in Season One of the Fempower Health Podcast that there's a lot of questions and potential controversy about birth control.

I wanted to get an MD perspective, a period expert perspective, and then the last one ends with a new innovation in birth control for you to consider. Here, I talk to Dr. Sophia Yen, who is an adolescent medicine specialist and co-founder of Pandia Health.


Georgie Kovacs: What are the benefits of birth control outside of preventing pregnancy?

Dr Sophia Yen: I listened to your interview with Dr. Briden, and I agreed with many of her points, and then she said some things, and I was like, I'd like to see the paper on that. I felt that there was definitely common ground on “to each their own.” But my belief is that the benefits outweigh the risks. The latest papers have said, the decrease in ovarian endometrial and colorectal cancer outweighs the slight increase in breast cancer.

Every time you have growth, you can have uncontrolled growth. And that is cancer. Every time you pop out an egg, you risk ovarian cancer. If we can quiet down the ovaries, be it through pregnancy or through the pill, the patch, the ring, or any other method that suppresses ovulation, we can decrease your risk of ovarian cancer by 50%. There is no other way to decrease your risk of ovarian cancer, other than taking out your ovaries, which I would not recommend.

The other thing is colorectal cancer. I find that fascinating. I think I heard on your previous podcasts that we, as women suck it up, we suffer. One in 10 women have endometriosis. One in 10 women have polycystic ovarian syndrome.

The pain of endometriosis is so horrific, and just because it runs in your family doesn't mean that it has to be. Life is actually better with the hormones being stable rather than up and down and up and down and up and down.

And so to me, if you're not trying to get pregnant, there's no point in building this lining and bleeding.

Georgie Kovacs: Why is it beneficial to not have a period? Isn’t that what women’s bodies are designed to do?

Dr Sophia Yen: We aren't supposed to be having as many periods as we're having. We're having 350 to 400 in our lives. And if you look at the Dogon tribe and Mali, which Dr. Beverly Straussman studies, the women are banished in the menstruation hut and they have a hundred periods in their lives.

We're having 350 to 400, because we have hyper-nutrition. We start our periods at 12, they start their periods at 15, 16, they have eight babies. We have two babies. They breastfeed for 12 months, exclusively. We breastfeed for zero, three or six, and they have seven or eight periods a year. We have 13 periods because as soon as you hit a hundred pounds or 22% body fat, that's when you get your period. As you know, we have tons of calories in the industrialized world and in the Dogon tribe in Mali, they don't have as many calories.

They're incessantly, pregnant or breastfeeding. How many periods do you have when you're pregnant? Zero.

How many periods do you have incessantly breastfeeding? Zero.

How many periods do we have over here? Where we're only having two children? Not saying we should have eight children, but I'm seeing the more natural state would be a hundred periods in our lives instead of 350 to 400.

Here, we have ovarian cancer, endometrial cancer. There, there is none.

And it's not like they're dying at 20. You know, we're comparing apples to apples. They too are dying at 70, 80 years old. And every single time you build that lining you risk cancer.

Georgie Kovacs: On the flip side, when women are struggling with PCOS, endometriosis, Hashimoto's disease, it just seems like medicine is “here is a problem, take a medication.”

The healthcare system is evolving where now, it's a 10-minute doctor appointment. It's not diving deep at the root cause. Also, there aren't enough clinical trials in women's health.

So now we have this situation where the trials aren't there and yet women are having to make these decisions with 10 minute appointments. You've got naturopaths that view it one way, you know, allopathic doctors have the traditional MDs, it's all about clinical trials and how do we know?

Dr Sophia Yen: I'm all about choice. It's about presenting the data out there, but looking at what has numbers behind it.

The pill, the patch, the ring, the IUD, the implant, all of those are out of your system within three days. The shot is a different matter because a shot sits in your fat and it could take nine months for it to get out.

The birth control pill, patch, ring makes you infertile while you're taking it, because that's the goal, that's birth control. 10% of women will get PCOS in their life, and the data shows this number does not increase because of the pill.

Georgie Kovacs: Much of the concern with birth control is the artificial hormones and what that can do to the body. Is it the way the clinical trials are designed that are not helping us get to the bottom of this, or is it that people potentially have more concern than there is?

Dr Sophia Yen: There are different approaches. When you are a naturopath (ND), your tools are this. So your answer to everything is this. When you're an allopath (MD), your tools are drugs and surgery. So your answer to everything is drugs and surgeries. And you believe in drugs because that's why you became an MD instead of an ND, right?

I think they can come together. If both sides bring the same scientific rigor and they absolutely can. I've absolutely seen studies where they did 50% sham acupuncture and 50% real acupuncture. I've seen 50% fake spinal manipulation and 50% true manipulate ideation, you know? And so if you do those studies with those numbers, then we can talk. But if you're not going to have the data, then we are just talking in the air, right?

We can't compare hearsay to data, and I think there's a concern about artificial hormones, but the question is, there's so many different hormones, there's so many different levels of hormones. That's the other thing I want to get across is that there are 40 different birth control pills. There are eight different progesterones. There are two or three different levels of estrogen and it matters how it comes to you. So if you get it, intra-vaginal only, it's a lower dose and it skips your stomach. If you take it by pill, it went through your stomach. If you use a patch, it's going to be a much higher level of estrogen. So one question you had brought to me is in choosing artificial hormones, how do I choose the one that's best for me?

The key is sometimes you have to trust the expert, but I absolutely agree that sometimes you, the patient, needs to be the expert.

If I were sick, I would want the most specialist or the specialist because they've been studying this thing and they don't have to know all hundred things. They know their one thing very well.

Georgie Kovacs: Women are still in a position where most have access to either no healthcare or if they do, they're going to the OB GYN, not the specialist. So if one were going to the OB GYN, who isn't the specialist, what should they ask? What is normal?

Dr Sophia Yen: First, what is normal? One of the number one causes of missed school and work in a woman under the age of 25 is her period, horrible pains, heavy bleeding anemia from it, migraines from it, depression from it. And that is sad to me because it's something we can absolutely treat. So if you are missing school or work because of your periods, please see a medical professional and get treated.