Technical Contraceptive Question


#1

Hello,
I am a youth minister going through “Theology of the Body for Teens” with my group. Today I mentioned that oral contraceptives can act as an abortifacient. Basically that the synthetic hormone (progestin specificially) thins the lining of the endometrium, so that if breakthrough ovulation occurred, and the egg was fertilized, the zygote could not implant and an abortion would happen. I said that the hormones basically trick the woman’s body into thinking it is pregnant. One girl asked that if the body thought it was pregnant, wouldn’t the endometrium lining thicken instead of thin, to support the baby? Great question, and I need some help, as I want to answer her accurately.
Thanks!:thumbsup:


#2

The pill raises your hormone levels to "trick" your body and prevent ovulation. Many women get pregnant on the pill because either A) they did not take the pill properly. The pill must be taken EVERY DAY at approx. the same time of day. or B) the hormone level in the pill they were prescribed was too low for their system causing ovulation and implantation.


#3

womenshealth.about.com/od/thepill/f/howpillworks.htm

Question: How Does the Birth Control Pill Work?

Answer: Birth control pills, or oral contraceptives, contain hormones that suppress ovulation. During ovulation an egg is released from the ovaries, without ovulation there is no egg to be fertilized and pregnancy cannot occur. There are 2 types of birth control pills -- the combined pill and the Minipill. The combined pill contains both estrogen and progestin, while the Minipill contains only progestin.
The progestin in the Minipill may prevent ovulation; however it may not do this reliably each month. The Minipill works further by thickening the mucous around the cervix and preventing sperm from entering the uterus. The lining of the uterus is also affected in a way that prevents fertilized eggs from implanting into the wall of the uterus. The Minipill is taken every day. You may not have a period while taking the Minipill, if you do have periods that means you are still ovulating and your risk for pregnancy occuring is greater.

Combination birth control pills come in either 21 or 28-day packs. You take one pill each day at the same time for 21 days. If you have a 21-day pack, you stop taking birth control pills for 7 days at the end of the pack. If you are taking a 28-day pack, you continue taking pills every day, the last 7 non-hormonal pills serve as a reminder to help you remember to take your pill at the same time every day. Your period will occur during the week you take the 7 reminder pills.


#4

[quote="Maureen1125, post:3, topic:230234"]
womenshealth.about.com/od/thepill/f/howpillworks.htm
The lining of the uterus is also affected in a way that prevents fertilized eggs from implanting into the wall of the uterus.

[/quote]

Thanks Maureen, but I need a little more info to explain this completely.

1.Regarding the sentence I quoted, how specifically does progestin affect the wall of the uterus?

  1. Is it accurate to say that the synthetic hormones from contraception trick the body into believing it is pregnant, or is it more accurate to say they trick the body into not ovulating according to the normal 28 day cycle?

  2. If it is accurate that the body is "tricked into staying in pregnancy mode", why would the uterine lining get thinner? The questioner assumed that the uterine wall would get thicker in "pregnancy mode".

Sorry for the confusion, and I appreciate the quick answer.

In Christ,
Dave


#5

[quote="NewEvanglztn, post:1, topic:230234"]
Hello,
I am a youth minister going through "Theology of the Body for Teens" with my group. Today I mentioned that oral contraceptives can act as an abortifacient. Basically that the synthetic hormone (progestin specificially) thins the lining of the endometrium, so that if breakthrough ovulation occurred, and the egg was fertilized, the zygote could not implant and an abortion would happen. I said that the hormones basically trick the woman's body into thinking it is pregnant. One girl asked that if the body thought it was pregnant, wouldn't the endometrium lining thicken instead of thin, to support the baby? Great question, and I need some help, as I want to answer her accurately.
Thanks!:thumbsup:

[/quote]

This is a great question! It really got me thinking and I was curious to find out the answer, so I looked at all the drug information I have lying around (I'm a pharmacy student).

Basically, here's what I figured out reading all about exactly how oral contraceptives work:

We commonly hear that oral contraceptives "trick a woman's body to think she's pregnant." While this is true at some hormonal levels, it doesn't mean her body is preparing for a baby all the way around. The main way oral contraceptives work is by the hormones estrogen and progesterone. The estrogen in the pills will suppress the release of the follicle stimulating hormone (which prepares an egg for release in the fallopian tubes). The progesterone works by inhibiting the luteinizing hormone (which triggers ovulation). Through the inhibition of both FSH and LH, ovulation is prevented. This is the main way oral contraceptives work and this is how they "trick" the body into being pregnant (since FSH and LH are suppressed, ovulation will not occur, which is natural in pregnancy due to the high levels of estrogen and progesterone).

