What Does the Pill Do to Your Body?

For many women, the contraceptive pill is part of their daily routine—a small white pill each day to keep fertility in check. But what exactly does that little pill do to your body? In this article, we explain how the pill works.

Before we go any further, we want to make one thing clear: the pill is an effective method for preventing pregnancy and offers many benefits. Yet, it’s sometimes prescribed too quickly—for example, as a teenager, right after your first period. Anyone?

Doctors often prescribe the pill for menstrual complaints, but hormonal fluctuations are a natural part of growing up. Teenagers’ bodies need time to establish a regular cycle. If this doesn’t happen, it’s wise to look at the underlying causes instead of taking the pill to mask symptoms. After all, it’s treating the symptoms rather than solving the root issue. Now, let’s look at how the pill actually works!

How Does the Pill Work?

The contraceptive pill contains artificial (synthetic) hormones—usually a combination of estrogen and progesterone (with the mini-pill containing only progesterone). These two hormones play an important role in regulating fertility.

Ovulation occurs when a series of hormones rise and fall in a precise sequence. It’s like a chain reaction or a set of dominoes: one hormone activates the next, ultimately maturing and releasing an egg, which travels to the uterus for potential fertilization.

However, with the synthetic hormones in the pill, this chain reaction stops. The hormones keep levels stable, preventing the fluctuations necessary for ovulation. No egg matures, meaning no egg is released for fertilization.

Natural Cycle vs. Cycle on the Pill

In a natural cycle, as your body regulates it each month, there are four phases:

1. Menstrual phase: The unfertilized egg and built-up endometrium are broken down and discharged. This is your period.
2. Follicular phase: The FSH hormone (follicle-stimulating hormone) causes follicles (eggs) in the ovaries to mature, and estrogen levels rise.
3. Ovulation phase: Roughly 14 days after your period starts, estrogen peaks, causing an egg to be released.
4. Luteal phase (premenstrual phase): The egg is in the uterus, waiting for fertilization. The corpus luteum produces progesterone to prepare the endometrium for potential fertilization.

With the pill, this process is different. The steady hormone supply suppresses the natural fluctuations of estrogen and progesterone:

1. Your body receives a constant hormone dose: This makes it continually “think” it’s in the luteal phase. There’s no estrogen peak, so ovulation doesn’t occur.
2. Your eggs don’t mature: The synthetic hormones prevent egg development and release.
3. Artificial menstruation: During the stop week (or when using a placebo pill), hormone levels drop, causing a “withdrawal bleed.” This isn’t real menstruation but the shedding of a thinner endometrium than in a natural cycle.

If you continue taking the pill without a stop week, the endometrium remains minimally built up due to the continuous hormone intake.

Why Is a Natural Cycle Valuable?

While hormones regulate fertility, they also influence many other processes in your body, affecting things like mood. Sudden irritability, anger, or sadness. Sound familiar?

Research shows that teenage girls have an increased risk of depression when taking the pill. Girls on the pill are 130% more likely to suffer from depression, meaning their risk more than doubles. Even if you’re no longer a teenager, it’s a factor worth considering when using the pill.

What Happens to Your Eggs on the Pill?

Eggs begin to mature, but they never fully develop because the pill keeps estrogen levels stable. Since they aren’t released, the eggs eventually die and are absorbed by the body. Contrary to popular belief, you don’t “stockpile” eggs; instead, those that start maturing die off and are broken down.

What Happens to Your Cycle When You Have PCOS?

In PCOS (polycystic ovary syndrome), hormonal imbalances often result in irregular or absent ovulation. PCOS is frequently associated with elevated estrogen and androgen (male hormone) levels, but without an estrogen peak, ovulation doesn’t occur.

Without ovulation, the body doesn’t produce progesterone, which keeps the endometrium thicker. The cycle becomes disrupted, resulting in a prolonged follicular phase. Eggs partially develop but aren’t released and remain as cysts in the ovaries.

Conclusion

• The pill suppresses ovulation by releasing synthetic versions of estrogen and progesterone.
• As a result, you don’t experience a natural cycle or natural hormonal fluctuations, which are important (e.g., for ovulation).
• Your eggs begin to mature but don’t fully develop. Instead of being released, they’re absorbed by your body.