Should I put my daughter on the pill?

Should I put my daughter on the pill?

Most parents of daughters will reach a stage where they’ll have to help them with this decision, so here’s what you need to know.

READ MORE: DIFFERENT TYPES OF CONTRACEPTION

Many moms worry about the possibility of their daughters getting pregnant once they start having periods and put them on ‘the Pill’. With the growing number of teenage pregnancies, this concern is real. Doctors may also recommend that teenagers take the Pill for skin and period problems. This can be extremely helpful for teen girls, but could it have adverse effects on their growing bodies?

How does the pill work?

The Pill stops ovulation (the ripening of an egg/ova), minimises the thickness of the endometrium (womb lining that becomes a period) and thickens the mucous plug of the cervix (mouth of the womb) to block sperm.

READ MORE: THE LIFE OF YOUR CYCLE

Advantages of the pill

In his book, The Pill and Other Forms of Hormonal Contraception – The Facts (Oxford University Press), Dr John Guillebaud, professor of Family Planning and Reproductive Health at University College, London, explains that a big plus for the Pill is eliminating painful, heavy or unpredictable periods by stopping ovulation and taking over the work of the ovaries. The Pill supplies synthetic oestrogen and progesterone. The placebo pills included in the cycle, which differ in colour from the rest, don’t contain hormones. When these are taken, there’s a sudden change in hormones which triggers a ‘withdrawal bleed’ or ‘pill period’ that’s less painful and more predictable.

The Pill is also used to treat fibroids and endometriosis, and to minimise ovarian cysts. A 2017 study from the UK’s University of Aberdeen found that it helped reduce the risk of bowel, ovarian and endometrium cancer for more than
35 years after women stopped taking it – but warned that women shouldn’t rely on the Pill alone to reduce their risks. Another advantage for teenagers is that the Pill can help to clear acne.

Risks

The Pill’s possible side-effects include blood clots, thrombosis, liver diseases and unbalancing not only reproductive hormones, but also the insulin, growth, adrenaline and thyroid hormones. Guillebaud warns that the Pill interferes with
the absorption of minerals and vitamins, causes fluid retention (bloating and weight gain) and increases blood pressure. It can undermine immunity and can mask polycystic ovarian syndrome (PCOS). Migraines and depression
may also be exaggerated for Pill-takers. Smokers, overweight women and those with genetic illnesses such as thrombosis, heart abnormalities, diabetes and liver disease should consult a doctor before taking the Pill.

READ MORE: THE DIFFERENCE BETWEEN ENDOMETRIOSIS AND POLYCYSTIC OVARY SYNDROME

Lowering the dose of hormones 

When the Pill first became available (in the early 1960s), each one contained 150 micrograms of oestrogen. Side-effects were common, and this formula was soon taken off the market.

Why is the pill risky for teenagers?

The Pill was originally formulated for older women who’d already given birth. Because a woman’s body is ‘matured’ by pregnancy and breastfeeding, she’s less likely to be exposed to the carcinogenic risks of artificial oestrogen. Teenagers, however, whose bodies are still maturing, are more vulnerable.

Dr Angela Lanfranchi, an American breast cancer surgeon who co-founded the Breast Cancer Prevention Institute, has done extensive research on breast changes during pregnancy and breastfeeding. Her research has shown
how a full-term pregnancy matures the breast from Stage 1 (changes caused by puberty) to Stage 4 – fully mature after pregnancy and breastfeeding. A mature breast ‘blocks’ unnecessary oestrogen and helps reduce cancer
risks. Teenage girls who are still at Stage 1 are at greater risk of early, aggressive breast cancer if they’re exposed to high doses of oestrogen.

Another risk for teenagers is changes to the cervix. This opening to the womb is an important gateway for sperm. Cells lining the cervix make different types of mucus either to ‘plug’ the cervix and prevent sperm from swimming into
the womb during the infertile phase of a girl’s cycle, or to mimic seminal fluid when her body’s fertile. The late Prof Erik Odeblad, a Swedish physician who pioneered research on how the Pill affects fertility and ages the cervix, found
that those who’d used it for seven to 15 years could experience serious infertility problems.

Here’s why. ‘S crypts’ are cells in the cervix which make a special mucus that help sperm to swim and are essential for fertility. This mucus also improves the fertilising capacity of sperm from a few minutes to approximately five days. These cells are very sensitive to changes brought about by oestrogens. The Pill causes early ageing or degeneration of these crypts and fertility is affected when the movement of sperm cells up the canal is reduced.

Odeblad warned that treatment is difficult and cautioned that after three to 15 months of contraceptive pill use, there’s a greater loss of the S crypt cells than can be replaced. While a pregnancy rejuvenates the cervix by two to three years, for each year the Pill is taken, the cervix ages by an extra year.

How can mothers help their daughters?

Teenage girls often struggle with heavy, painful periods and skin problems, and if they’re sexually active, they
need to be properly protected. Weigh up the importance of effective contraception and the possible risks with your
daughter before making a choice.

Skin problems 

These really begin at ovulation (two weeks before a period), when hormones peak and plump the skin with oil from
overactive sebaceous and sweat glands. When bacteria get into open pores, they cause a microscopic infection
that takes about two weeks to erupt – which is usually when their period starts. For some girls, meticulous daily skincare can help. However, those suffering with serious acne should be seen by a dermatologist, who can offer alternative solutions to the Pill.

Period pain

Prostaglandin is a hormone that helps the womb contract when a period starts. This helps to break down the lining, so that it can be shed as a period. High prostaglandin levels can be blocked by taking an anti-inflammatory the day before a period starts, or on the first day of a period. Period pain can be minimised with direct heat, distraction, yoga and gentle exercise. Debilitating period pain should be treated by a doctor.

Heavy periods 

Oestrogen thickens the womb lining and is stored in fatty tissue. Eating healthily and taking regular exercise helps balance hormones. Extremely heavy periods with clots could be a symptom of an underlying medical problem such
as anaemia or a blood disorder and should be investigated.

Moods 

When progesterone levels drop a few days before a period starts, this often triggers mood changes. It’s quite normal for teenage girls to feel irritable and depressed, especially when fluid retention makes them feel bloated and nauseous. An understanding ear, and making sure your daughter eats healthily and gets enough sleep and exercise, can help.

Top tips for moms:

  • Keep the lines of communication open – don’t try to scare your daughter into celibacy; rather educate her on sexual health and help her gain the confidence to make good, informed decisions.
  • Discuss the potential side-effects of the Pill with her and explain that it’s only effective if it’s taken daily, it
    can’t protect against sexually transmitted diseases, and extra contraceptive protection should be used.
  • If your daughter’s sexually active, but has decided against the Pill, educate her on other forms of protection such as IUDs (intrauterine devices or coils), IUSs (intrauterine systems or hormonal coils)
    and contraceptive injections.

READ MORE: TIPS FOR GOOD VAGINAL HEALTH

Did you know? 

On average, 70 000 babies are born to teenage girls in South Africa every year. Sensitive Midwifery magazine journalist Kelly Norwood-Young says the causes of teenage pregnancy are complex. The United Nations Population Fund recommends suitable sexuality education programmes in schools. For example, Nzululwazi Senior Secondary School used to have the highest number of teenage pregnancies in the Eastern Cape before a three-year intervention programme was introduced in 2014. The programme educates pupils about their sexual health, gender-based violence, pregnancies, HIV and career choices. Since the start of the programme, the school has had no teenage pregnancies.

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The content is not intended to be a substitute for professional advice, diagnosis and treatment. Always consult your GP or specialist for specific information regarding your health.

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