Low Cortisol

How birth control affects our hormones with Kate Vazquez


In this interview, Laurie and Kate Vasquez discuss How birth control affects our hormones, as well as what you can do for better hormone harmony and what alternatives are available for avoiding pregnancy.

Kate Vazquez is a Functional Medicine Physician Assistant, founder of Radiant Health, and is an Award-Winning & Best Selling Author of Estrogen Is A B*tch. She helps successful, driven women to get rid of PMS and fatigue by balancing their estrogen naturally so they never notice their period again, can perform their best every day, and become the confident leader, wife, and mother they aspire to be.

This is a transcription of an Instagram live conversation. You can find the full video on Laurie’s IGTV tab on Instagram and on soon on YouTube.


I’m with Kate Vazquez today and we’re going to be talking about all things birth control and hormones. We’re gonna dive into birth control and how that really affects our hormones in both positive and negative ways. 


I’m just so excited to be back again because birth control is a big topic. I think it’s important that a lot of women are aware. Especially having informed consent, if the first thing your practitioner does, because you have crazy PMS, heavy periods, cramps, and mood swings is to want to put you on birth control. 

I want women to have an understanding of what happens to their bodies when they are on birth control and what the long-term effects are. I’m a PA physician assistant in western medicine. I wasn’t taught to educate and train women. It was mostly like you have this symptom, here is the solution, which usually is medication.

Generally, we know when someone is smoking or if they have a clotting factor called factor fibroin that they shouldn’t take birth control, because it can increase the risk of clotting. We’re not taught about the long-term impacts, which is what happened to me. So I’m super excited to be talking about this today because women should be informed.


Yes. I’m so glad you’re here because I grew up as an average woman in America, thinking that taking the birth control pill was just kind of what you do. Growing up I thought you take it to balance your hormones. You take it if you have skin problems or if you have period problems. I also thought it was the best way to prevent pregnancy. Nearly all women use it and also from a very very young age, especially nowadays. 


Yeah. Especially if you think about it, I think I started my period around 12 or 13. Now girls are starting their periods at age seven or eight and they’re starting so young because there are a lot of things in our environment which are making that happen. 

They’re on birth control earlier and earlier. I got put on it in high school when I was 14 or 15 years old. I got started on it for acne, and the pill definitely cleared it up. But my acne was a sign of hormonal imbalance. 

Before that, I had gone to all the dermatologists and tried all these different creams. The only good thing the dermatologist told me was that because I had oily skin, I needed to moisturize. I thought I didn’t need to add anything, because then I would produce more oil, but my skin was producing more oil because it needed moisture. Ever since then I’ve been moisturizing my skin.

All the creams and stuff they recommended had just dried my skin out and no doctor ever talked to me. I remember asking a dermatologist if the acne was diet-related and if chocolate contributed. Even though I love chocolate, I was willing to give it up if it cleared my skin, because I was so self-conscious. They said that that was a myth and that chocolate couldn’t cause acne.

Once I came off birth control, I discovered that if I eat chocolate right before my period, it makes me break out. There are some clients that I see and if they eat gluten or dairy it causes their acne to flare up. So acne can be food-related if there are issues with the gut that are contributing to hormonal imbalances. 

Also, birth control doesn’t balance your hormones. It suppresses your hormones. So progesterone, estrogen, and even testosterone decrease. That’s why it helps with the symptoms of PCOS because it increases a protein called sex hormone-binding globulin. This protein just binds up all your hormones, primarily testosterone. Women with PCOS have high testosterone levels and it binds to all that, which really improves symptoms.

So it’s not really balancing out the hormones. It’s just binding the testosterone and suppressing the production of your own progesterone and estrogen. It’s really just a bandaid. It’s not getting to the root of what’s going on and not really balancing your hormones. It’s just temporarily giving you a quick fix.


In my practice, I have seen that there are definitely a lot of ways that we can approach acne that don’t require birth control and are better at getting to the root cause. 

But going back, birth control is given as a cure for so many things. As you’ve mentioned it’s not balancing our hormones despite what we’re taught. 

So what happens when a woman is on birth control? I can’t really say that I’ve been there personally because I was somebody who felt from the beginning that birth control wasn’t for me. I was having all sorts of symptoms and was put on birth control right away, but it didn’t make them better. Birth control actually made it worse. 

A lot of women take birth control for acne and don’t wanna go off it out of the fear that acne or their other issues might come back.