Now, onto the endometrial layer. Due to the constant high levels of estrogen and progesterone in a woman taking an oral contraceptive, the body will fail to respond properly to these hormones and an insufficient thickening of the endometrial layer will occur (i.e. the lining of the uterus will be thinned). Basically, the synthetic hormones are not following the body's natural production of hormones and therefore cannot respond "naturally" to these unnatural doses of hormones.

I hope this helps. Please let me know if I wasn't completely clear in my explanation or if you have further questions. Kudos to you for teaching TotB to your youth group! That is great stuff for them to learn.


#6

[quote="bellringer06, post:5, topic:230234"]
This is a great question! It really got me thinking and I was curious to find out the answer, so I looked at all the drug information I have lying around (I'm a pharmacy student).

Basically, here's what I figured out reading all about exactly how oral contraceptives work:

We commonly hear that oral contraceptives "trick a woman's body to think she's pregnant." While this is true at some hormonal levels, it doesn't mean her body is preparing for a baby all the way around. The main way oral contraceptives work is by the hormones estrogen and progesterone. The estrogen in the pills will suppress the release of the follicle stimulating hormone (which prepares an egg for release in the fallopian tubes). The progesterone works by inhibiting the luteinizing hormone (which triggers ovulation). Through the inhibition of both FSH and LH, ovulation is prevented. This is the main way oral contraceptives work and this is how they "trick" the body into being pregnant (since FSH and LH are suppressed, ovulation will not occur, which is natural in pregnancy due to the high levels of estrogen and progesterone).

Now, onto the endometrial layer. Due to the constant high levels of estrogen and progesterone in a woman taking an oral contraceptive, the body will fail to respond properly to these hormones and an insufficient thickening of the endometrial layer will occur (i.e. the lining of the uterus will be thinned). Basically, the synthetic hormones are not following the body's natural production of hormones and therefore cannot respond "naturally" to these unnatural doses of hormones.

I hope this helps. Please let me know if I wasn't completely clear in my explanation or if you have further questions. Kudos to you for teaching TotB to your youth group! That is great stuff for them to learn.

[/quote]

But assuming ovulation occurred for one reason or another, wouldn't the corpus luteum begin pumping out LH which would increase the progesterone level back up to normal levels?

I'm a med student and we're doing sex hormones right now in my Pharmacology class (which I realize is a hugely dumbed down version of what you're learning--forgive me if I don't know the mechanisms as thoroughly as you do :o), but we were told that studies don't really support the "prevents implantation" mechanism for birth control. We were told that if for some reason (99% of the time, human error) an egg is released and fertilized, it can still implant even if the uterine lining is less than ideal. We were given some resources too, but unfortunately, I can't find the packet we were given. I'll look later for it. Have you been taught differently?


#7

[quote="NewEvanglztn, post:4, topic:230234"]
Thanks Maureen, but I need a little more info to explain this completely.

1.Regarding the sentence I quoted, how specifically does progestin affect the wall of the uterus?
**
2. Is it accurate to say that the synthetic hormones from contraception trick the body into believing it is pregnant, or is it more accurate to say they trick the body into not ovulating according to the normal 28 day cycle?**

  1. If it is accurate that the body is "tricked into staying in pregnancy mode", why would the uterine lining get thinner? The questioner assumed that the uterine wall would get thicker in "pregnancy mode".

Sorry for the confusion, and I appreciate the quick answer.

In Christ,
Dave

[/quote]

No. Not really. There are two hormones in the woman's body that regulate ovulation and menses. The first is Follicle Stimulating Hormone (FSH) and the second is Leutenizing Hormone (LH). FSH is produced in the beginning of the cycle in order to "ripen" the follicles which will release the egg. While ripening the egg, estrogen is being produced. Estrogen is responsible for Uterine lining build up. Just before ovulation, the estrogen build up in the body will reach a certain point. When this happens, the LH surge occurs. This LH surge is what triggers the follicle to burst, releasing the egg. THIS is what most oral contraceptives control -- the LH surge. AFTER ovulation (releasing of the egg), estrogen is still produced, but in much smaller amounts. In addition, progesterone is produced in preparation for maintaining a pregnancy, should a zygote make it far enough.


#8

Thank you all for your great and thoughtful responses! I am going to attempt to recap here, and let me know if I'm in the right zip code.:)

Estrogen suppresses FSH/Follicle Stimulating Hormone (which “ripens” the follicles).

Progesterone suppresses LH/Luteinizing Hormone (the LH surge triggers the follicle to burst and release the egg)

Most Contraceptives boost both Estrogen and Progesterone, which respectively suppress FSH and LH, and prevent the egg’s release.

