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Research suggests women who ovulate may have better COVID-19 outcomes

covid, birth control

Hormonal birth control (HBC), which prevents ovulation, is the societal norm when it comes to pregnancy prevention, as well as the treatment of acne and ovarian cysts. However, there are known women’s health benefits to ovulation and Natural Womanhood’s three-part series, “Reasons Why You Need a Period,” recently explored the relationship between a woman’s normal menstrual cycle and her immune, heart, and bone health. FEMM (Fertility Education & Medical Management) also recently released a white paper stating that women who ovulate and contract COVID-19 have better health outcomes than women who do not ovulate and contract COVID-19. This adds to the list of reasons why women may want to consider using fertility awareness methods rather than hormonal birth control.

Women on Hormonal Birth Control Miss Out on Immune System Benefits

Women receive several immune system benefits from having a properly functioning menstrual cycle, and those benefits change based on where they are in their cycles. During the first half of the cycle leading up to ovulation, the woman’s cervical mucus quality and consistency actually changes and is now high in immunoregulatory proteins that filter out poor quality sperm as well as bacteria or viruses that could cause infection.

In contrast, a woman on HBC, which prevents ovulation, does not receive the immune benefit of this cyclical change in her cervical mucus. During the second half of her cycle, following ovulation up until her next menstruation, a woman experiences a temporary suppression of her immunity that helps her to become pregnant — a true biological miracle. Additionally, during the teen years, the menstrual cycle and immune system cooperate to yield a mature cervix that helps to fight infections including HPV (human papillomavirus).

While there are definite immune benefits of having a normal menstrual cycle, in contrast hormonal contraceptive use has known detrimental effects to the immune system and makes young women in particular more susceptible to sexually transmitted infections like HPV.  Concerned parents may wonder why their teenage daughters are simultaneously being encouraged to receive a vaccination against HPV and to take birth control which may increase their susceptibility to the very same sexually transmitted infection. Some research also suggests that women who have HPV and take oral contraceptives are more likely to develop cervical cancer than women who have HPV but are not on the birth control pill.

Hormonal Birth Control Deprives Women of Benefits to Heart Health

Normal ovulation isn’t only an indicator of reproductive health. The sex hormones estrogen and progesterone impact the heart as well. Research suggests that a woman’s resting heart rate varies in predictable ways depending on where she is in her cycle, with a faster heart rate noted in the first half of the cycle when estrogen dominates. This part of the cycle is also characterized by bone growth, increased libido, uterine lining thickening, and brain cell stimulation.

In the second half of the cycle as progesterone rises, the resting heart rate drops. During this same time frame, libido decreases, brain cells and bone cells rest and repair, the uterine lining is maintained, and moods stabilize. Additionally, estrogen helps prevent the buildup of calcium in the heart’s arteries that can lead to narrowing of the heart’s blood vessels and heart disease. Estrogen also helps the heart pump more efficiently. High blood pressure is a known risk factor for heart disease, and naturally occurring progesterone decreases blood pressure by dilating blood vessels and helps modulate the body’s response to hormones that raise blood pressure.

On the flip side, hormonal contraceptive use is associated with increased risk for developing high blood pressure, high cholesterol, and diabetes, which are all risk factors for heart disease. Women may wonder why naturally occurring progesterone and estrogen benefit them, but the progesterone and estrogen in HBC do not. This is because HBC contains a synthetic form of progesterone called progestin and a synthetic form of estrogen called estradiol which both function differently in the body than naturally occurring progesterone and estrogen. Hormonal contraceptive use is additionally tied to increased rates of blood clots which can lead to heart attacks.

Birth Control and Bone Health

Estrogen helps to prevent the breakdown of bones and aids in the growth of new bone cells. This is part of why osteoporosis, where bones become brittle and weak and more likely to break, is more prevalent in perimenopause and post-menopause, when estrogen levels are significantly lower than pre-menopause. Besides the known role of estrogen in bone health, a 2010 research paper by two leading researchers on the relationship between reproductive hormones and bone health stated, “In vitro studies of human osteoblasts in culture, prospective studies in adolescent, premenopausal, perimenopausal, and post-menopausal women all indicate that progesterone—likely working through bone formation pathways—plays an active role in maintaining women’s bone and in osteoporosis prevention.” This research suggests that estrogen and progesterone are actually both implicated in healthy bone growth.

READ: Report: Birth control increases risk of deadly blood clots from COVID-19

“You need ovulation, as well as normal cycles, for healthy bones,” researcher Dr. Jerilynn Prior told Natural Womanhood. “Women spend the first 25 years of their lives building bone mass. If they are ovulating normally, they should be able to keep that bone mass throughout their reproductive life and beyond.”  Dr. Prior addressed the common misunderstanding that osteoporosis is directly related to estrogen deficiency, saying, “The story that everyone hears is that it’s estrogen deficiency that causes post-menopausal bone loss. But in reality, it’s the long time of pre-menopausal bone loss that’s silent if you’re not cycling regularly over the course of your reproductive years.” The article author summarized, “In other words, if you’re not ovulating during your prime reproductive years, your bone density will be negatively impacted, and those effects will manifest in your post-menopausal years.” Research on the relationship between HBC and bone health are mixed, but both the progestin-only Depo-Provera shot and oral contraceptive use are associated with increased bone loss amongst adolescents in particular.

Ovulation and COVID-19

Finally, the FEMM white paper commented on a new study released on July 22nd, “Potential Influence of Menstrual Status and Sex Hormones on Female SARS-CoV2-Infection,” which “explicitly links healthy hormone levels and ovulation to improved outcomes in women suffering from COVID-19.” The study examined why men seem to be more vulnerable to COVID-19 than women. Scientists hypothesized that sex hormones could play a role in the difference, and this study zeroed in on the specific role that female hormone levels and ovulation may play, noting that postmenopausal women who are no longer ovulating had similar outcomes to men. Further research is needed, but as the FEMM article concluded, “this study is a reminder that women’s reproductive health can never be separated from overall health and wellbeing.”

While menstrual cycles have long been considered a more-or-less-monthly nuisance, the rise and fall of sex hormones around ovulation actually has tangible benefits for immune, heart, and bone health. Hormonal birth control, which is regularly prescribed for pregnancy prevention as well as various reproductive health issues, deprives women of the immune, heart, and bone health benefits that result from normal ovulation.

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