So I’d love to dig in a little bit about what’s really going on. And some of the things that could actually help with symptoms instead of birth control, if that’s not the route you wanna take. 

Then I’d love to talk a little bit about other options. If people are wanting birth control to prevent pregnancy, are there other ways that women can do that, that maybe wouldn’t have the long-term effects?

Which hormone type are you?

Learn to finally ditch the fatigue, cravings, moodiness, brain fog, skin woes, overwhelm — & more — by discovering your personal blueprint to optimized health & hormones.


Yes, there is so much to talk about it. Birth control definitely does help a lot of women, but then there are other women where symptoms get worse or they maybe even develop new symptoms. For example, I had a friend who was on birth control and she actually started getting acne. Some women will actually gain weight on birth control or they feel worse with menstrual cramps and mood swings. 

That’s because you’re taking in synthetic estrogen and progesterone. If you’re not supporting your liver, you’re gonna have trouble processing these synthetic hormones, because your liver metabolizes the hormones. 

Even if you’re not on birth control like I discovered that I had trouble breaking down estrogen in my body, which is probably one of the reasons why I developed acne in the first place. 

So it’s definitely worth thinking about why women feel worse when they get off birth control. For one your hormones are typically suppressed for so long that it actually makes the problem worse. 

When I came off birth control, my progesterone levels were so low. I was amazed when I did the testing. I had to support my body to produce it again naturally. That’s one of the problems. Your progesterone levels plummeted after being on birth control because they were suppressed, even if you had regular levels before taking birth control. 

The main thing I look at is hormone balance, especially from the perspective of estrogen dominance. That means that estrogen becomes a dominating hormone because progesterone is not being produced. 

We need a nice balance of estrogen and progesterone because progesterone really balances out estrogen. 

That’s why a lot of women will actually feel worse coming off birth control. That’s also what happened to me. I came off birth control, which I had because of my acne, and ended up with irregular cycles, severe menstrual cramps, breast tenderness and I gained weight in my butt, hips, and thighs. 

Before I never had these issues with my period and I had always had a very lean athletic build. So when I really dug deeper into my hormones, I realized that my progesterone levels were low and that I needed to support the breakdown of estrogen through my liver. Once I was able to support my hormones naturally all the symptoms went away. 

Estrogen dominance is probably the main reason why women are experiencing a worsening of their symptoms. I also came off birth control for a year at one point and my acne started popping back up again. That worried me, so I went back on the pill. 

Sadly at that point, I hadn’t learned about function medicine yet and it was only later that learned what birth control was doing to my body. Then I started healing my body and balancing my hormones from a more natural standpoint, by eating the right foods, taking the right supplements, and nutrients, and really supporting the liver metabolism of estrogen, but also making sure it was eliminated properly by my gut.

Once I did all these things, those symptoms significantly improved. There are so many different factors to look at. If women are getting worse symptoms, when they come off the birth control, we gotta look at the gut. We gotta look at the sex hormones: Are they being produced? Do we need to support the breakdown of estrogen? We also need to look at the adrenals because a lot of women produce a lot more cortisol when they are under stress, which also takes away from progesterone production.

We also make sure there are no toxins in the woman’s environment because birth control is a xenoestrogen. It’s a foreign estrogen that we take into our bodies. There are tons of xenoestrogens in our environment with all the products we’re using, like makeup, body wash, shampoo, detergents, and more. We have to really start looking at all the different things that can be contributing to symptoms. 

So then we’re at “I wanna come off birth control, but I don’t wanna get pregnant.” This is exactly where I am in my journey because I went off birth control three years ago. I’m still not ready to have a baby, but I wanted to have enough time to really support my hormones and my body. So that when the time comes and I am ready that I don’t have to worry about a miscarriage.

I noticed in a lot of women, family, friends, and coworkers that with women who come off birth control, their first pregnancy ends up resulting in a miscarriage most of the time. That’s because their hormones are all over the place. 

When women come off birth control and they want to prevent pregnancy, I look into the natural fertility awareness method, which you have to follow immaculately. The first step is to track your cycle. You need to know and be aware of how long your cycle is. That means the time from one period to the next with the start of your period being the start of your cycle. Day one of your period is day one of your menstrual cycle. 

Once you start tracking your cycle, you wanna have data from at least five or six months of tracking, especially if you’re coming off birth control because your cycle is going to be all over the place. If you can get enough data then you have an idea of how long your menstrual cycle is. 

