Birth Control’s Hidden Link to Brain Health & Autoimmune Disease | Dr. Sarah Hill

Hormonal birth control use is linked to altered stress responses and inflammatory profiles, potentially increasing the risk of autoimmune diseases and affecting brain health and mood.

• Hormonal birth control is linked to altered stress responses and pro-inflammatory profiles, potentially increasing autoimmune disease risk.

• Individuals with a history of autoimmune disease, mental health issues, or substance use should consider risks of hormonal birth control.

• Caution is advised when prescribing hormonal birth control to adolescents for non-pregnancy reasons, due to unknown long-term brain development impacts.

Hormonal birth control is increasingly linked to the development of autoimmune diseases due to its impact on the body's stress response, specifically by blunting cortisol and promoting a pro-inflammatory cytokine called TNF-alpha. Beyond autoimmunity, hormonal birth control can influence brain development in adolescents, exacerbate certain mental health conditions like depression and anxiety, and may increase alcohol cravings due to altered neurosteroid production. Critical research is needed to understand the long-term effects of hormonal birth control, especially when prescribed to teenagers for non-pregnancy prevention reasons.

Hormonal Birth Control & Autoimmunity

• 00:00:00 There is a possible connection between hormonal birth control and autoimmune disease development, with research linking its usage to increased risk for certain types like Crohn's disease or diverticulitis. Hormonal birth control blunts the cortisol response to stress, which is problematic because cortisol normally decreases inflammation. This blunted response can lead to exaggerated inflammatory activity, a hallmark of autoimmune disease.

Inflammatory Response Research

• 00:02:12 Research shows women using combination hormonal birth control pills exhibit a different inflammatory response to stress compared to naturally cycling women. Those on birth control show a stress response characterized by the release of TNF-alpha, a uniformly inflammatory cytokine known to be implicated in autoimmune disease development. In contrast, naturally cycling women release IL-6, which has both pro- and anti-inflammatory effects.

Caution for Autoimmune History

• 00:05:31 Given the potential links, individuals with a family history of autoimmune disease should exercise caution with hormonal birth control. Natural hormones are very anti-inflammatory and protective against autoimmune disease, as seen in changes during menopause. While long-term research is limited, existing evidence suggests avoiding hormonal contraception if possible, due to its influence on immune system regulation.

Mental Health & Substance Use

• 00:09:04 Hormonal birth control can have divergent effects on severe PMS or PMDD, helping some women while worsening symptoms for others. Those with a family or personal history of depression and anxiety are at greater risk for negative mental health side effects. Additionally, by suppressing natural progesterone and its calming neurosteroid 'allopregnanolone,' birth control may lead to increased alcohol cravings and consumption, suggesting a risk for those with a history of substance use.

HBC's Impact on Adolescent Brains

• 00:14:51 Prioritized future research should focus on the developmental impact of hormonal birth control on adolescent brain development, as early evidence suggests changing hormone profiles during critical growth periods can have lasting effects. Prescribers are encouraged to be more cautious when offering hormonal birth control to teenagers for non-pregnancy prevention issues like acne, ensuring families are fully informed about the lack of long-term research on these effects.