If I can draw an analogy to gauge my understanding (I love analogies), the levels of hormones are like pins in a lock. Suppose a woman on oral contaceptives always has her estrogen and progesterone levels propped up to a level 10. For a key to open a lock, the bumps and ridges on the key have to move the spring loaded pins to just the right position for the lock to open. Suppose the Estrogen has to build up to level 6 so the the LH surge can be triggered and the egg released. Estrogen levels can be too low, or artificially high (through contraception, 10 in my analogy) to block/prevent the process.

While I realize this analogy is an over-simplification, it could be helpful in explaining to a teen why the endometrial layer does not thicken properly with an excess of progesterone and estrogen in the body.

In essence, the steps the body takes through ovulation, menses, and pregnancy are like a series of locked doors. The correct levels of hormones at key moments are like the ridges/bumps on the key which open each door in succession. If the hormones are not at the correct levels, the cycle/process is stalled, and the key will not open that door in the series.
While a student may reason that since there are high levels of Estrogen and Progesterone both artificially through contraception and naturally during pregnancy, it would follow that the endometrial layer would thicken. In reality hormone levels which are too high or too low can frustrate the process, keep the "door" locked, and stall everything.

Let me know if this is correct, and I appreciate all the scholarly responses. 


#9

[quote="NewEvanglztn, post:8, topic:230234"]
Thank you all for your great and thoughtful responses! I am going to attempt to recap here, and let me know if I'm in the right zip code.:)

Estrogen suppresses FSH/Follicle Stimulating Hormone (which “ripens” the follicles).

Progesterone suppresses LH/Luteinizing Hormone (the LH surge triggers the follicle to burst and release the egg)

[/quote]

Not exactly... I think "suppresses" is the wrong word. FSH is produced. This tells the follicles to start getting the egg ready. As the follicles are doing their thing, they are producing estrogen in order to ready the uterus. Once the estrogen gets to a certain level, it signals the LH receptors to release LH in a surge in order to release the egg. Once this happens, progesterone is produced. If the LH surge doesn't happen, the egg, theoretically, does not release.

[quote="NewEvanglztn, post:8, topic:230234"]

While a student may reason that since there are high levels of Estrogen and Progesterone both artificially through contraception and naturally during pregnancy, it would follow that the endometrial layer would thicken. In reality hormone levels which are too high or too low can frustrate the process, keep the "door" locked, and stall everything.

Let me know if this is correct, and I appreciate all the scholarly responses. 

[/quote]

I'm not really sure I follow the thought process. BCP (most of them) stop the LH surge which is what tells the follicle to release the egg. Yes it is true that the progesterone and estrogen will still form in normal cyclical ways however, when there is no released egg, there is no change of pregnancy.


#10

This isn’t medical or anything, but wouldn’t the thinning of the endometrium be the same reason why taking the Pill lightens or stops periods all together?


#11

[quote="jilly4ski, post:10, topic:230234"]
This isn't medical or anything, but wouldn't the thinning of the endometrium be the same reason why taking the Pill lightens or stops periods all together?

[/quote]

The reason BCP's and shots lighten menses is becasue it controls the hormones which control how much lining (and therefore shedding) is is created.


#12

[quote="NewEvanglztn, post:1, topic:230234"]
Hello,
I am a youth minister going through "Theology of the Body for Teens" with my group. Today I mentioned that oral contraceptives can act as an abortifacient. Basically that the synthetic hormone (progestin specificially) thins the lining of the endometrium, so that if breakthrough ovulation occurred, and the egg was fertilized, the zygote could not implant and an abortion would happen. I said that the hormones basically trick the woman's body into thinking it is pregnant. One girl asked that if the body thought it was pregnant, wouldn't the endometrium lining thicken instead of thin, to support the baby? Great question, and I need some help, as I want to answer her accurately.
Thanks!:thumbsup:

[/quote]

The endometrium builds up prior to ovulation as well as after it to provide a thick lining for implantation which usually occurs 5-10 days after ovulation. So your body would naturally be preparing for pregnancy from early on in your cycle--your body doesn't "know" that you're pregnant until implantation has occurred and hcg is in your system. If you have a breakthrough ovulation, your corpus luteum produces progesterone which helps with a healthy lining but that is assuming no artifical combinations of hormones designed to prevent ovulation. Your body's natural hormones that would prepare your body for ovulation and pregnancy have been messed with so by the time you could be pregnant (i.e. after a breakthrough ovulation) it may be too late to make the endometrium thick enough to not have a failed implantation.


#13

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