Then you can start predicting ovulation. Don’t only rely on an app though because when I use other metrics then ovulation is typically off a day or two in the app, which can result in pregnancy if you’re not careful. 

The second step I recommend doing is checking your basal body temperature. That means checking your temperature as soon as you wake up in the morning. I used to do this with a thermometer every single morning and I would write it down, but I then learned about the Oura Ring and invested in it because it checks my temperature for me. I don’t have to worry or think about it. I just wake up and go.

I know once my temperature increases, that’s when I ovulated and so I know when I was fertile. So once you track your cycle, and start checking your temperature, you start getting an idea of when you are ovulating. Not every woman is going to ovulate on day 14, which is an average ovulation day of a 28-day cycle. So that’s really important. You need to know what day you’re ovulating. 

The third thing is checking your cervical mucus because our cervix is going to be producing mucus. So right after our period, we’re dry for a few days. Then it becomes this white or yellowish mucus that feels kind of wet and that’s for a few days. After it starts getting really thick and white like a jelly, which you have for a few days.

Now you are getting close to ovulation, which is in the fertile zone. The mucus will then turn into this clear, stretchy, egg-like consistency. That’s when you are the most fertile. Women are typically fertile for only 24 hours. However, you have to be mindful that sperm can live in the vaginal canal for up to five to six days

When you do these three things, you have an idea of when you’re getting into the fertile zone and when your ovulation is. Once you are aware, of when you are exactly you’re ovulating every single month, I always tell women to avoid sex or use condoms the first five to six days before ovulation and the one to two days after. 

For condoms, there are a couple of great brands that don’t have toxic chemicals, like Sustain. Use condoms on days before and after ovulation or just don’t have vaginal sex, because vaginal sex is the only way to get pregnant. 

You have a couple of options during those like six to seven days of your cycle. If you follow those things and pay close attention, you’re not gonna get pregnant. It’s a 99% chance. I say 99% because there’s always that 1% chance of error. That’s why it’s so important to track your cycle, check your basal body temperature, and check your mucus because all three things are gonna really help you determine when it is your fertile zone and when to use extra protection.

We need a nice balance of estrogen and progesterone.”


Yes. That’s so helpful. And then, okay. So you talked about the changes that happen when you are on birth control. That those are synthetic and not our natural hormones and also the changes that happen with progesterone.

I wanna talk a little bit about our natural estrogen. So you wrote a book called “Estrogen is a b*tch” but estrogen can be great and progesterone as well. Progesterone is the calming hormone and estrogen is the youthful hormone. So let’s talk a little bit about why having natural hormones is beneficial for our body and our health as women. 

I think that’s an important topic. Also, what’s the difference between producing our own natural hormones, the quantities that are natural for a woman, and what we would produce if we’re on birth control and it’s suppressing things.


Absolutely. This is such a great question. Even though my book is titled “Estrogen is a b*tch” I don’t wanna give estrogen a bad rep. It’s just a bitch when it’s imbalanced. But we can take the steps to naturally balance our hormones and support a healthy relationship between progesterone and estrogen so that estrogen’s not dominating anymore. In fact, we can actually make it become our best friend. That’s what I talk about in the book. 

This is such a great question because there are so many benefits. Progesterone is our feelgood hormone. It helps us to sleep at night. It keeps us calm and peaceful. In fact, we always call it nature’s valium. Testosterone is nature’s viagra. 

Estrogen, as you said, is our youthful hormone. It’s what makes our skin supple and soft. When we age and our estrogen levels start to decline, we start losing collagen, and not having estrogen causes our skin to wrinkle. 

Estrogen is also really protective for our hearts and it helps with blood sugar. Low estrogen causes insulin resistance, but too much estrogen in the body can also contribute to that. That’s why it’s important to have a natural or healthy balance of estrogen. That’s when it protects our hearts, when it’s really good for our brains and for memory. It can actually prevent Alzheimer’s. We need estrogen for our bones to keep them strong and healthy. There are so many benefits and I talk about them in my book too. 

So the goal is not to get rid of estrogen, suppress it, or reduce it. We wanna support a healthy balance. That’s why I call it a Goldilocks hormone. We don’t want two little or much, we want just the right amount in our body. 

Testosterone is really important too. I jokingly said that it’s nature’s viagra because it does help improve libido and sex drive. It’s also important for our hair. That’s another thing that I noticed when birth control increased my sex hormone-binding globulin, it also bound a lot of my testosterone. I was losing a lot of hair. I was so confused because when I was younger, I had a lot of full thick hair, and all of a sudden I just was losing so much of it. That was because my testosterone plummeted. 

For a lot of women who train taking birth control can be difficult. You need testosterone to build up that muscle mass. That isn’t gonna happen if your testosterone levels are low, no matter how hard you push in the gym. You’re gonna burn out. You’re gonna increase cortisol and eventually, you’re gonna burn out your adrenals 

So that’s why it’s important to naturally support our hormones because when we take these synthetic hormones there not the same as our own bodies and our body is going to have a different reaction. That’s the case whether it’s birth control or even hormone replacement therapy when women get older. Some hormone replacement therapy comes from a pregnant horse’s urine.

So our body is not gonna handle them the same way. I’m not discouraging from hormone replacement therapy when women go through menopause, there are benefits to getting hormone replacement therapy, but find a practitioner who does compounding hormones that are coming from plants, because the plant hormones are actually the exact same as our own hormones and our body. Some women actually have better results and can actually improve health and longevity through that path. 

But while women are still cycling, I think it’s so important that we support the production of progesterone and help keep estrogen in balance and check that it’s being metabolized out properly. So it’s not present in excess, getting reabsorbed and increasing the amount of estrogen in our body.

We also need to be working on adapting to stress, because when our bodies are stressed it also causes low testosterone in women and not only low progesterone. I see a lot of women with initially high testosterone, high androgens, and DHEA but when women are burnt out, their testosterone levels plummet. So we wanna make sure that we are doing things to really support our body and our health, to naturally support our hormones.

Low Cortisol


Yes. Despite what we’ve been told or what we understand from conversations with our friends and such, birth control is not always the answer. And it’s really not the answer to balancing hormones, it might be helping with other things, but balancing hormones is not one of them. 

There are a lot of solutions in different ways that we could balance our hormones naturally to really harness the power of our natural hormones. To do all those things that help us look and feel our best.

We’ve talked about what goes on when you’re on birth control. That it’s more of a bandaid and suppressing the natural hormone flow. What happens in the long term when you’re on birth control for years and years? A lot of women have been on it forever.


Yeah. That’s so crazy. In fact, some women are on it so long that when they come off, their body just goes into menopause and because they’re in that transition phase, they never get their period. Birth control can actually increase the risk of cancers like breast, uterine and endometrial cancer. Especially if the woman never really had normal cycles. Not having a period for years isn’t good. It’s not normal. It’s not healthy. 

When we have our period, that’s a way to actually release a lot of toxins too. It’s a way of cleansing and detoxing, which we do through sweating and when we go to the bathroom and poop and pee. When women have their periods every single month, that’s a form of detox. If that’s not happening in the body there are long-term effects.

One of the things that I looked at in studies was that it impacts gut health. It causes something called leaky gut. We have a really thin intestinal lining, as thin as one piece of salt. We’re supposed to have this nice thick mucus layer to protect it. But birth control really does insult that, it disrupts the integrity of that gut lining, which is supposed to be really tight and not allow things to pass through, except for water, vitamins, and minerals. When we have a disruption of gut integrity there are holes and things passing through to the immune system on the other side of the lining.

A lot of women that go on birth control end up developing autoimmune disorders for this very reason. I think that’s also why I started having a lot of gut issues. I started birth control in high school. Then in college, I started having bloating, constipation, and a lot of gas. I’m not saying it was the only reason that contributed to my gut issues, but it was definitely one of the reasons. Studies actually show that there is a link between birth control and leaky gut. I mentioned autoimmune disorders. There’s also a link between the development of Crohn’s and ulcerative colitis, which makes sense because it’s impacting the gut and the immune system, so it’s gonna contribute to these disorders. 

A lot of women can develop issues with their gallbladder because birth control impacts the ability of our liver to produce something called Bilirubin. We need Bilirubin to produce bile because it gets produced in the liver, and then it’s stored in the gallbladder. So if birth control is affecting this process, it’s actually impacting our gallbladder and we’re not able to digest that well. 

We also need the bile to bind estrogen that is inactive. So when it gets broken down in our liver estrogen becomes inactive, we need it to bind to bile. Then it can go to our intestines and we can poop it out. If that process is being affected and impacted, it contributes to the reabsorption of all this estrogen in our body that we need to get rid of. This is why birth controls can contribute and even cause gallbladder disease. 

In fact, I had a client come to me who was on birth control and developed gallbladder disease. She asked her doctor if the birth control could have done it and her doctor said no. But if you look at the literature, look at the research and look at the studies, there are women that have gallbladder issues and are put on birth control, which actually makes their gallbladder issues worse. There are also some women that never had issues with their gallbladder until getting on birth control. So you definitely wanna start thinking about this. 

The result is the removal of the gallbladder and when gallbladders are removed, they’re not breaking down fats efficiently. People have a lot of gut issues afterward and they’re not absorbing certain fat-soluble vitamins like vitamin D, K, and E, which are really important. We need fats to absorb these nutrients. 

At the end of the day, we have to look at what’s causing the gallbladder issue. With birth control, it can be a chicken or the egg situation. If it’s the birth control you need to come off it. If it was some other reason, you gotta fix that first. 

So those were a lot of common things we see in women long term, not only does birth control increase your sex hormone-binding globulin and bind up hormones like testosterone, but it also suppresses the production of your hormones and contributes to leaky gut and gallbladder issues.


That reminds me. We joked that testosterone is nature’s viagra and you mentioned that it gets bound by sex hormone-binding globulin. A lot of women struggle with the loss of libido after they go on birth control.


Absolutely. You’re losing your libido and you’re losing your hair. If you’re not supporting the metabolism of estrogen properly, you’re setting yourself up for a higher risk of estrogen-related cancers. It’s not just breast, endometrial and uterine, but there are other estrogen-related types of cancers, such as brain cancer, thyroid cancer, lung cancer, intestinal cancer, and bone cancer. That’s because we have estrogen receptors all over our bodies. If we’re not supporting the metabolism of estrogen in our body, this excess estrogen is gonna bind to these receptors and it’s gonna turn on cancer genes. 

Unfortunately, for a lot of women that end up developing these types of cancers, no one’s looking at how well estrogen is being metabolized in their liver and in their gut. This is a huge, important piece that’s missing. So we really need to dive in deeper and support all these different systems and all these different pathways. That way we’re preventing a lot of these things from happening in the body.


Yes. We covered so much. You said at the very beginning that women should be better informed before going on birth control and learn about how that’s gonna affect their body when they’re on it and in the long term even after they come off of it. A lot of times we’re not well informed about that. 

There are other options and this is no judgment to any woman who decides that birth control is the best choice for them. A lot of times women are making that choice without having all of the information. Before we make that choice, we should be able to have that information provided to us so we can make the best choice for us. Would you rather be on birth control and then give up your libido, perhaps that’s the choice you wanna make, but maybe you went on birth control because you wanna be very sexually active and you don’t wanna lose out on that libido.

There are other options out there and it’s so great that you came on today to help me talk about this. Hopefully some women out there are getting a better understanding of birth control, the knowledge is out there, but we women, on the whole, aren’t very well informed. There’s a lot more that we could know about this stuff.

That is what we practitioners are here for. We help educate and level up our knowledge around our hormones so that we can make better-informed decisions that are gonna impact how we feel and show up every day because we care about all of our long-term health.


Absolutely. I completely agree. The key takeaway that I too want to leave you with is that if your doctor just told you that you need to take birth control, you have all this information now to make the best decision for you going forward.

When you go on birth control or if you are on it, are there some things you can still do? Absolutely. Working with a practitioner who has that understanding and can support and guide you through that. Granted, for me, I try to do everything that we can before you get on that birth control and if everything doesn’t work out then birth control is the last resort and choice.

Thank you so much, Laurie. This has been awesome. I hope this was helpful because it is our goal and mission to educate more women.

Find out more:

Connect with Kate on Instagram @katevazquez_pa and be sure to check out her website to find her book, more amazing tips and guidance.

This information is for educational purposes only and is not intended to diagnose, manage, or treat disease or serious conditions. Always check with your doctor before making any changes. It’s important to consult a well-informed health practitioner for personal advice about your situation before relying on general information we’re all wonderfully unique.

Laurie Villarreal, FNLP, CHWC, FNS, LMC, CPT, RYT

Hi, I'm Laurie, a functional nutritionist and board certified health coach, athlete, dog-mom, and biohacking adventure-lover. After having struggled for years to find lasting solutions for my own debilitating hormone-related symptoms, I created my online practice to begin helping other active, driven women get the support they need. I now help  women around the world elevate their health, energy, business and life by optimizing their hormones with personalized nutrition and lifestyle tweaks. Together, we discover new tools and strategies that keep you showing up at your best so you can play even bigger in your life and work.

Let's Connect: