1032: Sarah Hill | How Birth Control Rewires Women’s Brains Part Two

1032: Sarah Hill | How Birth Control Rewires Women's Brains Part Two

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[00:00:00] Jordan Harbinger: Coming up next on the Jordan Harbinger Show.

[00:00:03] Sarah Hill: So here we are going through this period of intense brain development that we're going through during the teenage years. And we decide that it's a good idea to give teenage girls whose brains are still developing, coordinated by sex hormones, something that shuts down their brain, ovarian access, so it prevents their ovaries from producing hormones and then replaces them with a daily dose of the same synthetic hormone every day.

And we don't think this is gonna affect brain development.

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Just visit Jordan harbinger.com/start or search for us in your Spotify app to get started today, part two with Dr. Sarah Hill. If you haven't heard part one, it's absolutely fascinating. You won't regret it, and this conversation will make a whole lot more sense if you've already listened to that episode.

Alright, here we go, part two with Dr. Sarah Hill.

I would love to talk more about the benefits of birth control. Obviously you don't get pregnant. Well, uh, not always. Most of the time you don't get pregnant when you're on it, but I know it's prescribed for various reasons. And so I'd like to talk about that because I think the problem is a lot of people are like, well, I don't have to worry about this because I'm not sexually active.

And then they go in for like, I don't know, acne, and they end up on birth control and it's like, oh, and now all these other things are potentially gonna happen to me and I, I need to pay attention.

[00:02:08] Sarah Hill: Right. So, uh, you know, birth control when it's used as a contraceptive, I mean, just in terms of, you know, being able to regulate fertility is a huge benefit.

And in some ways I, I don't think that we can overstate how important it has been for women to be able to be given a tool that they can use to be able to safely and effectively regulate their fertility. Because until we were able to do that, I mean, it was really difficult to make long-term plans if you were a woman.

Um, I mean, if you think about like educational goals, it's like who's gonna start a 10 year degree program as a female who's like, let's say that you're married or in a relationship and you aren't able to regulate fertility, I mean, there's a very good chance you're gonna end up getting benched because of pregnancy.

And so there's just really no reason to even start trying. And what we saw is that when you look at, uh, historical trends of in education, what you see is when birth control pills began to be legally available to single women. All of the sudden applications to post-secondary degree programs like law school, business school and medical school went off the charts.

It increased by something like 700%. And this is because birth control allowed women to make plans. And when women are able to plan, they do more, they achieve more, they are able to become economically, financially. Uh, I guess that's the same thing. Mm-Hmm. Um, politically independent from men. And so, you know, when we think about birth control as being this amazing tool to allow us to regulate fertility, I mean, I think that it is an important, you know, it's been a really important piece of technology for women.

And I think for that reason there's been, you know, sort of a tendency to feel pretty protective of the birth control pill.

[00:03:45] Jordan Harbinger: Yeah.

[00:03:45] Sarah Hill: Which we can get into in just a minute. But as you noted, in addition to those benefits, which. Pretty huge now. Birth control is being prescribed for all kinds of reasons, many of which are far less important than that.

And so just to give you some examples of that, you mentioned acne, certainly when I was a teenager. I mean, and that was a long time ago. That was being recommended. Don't have to do that to yourself

[00:04:07] Jordan Harbinger: on this show. We can, we can live into that. No. Okay. Yeah,

[00:04:09] Sarah Hill: we can. We can, yeah, we can just I love it. I love it.

So maybe it is just a river in Egypt. Mm-Hmm. Maybe it's so, um, exactly. So, no, I, I mean, I was even recommended that in, you know, back when I was a teenager, as a means for preventing acne. Certainly now, I mean, it's recommended almost as a first line of defense if you're having problems with your skin or if you're having menstrual cycle irregularities, you're having bad cramps or that sort of thing.

Women are being given and, and I use the word women very loosely. 'cause a lot of times these are girls, you know, very young girls being put on hormonal birth control, which has all these effects that we were talking about earlier today. Yeah. That, you know, that, uh, are really wide ranging and potentially not what they are really bargaining for when they're just looking for a way to clear up their skin.

[00:04:57] Jordan Harbinger: Yeah. It's a, I want to jump back on one thing 'cause I know someone's gonna email me about this. You said that when the birth control pill was essentially invented or approved and, and started to get prescribed Mm-Hmm. That enrollment in university studies went up among women. Some people might say, well, that was just a general shift in society.

We can't, that's correlation, not causation. But do we know that?

[00:05:18] Sarah Hill: Well, of course it's correlation, not causation. But the fact of the matter is it's, that's all part of the societal trend. I mean, all that societal trends are, is the result of individual people making decisions at the same time?

[00:05:29] Jordan Harbinger: Right. Okay.

That's right. And that's true. Those individual

[00:05:31] Sarah Hill: people making decisions at the same time are a bunch of women, you know, who are now not being burdened by the burden of their fertility and able to actually plan and say, oh my gosh, like I can actually decide what I wanna do 10 years from now, or five years from now, and not have to worry about getting totally sidelined because of pregnancy.

And so it really opened up these doors for women and, and I think that planning and having agency over kind of what happens in your life is like one of the most powerful tools that you can have. Because without it, what can we do? And so I think that, you know, there's been a lot of. A difficulty around conversations about birth control, just because I, there's a lot of women who feel very much like you can't talk about the potential drawbacks of something that's been that important to us because it has been, it's incredibly important to us being able to regulate our fertility and, and there are other ways to do it, of course, that are non-hormonal, but was really nice about hormonal birth control is that it works really well and it's pretty easy to use and it's pretty accessible.

Particularly now you know that we have organizations like Planned Parenthood that help to provide these services to women who are in low income groups. And so it's something that most women can have access to, most women can use effectively, and most women are able to manage to avoid pregnancy without too much difficulty.

But of course there's all of these side effects and so it, it's the discomfort of holding those two truths at the same time that makes people get a little bit uneasy, I think. And, and that's, yeah,

[00:06:59] Jordan Harbinger: that makes sense. I'm already uneasy 'cause I'm a, a male talking about birth control. So I have, the bar has to hit like a pretty high level for me to red line on, on the anxiety around this conversation.

I'm curious though, you, you mentioned, you said before that we're prescribing this for skin and, and I can't remember what else. Timing of periods. Cramps. Yeah. Cramps, yeah. But in essentially, can I say little girls? 'cause they're 13, I guess that counts. That's a little girl ish type person. That's little girl.

That seems like a bad idea. And again, I'm no doctor, but like knowing all the side effects that we discussed earlier, it's like. This isn't, I took antibiotics for acne as a teenager, and I didn't even have that bad of acne. It was just something the doctor was like, Hey, if you get a Zi every now and then take, I can't remember what it was called.

Erythromycin or Amox something.

[00:07:42] Sarah Hill: Yeah.

[00:07:43] Jordan Harbinger: And now the insides of my teeth are brown, because that's what it does to your teeth if you take it over a long period of time. And Oh, yeah. Taking antibiotics for five years is a really bad idea because it messes with your gut and all kinds of stuff. So I stopped taking it, and when I had my wisdom teeth removed, the surgeon was like, oh, you took antibiotics on it for such and such, whatever it was called.

And I was like, oh, yeah. And he's like, I said, how do you know? And he goes, well look at it inside of your tooth. And it was like a brown, he's, I said, oh my God, my tooth is rotten. He's like, no, no, no, no, it's fine. It's just brown on the inside because the, I think it's called dentin, not the enamel, the stuff underneath.

He's like, it just turns brown with that. I'm like, that can't be good. And he's like, it's fine, but my teeth, I can't, like if people go and whiten their teeth, that's never gonna work for me because the inside is brown. It doesn't matter how white the outside is. I just thought to myself, I'm lucky. I'm really lucky that I have merely a cos minor cosmetic issue with this.

I'm sure I screwed up my gut biome. I, who knows what else got messed up. But we just over my point is we prescribe things thinking this is fine. Look, her acne went away and now she doesn't have these minor cramps. Oh, oops. We've been giving a 13-year-old girl hormonal birth control that's been messing with her brain and now she's 35 and she wants to have kids and she doesn't, literally has no idea who she is off of these things.

[00:09:05] Sarah Hill: Right. Yeah. I mean the, there's so much that you said there that I have something to say about, and the, the first just, we all have a blind spot with medication in this way. It's like when you take it for something, that's the only thing you're really focused on. Right. And then this is

[00:09:17] Jordan Harbinger: only doing the one thing I want it to do.

[00:09:19] Sarah Hill: Right, right, right. And the fact is, I mean, our body, we are not built by an engineer. Like an engineer did not say, okay, now this part lives on this island and if you take a drug that affects this, it only affects that. And oh, and if you, you know, and this part of your body is operated by this little cog and sprocket over here and it doesn't affect anything else.

Instead, you know, our whole body is just a big mess of electrical spaghetti that's been thrown together. You know, reverse engineered by natural selection and everything is intertwined into a degree that you would never even imagine, because everything affects everything else. And the body is just incredibly messy that way.

And so you can't treat one thing, especially with like a pill, which is generally systemic and have like the one effect. And so we never think until recently, you know, I think we've gotten a little bit smarter about asking questions about things like antibiotics and that sort of thing. Like, gee. You know, does it make sense to wipe out that that person's microbiome and the service of, maybe they have a sinus infection when they probably don't, it's probably a virus and that's not a good idea.

But, um, certainly for a very long time. I mean, this was just like they were giving medication, like you were talking about off Oh, like

[00:10:23] Jordan Harbinger: cancer for cosmetic reasons in a teenager. Yeah. And

[00:10:26] Sarah Hill: it wasn't

[00:10:26] Jordan Harbinger: like I, I didn't have my face covered. I didn't need like, what is it called, Accutane, where like it just dries you up.

'cause otherwise you look right.

[00:10:33] Sarah Hill: Yeah, yeah, yeah. Kind of

[00:10:34] Jordan Harbinger: rough. I had like the occasional zit from being a dirt ass at age 13 and Oh yeah. Right. Every kid has zits. Okay. Put a little sticker on it and go on with your life. No, no, no. Take antibiotics for a decade or whatever it was. Right. It says ridiculous now.

[00:10:50] Sarah Hill: Well, no, I know. And in instead of saying like, Hey, perhaps you should cut back on sugar or wash your face. Like, hey, if you consider Yeah, exactly. If you consider washing your face,

[00:10:58] Jordan Harbinger: eat dirty little prick.

[00:11:00] Sarah Hill: That's what I think about with my son. I have a, I have a 14-year-old son and it's like, have you tried washing your face?

Well, 'cause that'll do it. Like, I think that'll help you out

[00:11:10] Jordan Harbinger: soap buddy. And I think

[00:11:11] Sarah Hill: that'll help you a little bit. Soap goes a long way. Mm-Hmm. But, um, I mean, with the birth control pill, you know, here we are giving girls, as you said, hormones and a few things that we need to, a little bit of background to kind of illustrate how much of a big deal this is.

Our brain isn't done developing until we're in our twenties. And so it is usually our early twenties brain development is still going on and during the pubertal transition. So when we trans, you know, go through puberty, get, and for women it's like getting your periods. And for boys it's all of the other sort of comparable activities.

All of that is

[00:11:42] Jordan Harbinger: comparable activities is a great euphemism for what goes on during that phase of life. Yeah.

[00:11:47] Sarah Hill: Look, I, I'm trying to be polite. Yeah,

[00:11:49] Jordan Harbinger: I appreciate that.

[00:11:51] Sarah Hill: Um, but all of that remodeling that goes on, I mean, 'cause your brain is seriously undergoing a major remodeling project because it's remodeling it from like this kid brain, which is just like happy and sunshine and rainbows and like Oh, it totally is transforming that into the really complex adult brain.

And the adult brain is incredibly complex. It takes a long time to develop. And that remodeling project is coordinated by our sex hormones. So here we are going through this period of intense brain development that we're going through during the teenage years, and we decide that it's a good idea to give teenage girls.

Whose brains are still developing, coordinated by sex hormones, something that shuts down their brain, ovarian access. So it prevents their ovaries from producing hormones and then replaces them with a daily dose of the same synthetic hormone every day. And we don't think this is gonna affect brain development.

[00:12:44] Jordan Harbinger: Yeah,

[00:12:45] Sarah Hill: and like what's really messed up about this is that I have only seen in my career fewer than 10 studies that have even bothered to ask the question. Nobody's even asked. It was just like, oh yeah, let's give this again, it's kind of like, you know, I feel this way with psychotropic medication as well.

Like, you know, you see this with things like they're giving, you know, Ritalin and Prozac and stuff to teenagers and I'm thinking to myself like, like, no way. Like, yeah, there's not enough studies showing what this actually does then to long-term development and looking at this question with birth control pills, with girls.

The few studies that have actually bothered to ask the question seem to indicate that if you go on the pill during development, when your brain is still developing, that it might put you on the road for having a greater risk, a major depressive disorder throughout the rest of your lifetime, even after you go off of it.

I

[00:13:34] Jordan Harbinger: was gonna ask if that had anything to do with depression or even maybe like postpartum depression or anything that triggers depression because the same way like going on. Anabolic steroids, messes with your natural endogenous testosterone. It sort of seems like the same thing. And by the way, anabolic steroids highly illegal.

Right. But are basically, I know the male version of kind of what we're giving to 13-year-old girls to get rid of their acne. Not quite the same, but it's serious.

[00:14:04] Sarah Hill: But yeah, I mean, it's the same thing. You're giving them a systemic drug that has widespread effects from head to toe.

[00:14:09] Jordan Harbinger: Right.

[00:14:10] Sarah Hill: And it's illegal for men to take steroids.

I mean, to, you know, have them available because it, because they have these like wide ranging systemic effects.

[00:14:18] Jordan Harbinger: Right.

[00:14:18] Sarah Hill: But for birth control pills, yeah. It's like, oh, you've got cramps.

[00:14:21] Jordan Harbinger: Yeah.

[00:14:22] Sarah Hill: Take the pill.

[00:14:22] Jordan Harbinger: Nobody on earth would go. Oh, are you a little like, my son is quite small for his age, and I was like, oh, I know.

When I was a kid, there was a kid who was really small and they gave him some sort of growth hormone or something and they're like, whoa, yeah, we don't do that anymore. We do not do that anymore. And I was like, oh really? And they're like, yeah, that's not good. It's better to be small than the side effects of taking this and it's such.

And I was like, oh my gosh. 'cause you know, Ryan turned out okay, but he's also like seven feet tall now, right? Because they overdid it or something. And I was like, holy crap, he's really tall. It's ridiculous how tall this kid got. And he probably had a growth spurt and they gave him all this stuff, but you would never go, you know what, Jaden, you are a little small for your age.

You should take anabolic steroids. Meanwhile, a 13-year-old girl walks in and is like, I have zits and my back hurts sometimes, or my stomach hurts sometimes. And they're like. Take this for the rest of your life until you want to have kids.

[00:15:14] Sarah Hill: Right?

[00:15:15] Jordan Harbinger: So of course it's suppressing stuff and then you go off it and you're like, wow, I feel horrible.

My brain doesn't know how to adjust to this new reality.

[00:15:23] Sarah Hill: Well, right. And when you think about, you know, if, and I wish I had a figure, I would love to show a figure, but graphs, you know, for naturally, yeah. A graph, like for a naturally cycling woman, you go through these periods of escalating estrogen that goes on in the first half of the cycle, and then it decreases, then it increases a little bit, and then progesterone is really low in the first half of the cycle, and then it rises in the second half and then falls.

And it's like when you're going through puberty and when you're developing as a woman, you have these irregular cycles and all of these things as your body is learning to communicate with itself. So the brain is learning to stimulate the ovaries, it's learning to pick up on the hormonal messages from the ovaries.

And so you get a little bit of messiness where girl cycles are irregular and this and that and the other thing. But that's all part of like normal development. And that's something that's super important. It's like developing what I guess I could only refer to as like hormonal tone.

[00:16:14] Jordan Harbinger: Mm-Hmm.

[00:16:14] Sarah Hill: You know, it's like your brain and your and your ovaries become really responsive to one another and one another's signals.

And that is how you get a healthy functioning body is that you develop this tone that's very responsive and it knows exactly how to adapt when, oh my gosh, there's a lot of estrogen going on right now. Like, you know, let's go do the high estrogen things and oh no, it's decreasing. Well, don't worry, we're not gonna make a b too jarring.

We know just what to do. And when you have a girl who is brain development is going on with, um, synthetic hormones in the birth control pill, which is the same message every day, you're not developing that tone. You know, and the ovaries are never even learning to produce the hormone at all because there's no, you're not ovulating.

And so your brain is used to only getting this. Right. The same hormonal message every day. Your ovaries aren't used to doing anything and then you go off of it. And if all that was going on during the period of brain development, you know, and again, when you're a teenager, it's like you're not done being built.

[00:17:09] Jordan Harbinger: Yeah. And

[00:17:09] Sarah Hill: like, and so all of that could potentially lead to long-term changes. And we just, we just don't know. 'cause nobody's bothered to ask the question. It was just like, oh yeah, look, here's this thing that prevents pregnancy. Let's go ahead and give it to teenagers without anybody bothering. To take two steps back and say, well wait, well, what is it that we're actually giving teenagers?

And like, is that a good idea? But when you look at the research on things like depression and anxiety and, and that sort of thing, what you tend to see is overwhelmingly it's the teenagers who are suffering from this. So for example, when you look at the risk of developing depression on different types of hormonal birth control, especially with the combination birth control pill, what you find is that you do get a little bit of an increased risk of developing depression among adult women, but it's not that significant.

But for, when you look at that same risk in teenagers, and I'm defining a teenager as somebody who's 19 and younger, what you get is like a 280 or 300% increased risk of developing depression.

[00:18:05] Jordan Harbinger: That's scary. Well, it's, that's really scary.

[00:18:07] Sarah Hill: And so here's these girls, you know, 'cause we talked about the benefit of, you know, like the big benefit of birth control, which is fertility regulation.

And it's something that for some women, it's gonna be worth all the costs that we talked about at the episode we recorded earlier. But for something like acne, like I think that if you told, you know, these girls or told their moms like, Hey, there's no chance you could develop major depressive disorder, and we also don't know what this does to brain development.

I think that most of them would say, you know what, I might wash my face a little bit more carefully. Right.

[00:18:36] Jordan Harbinger: We'll get to the expensive face care shampoo instead of the pill,

[00:18:40] Sarah Hill: right? Yeah. Instead of the pill. But these conversations aren't being had. And I don't think that it's because I like to think most people's doctors are pretty well-meaning, and they mean to take care of their patient.

I just don't think that they're thinking about it,

[00:18:52] Jordan Harbinger: whether you're on or off the pill. Hopefully your taste in podcast doesn't change, nor your propensity to support the fine products and services that support this show. We'll be right back. This episode is sponsored in part by Better Help got any self-care, non-negotiables.

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If you are a Reddit user, and if you're not, why not start now? It's the best social media platform out there. It's only mildly, ridiculously toxic most of the time, some of the time. Now, back to Dr. Sarah Hill, why my dermatologist gave me antibiotics for five, like it was literally like five or six years.

She was just thinking, ah, this is probably fine. But she was a hundred years old in the early nineties and she wasn't used to thinking that there could be knock on effects from this. And she wasn't reading journals, she didn't use the internet. Right. And I think I said face care shampoo, everybody knows what I mean.

Right. That's not a real thing. It sounds like with with the pill. The female body turns into a symphony without a conductor, right? Where they're just like, okay, the drums might play, the people might play the, they're trying to match with one another. They're doing maybe the best they can. And it might even sound okay if you're just in one section and then later the audience comes in and the conductor comes back 'cause you wanna have a baby.

And it's, and the guy's just like, what the hell have you been doing for the last 10 years? This is horrible. Right? They're out of practice. They're out of sync. It's like they've never played together before and that's horrifying.

[00:22:21] Sarah Hill: Yeah, it is. And I mean, honestly that that, that's actually a really good analogy because in a lot of ways, normally it's like the, you know, the brain is telling the ovaries what to do and then when the ovaries producing hormone, then that kind of tells the brain how to conduct.

You know, it's like, oh, okay. Too much tuba, you know? Yeah, yeah. And they start to like decrease that. A theme

[00:22:38] Jordan Harbinger: in your house. Too much tuba.

[00:22:39] Sarah Hill: It is. It is definitely a theme in my house. And so you get that like really nice feedback loop between somebody who's in charge of the, what's happening and then the activities that are going on in the ovaries.

What happens with the pill, like you said? I mean, it's just like music is being played and it's not being controlled by anybody. It's just like being released and the brain is just having to figure out how to deal with it. And it's not learning how to adjust to hormonal variation. It's not, all of that is potentially.

Problematic, but we don't know because nobody's bothering to ask the research question.

[00:23:08] Jordan Harbinger: Do we know what this is? Maybe too in the weeds, but do we know why it might cause depression? I know I've read something about brain shifting memories around that's, that gets an inhibited and it can make us feel like our lives lack meaning.

Do you know what I'm talking about at all? Yeah.

[00:23:22] Sarah Hill: Yeah. So one idea is, well, so there's a few things. So one is the blunted, uh, stress response that we talked about last time. And stress is something that occurs in our body when bad things are happening. But it's also something that happens when good things are happening.

And so having regular bursts of stress and regular bursts of stress hormone, you know, is one of the ways that I think that our brain learns to appreciate that it lives a meaningful life. Like if you have nonstop flatline stress, that means that your life is pretty boring and there's probably not a lot that's meaningful going on because when meaningful things happen, it increases our stress response, excitement.

Those sorts of things increase stress in addition to the bad things. And so lacking like regular ups and downs from our stress response is potentially one mechanism by which you sort of develop this kind of flat line where everything is just kind of blah, and then that doesn't really make anybody feel good.

[00:24:17] Jordan Harbinger: What is that called? Like anhedonia is, or is that Yeah,

[00:24:20] Sarah Hill: anhedonia. Yeah. No, that's like a real, that was like a nice Tencent word you just threw out there. Yeah. Yeah. 10 cents only. I was like, yeah. I was like, literature, like That's a good one. Yeah. Yeah. No. So yeah, lack of pleasure. I mean, just like where everything just feels kind of.

And that's one of the, the sort of key defining features of depression is anhedonia

[00:24:37] Jordan Harbinger: finding joy in basically nothing.

[00:24:39] Sarah Hill: Yeah. Yeah, I know. Sounds great, doesn't it?

[00:24:41] Jordan Harbinger: Yeah. Yeah.

[00:24:43] Sarah Hill: And then there's just lacking the release of or exposure really at all to, um, endogenous progesterone, which is women's other sex hormone.

And it is, even though estrogen is the one that gets all the attention, progesterone is actually super good for the brain. It, it's really good for a lot of things, but just keeping the brain happy and calm and smooth, uh, running smoothly is something that progesterone is really good at. And it's good at this, 'cause when it gets metabolized, it releases this compound called allopregnanolone.

And Allopregnanolone activates like the chill out program in our brain. Yeah, I

[00:25:17] Jordan Harbinger: remember we talked about this. Yeah,

[00:25:18] Sarah Hill: yeah, yeah. So you like, you hit those chill out switches. And it was really good at it's inhibitory, so it like caused their brain to just kind of like this. And it's very, um, relaxing, like the progestins in hormonal birth control because they're made outta testosterone usually.

Uh, they don't get metabolized on the same pathway. They, you don't release allopregnanolone women's who are using birth control, they have significantly lower levels of allopregnanolone. And so their brain is probably not able to chill itself out as much. And obviously when you get that, you can get major anxiety and anxiety that's unrequited, like if you're feeling anxious all the time and can't solve it.

That leads to depression. I mean, anxiety and depression are about, you know, the two sides of the same coin.

[00:26:00] Jordan Harbinger: What about. Oxytocin signaling is that left alone? I, I think I've read this in your book, but it could be in from another article. There were some women that had trouble recognizing expressions in babies, and that was a little confusing because if you've had a baby, right, you're not on birth control.

So how does, does that affect stick around after you've stopped taking the pill? Is that what I'm understanding?

[00:26:22] Sarah Hill: No. Well, so we don't know yet about that, but we do know is that women who are on it, they seem to have dysregulated oxytocin signaling. And so they've, they've studied this a couple of different ways they've done it where they've done intranasal oxytocin and then just seeing whether or not the brain's pleasure pathways light up in response to seeing faces of people that they love.

Um, which is generally what happens when oxytocin is on the scene. If you like see a picture of like your wife or your children, your pleasure centers in your brain will light up and it'll be like, yay. It's people I love. What they found is that for women who are on birth control, that you don't get that.

So you give them some oxytocin and their brain is just like, they just see it as just another person. Yeah. And which is really kind of scary and, um, scary. And sad. Well, yeah. It is scary and sad. And it also, like, I know for me, and, and we talked about this a little bit last time, but my six, I think it was a six week visit after I had both of my kids.

They were like, all right, what are you doing for birth control? You know, what are you doing for birth control? And I'm like, well, I'm, you know, I'm breastfeeding. And they're like, well, that's not gonna cut it. 'cause some women ovulate when they breastfeed, which is true. But I, I was not. Mm-Hmm. And I know I was not because I in tune with my cycle, but I mean, they, they tried to put me on progestin only birth control pills while I was breastfeeding.

'cause apparently it doesn't get in the milk, which I don't know that I believe, but better than pregnancy, I will say. Like, I would not, I would not have wanted to have another baby right after the baby, but I probably would've done something different. But I wasn't ovulating, so I didn't have to worry about it.

But yeah. Anyway, so when you think about that, when there's a lot of women who are being put on this at their six week appointment, when those attachment things are still happening with mothers and children and, you know, a lot of women, like if they're not breastfeeding, like, and they know it, like at the hospital where they're like, I'm not breastfeeding.

Their doctor will put 'em on birth control right away. Which again, when you think about the importance of oxytocin to bonding with your infant and all of that sort of thing. And there hasn't been any research that's done on, on this particular issue. So like I have not seen a single study that's looked at hormonal birth control use and bonding to offspring.

But the research that I've seen in adult women, like looking at other attachment figures, so partners and so on, um, suggests that there could be some disruption there. And again, we don't know the answer to it because it's, nobody's really asking the research questions.

[00:28:39] Jordan Harbinger: Geez.

[00:28:40] Sarah Hill: It's like we're just, you know, I, I feel like for the last however many years with 60 years, um, we've been doing this experiment on women that they didn't even know that they had consented to.

Right. They're

[00:28:51] Jordan Harbinger: not recording the results necessarily. Yeah,

[00:28:54] Sarah Hill: yeah, yeah. We're not even necessarily recording the results. So it's like we don't, you know, when you look at how much society has changed in the last 60 years, the differences that we get in rates of problems with mental health and all these other things, it's like we have absolutely no idea because our society has changed so quickly in the last six years.

But like, it would be surprising to me if there weren't some of the differences that we see in things like risk for mental health and, and increase in postpartum depression and that sort of thing that aren't impacted in some way by our use of hormones.

[00:29:26] Jordan Harbinger: Yeah. Like everyone wants to blame participation trophies or something, and it's like, well, maybe it's the fact that we've been taking, I don't even know what the percentage is, a huge num.

Millions and millions, tens of millions of women taking this hormone from an early age. I, I don't know. I mean, that seems more likely than TikTok being the root of all, even not that I'm a fan of TikTok either, it seems more likely that Right, that's causing the problem than participation trophies or, or, or cell phones.

[00:29:51] Sarah Hill: Right, right. Well, I mean, I think it's a, you know, and obviously it's a combination. It's a combination of all of these different things. Combination. Yeah. But I mean, I, when you look at the risk of mental health problems in young women, I just can't help but think that hormonal birth control isn't a really important player in this conversation because you add that.

To, you know, so we already know that young girls when they're on it are at a much higher risk of developing depression than adult women. Probably just by virtue of the fact that their brain is still developing and that their developing brain just can't handle that shutdown of their ovaries because I'm sure that it causes a wider spread sort of set of changes than, than we in adult women.

But you take that and then you add to it social media and all of these other things. I mean, it's just like a perfect storm of environmental influences that are not great for mental health. For young girls.

[00:30:43] Jordan Harbinger: It seems like if women go off the pill, they should tell people around them to look for signs of depression.

Right? Because when you're experiencing it, you just believe. You believe that there's a reason for it. Your mind's gonna rationalize it. Oh, exams are really awful, and my boyfriend's being kind of a jerk and like, I just haven't hung out that much with my friends and I don't know what I'm gonna do with my major.

And it's like, well, that's all maybe true. But the truth is you are also going through through hormonal hell, and you don't know about it because you stopped taking the pill or whatever. Which think our life's crappy.

[00:31:16] Sarah Hill: Yeah. Starting or stopping, you know? I think that it's so important that people know about the possibility of effects that can happen from having hormonal changes in that way.

So that way we have people looking out for us. 'cause the fact of the matter is, as you were saying, it's like our brain tells itself stories about what's going on all the time. I mean, the left half of our brain, which is like the communication center, is really just a spin doctor, just making up stories about why we do things.

You know, it's like, oh well you know, I must be thirsty 'cause I'm drinking water. You know, it's like, it just tells the stories. And, and like you said, it's like if we have depression from, that's creeping in for some reason, including, you know, hormonal birth control. Like, we just think like, gosh, like nobody likes me like.

My friends all seem to hate me now. Like Oh. Or like, gosh, my job just sucks. Like it used to be so much better than what it is now.

[00:32:03] Jordan Harbinger: Yeah. And

[00:32:04] Sarah Hill: we come up with all of these stories about why everything is happening. It must

[00:32:07] Jordan Harbinger: be my new manager, but maybe it's not. Yeah, maybe that's not the only reason.

[00:32:10] Sarah Hill: Right, exactly.

And I think especially, you know, when we, we were talking about these young girls, 'cause they are the ones who are overwhelmingly affected by the mental health side effects. There should always be somebody who's looking out for them. I'm concerned about, you know, 'cause now we have this O pill, right?

This over the counter birth control that's gonna be available to women. I'm concerned about that for the that reason. So on the one hand, like I love that we're trying to increase access. To products to help women regulate their fertility, particularly in this day and age when, you know women's reproductive health is under fire.

Uh, like on the one hand I'm happy that okay, we're increasing access. I feel good about that. I don't feel good about women being able to go on birth control and especially this one. And the reason I don't like this one is it's a progestin only drug, which is safer than a combination product. So, you know, when you're talking about birth control, you have progestin only drugs, which only have a progestin, that synthetic progesterone.

Um, and then you have what are known as these combination products, which most birth controls are, like, most pills are where you have progestin and then you also have some estrogen. And the estrogen piece of it is a little bit more dangerous in terms of physical health. So just, uh, estrogen for example is, uh, thrombotic.

So it's what's known for increasing heart attack risk and stroke risk when you have the pill. And so they've made this over the counter product progestin only because it doesn't have all of those risks. 'cause progestins don't have that risk. You don't have an increased risk of heart attack or stroke.

And so that's why they made this product, the one that's available over the counter. 'cause it's like safer for physical health, but for mental health it is absolute trash. And the reason, oh no. I mean the reason that most birth control pills are combination products is 'cause the estrogen piece of it kind of takes the edge off how terrible you feel with this progestin.

Interesting. Yeah. And so progestin only products are some of the biggest offenders when it comes to the things that women hate the most about birth control, weight gain, and mood changes. Mm-Hmm. Yeah. So that's the one that's gonna be available over the counter. And I just, I don't like the idea of women or girls getting access to these products.

Nobody knows that they're on them.

[00:34:17] Jordan Harbinger: Right. I was gonna say their parents don't know. That's why they chose it.

[00:34:21] Sarah Hill: Yeah, I know. Nobody knows to look out for them and they're going on something that can increase their risk of depression by 300%. Yeah.

[00:34:28] Jordan Harbinger: That's terrifying.

[00:34:30] Sarah Hill: I mean, it's, it's just like, it's not good. I really worry about that.

So I've got kind of mixed feelings about the over the counter birth control. I, I like the spirit behind it. I would like to see it implemented in a way that makes sure that women are being taken care of. 'cause I do like that, you know, women are able to access it and they're, you know, without, and they don't have to worry about their parents if they're gonna be having sex.

'cause I think that that's important. But then on the other hand, it's like, how can we still look out for these girls and make sure that they're okay?

[00:34:57] Jordan Harbinger: I could not agree more. I mean, I'm doing this episode, this double episode because I want women and those of us that love them to stop thinking that something is wrong with them when maybe there's something wrong with their medication.

It seems like the access to it over the counter. Access is always better. However, yeah, we don't, we don't, I don't, it's a nightmare scenario that young girls who are already under fire from TikTok and Instagram screwing with their mental health are now maybe gonna take something that is gonna make that worse.

We just, they're just being dealt a really bad hand this decade or so. It's awful. What do you think of the latest politicizing of birth control? I know we touched on that a little bit last time, but if you search for birth control on social media, there is just a cascade of misleading videos. And it's like, if you take this, you're gonna get fat possible.

But other people are like, oh, it'll make you infertile, which is not great. And you see these testimonials online from health influencers if you can call 'em that. And they're, these are not doctors, these are just like random people that are stating birth control can make you infertile. They're not saying that it happens to one in every million people who take it and they have a preexisting condition.

They're making it seem like it's a dice roll. If you take birth control pills, that you're gonna end up infertile. And they're also looping IUDs in with like the pill and the nuva ring and all that stuff. Just like it's one monolithic thing.

[00:36:24] Sarah Hill: Right? Yeah. I mean there's a lot of, um, there's a lot of bad information I think on, yeah, both sides.

Like on the one hand, like the sort of prevailing paradigm for so long has just been birth control pills. Once, you know, it's like everybody take the pill and everybody's gonna, and, and just take it and just shut up. And don't worry about the side effects. 'cause who cares? And they're just fine. And then on the other hand, you know, the other extreme end, you have exactly what you're talking about.

You have a lot of health influencers who don't know and never read a research paper and don't, you know, have a degree of any type and you don't need to have a degree to be able to understand science. But I have no background in science. And you

[00:37:04] Jordan Harbinger: also have to try to understand science. Yeah.

[00:37:06] Sarah Hill: Well, right.

And you also have to like say like factual things. Yes. One would hope

[00:37:11] Jordan Harbinger: Yes.

[00:37:11] Sarah Hill: And, um, say saying things like, like you're saying like with the fertility issue, like, you know, that birth control makes you infertile, which it absolutely does not. And in fact, um, there, there's research that shows that the, that there is a, a, a, it's slower to get pregnant, like when you have discontinued birth control compared to not, but by like two weeks on average.

I see. You know, people who are using it. That's good to know and not, I mean it's just really not, um, the long-term effects on fertility are, except that when women are on it, it allows them to postpone childbearing. And so what you get is you get some women who are infertile because they waited until they were 35 to start having children.

[00:37:46] Jordan Harbinger: I see.

[00:37:47] Sarah Hill: So they are like, oh, my birth control made me infertile. It's like, no, actually female fertility peaks at 25. And it's really horrible. It's a cruel biological fact, but it's a fact nonetheless. And so it's kind of where we're at. I think that it is very difficult to have conversations about birth control without, it always seems like it's one thing or the other.

Like birth control is evil and it's gonna make you grow a tail. Right. You know, which isn't true. And then it's like, birth control is a sacrosanct and how dare you say that It can, you know, do this or that or the other thing. It's like people don't like to hold onto contradictory information. You know, it's like it causes dissonance where it does, you know, where like black and white thinking

[00:38:27] Jordan Harbinger: is a lot easier.

For sure.

[00:38:29] Sarah Hill: Yeah. I mean it totally where it's like, okay, well, so the birth control pill is really important for women and we need to make sure that women are able to have access to it. At the same time, it is imperfect and it can potentially be linked with, you know, different types of side effects that you should look out for.

Mm-Hmm. And they're not one size fits all and everybody's gonna respond a little bit differently. And so it's just important that you know that these things are possible so you know what to look out for them. And so then it's like everybody wants to say like, well, so are you for it or against it? I'm like, right, neither.

Right. For it in certain

[00:39:00] Jordan Harbinger: circumstances. Yeah. It's like, no, that's not what we wanna hear. It's

[00:39:03] Sarah Hill: like I am for you, having all the information that you need to be able to make the decision that's right for you because what is the right decision for you might not be the same decision That's right for me.

And the decision that's right for you right now might not be the same decision that's right for you in five years. It might not be the same decision that's right for you tomorrow. I mean, it's like all of us, our circumstances change and it's like we're all smart enough to be able to take all the information in about what range of effects, you know, the benefits and also the potential drawbacks.

And then make decisions about what's right for us based on, at this point in my life, like, so for example, if you are a woman, like, so I'm, I'm gonna think back to like 20-year-old Sarah, you know, 20-year-old Sarah, when she is not in a relationship and is doing things like dating and choosing partners and figuring out her career goals and that sort of thing.

20-year-old Sarah does not need to be on hormonal birth control when she's not in a relationship because she's not getting pregnant anyway. And she may as well be having her brain in the absence of these other hormones. You know, trying to figure out who she is and what makes her happy, and what job makes her happy, and what kinds of partners she's attracted to, and so on and so forth.

20-year-old plus six months, Sarah, who's in a relationship and also getting a college degree. Um, it needs to not get pregnant in order to finish those things. For her, it might make the right decision to be on hormonal birth control because it's gonna work. And so at that point I make a different set of trade-offs and e each one of us, you know, it's like you have to kind of weigh what the costs and benefits are and it's always gonna be a little bit dynamic.

And I think that we can, are smart enough to have the conversation that here is this drug that's been incredibly pivotal in terms of moving women forward politically, economically, and so on, but is also imperfect. And it's something that women have. Absolutely. I mean, we should absolutely exercise caution with, especially with young girls, and when the benefits aren't potentially great enough to outweigh the risks and we need to have real conversations about whether or not it even makes sense because this off-label use of birth control for things like skin and, and cramps and that sort of thing for teenagers, like, I don't even know whether that's good medical practice.

I feel like that should be a conversation that's being had among those in the healthcare industry is like, is this. Good practice at all for this group of women. And because I don't know that those benefits, is there an acne, you know, clearance benefit that's so great as to outweigh the risk of long-term brain problems?

Yeah, no, like,

[00:41:29] Jordan Harbinger: I mean I really, I don't think so. Don't think so. What about IUDs, intrauterine devices? Do those have a hormonal component or is it just a metal object in your uterus? I don't even know.

[00:41:39] Sarah Hill: Yeah, so there's two different types. There is the metal device, which is the copper IUD, and that one does not have any hormones.

And so, um, those women cycle just like regular, you know, naturally cycling women and the fertility regulation effect comes from the effect that you get a little bit of an inflammatory event that's going on in the, in the uterus from the little object. That prevents implantation. And so that's how you get pregnancy prevention with that.

The hormonal IUD is a little bit of a tricky device and it has hormones and the hormones are getting released. And whenever you have hormones getting released in the body, it is a systemic effect. So a lot of times you'll hear doctors say that the hormonal IUD acts locally, that doesn't

[00:42:24] Jordan Harbinger: make sense. It's in your blood.

[00:42:25] Sarah Hill: Yeah, I know. There's no such thing. It's like there's no such thing as a local hormonal. Go back to medical school. Well, I know. I mean honestly like I think that if you ask the doctor to repeat that, I'm like, can you repeat that back slowly? Like listen to what you're saying. I think that they'd be horrified that that ever even came outta their mouth.

'cause it's impossible. And so what you get, because it has low doses of hormones. These hormones will still, because they're getting in the blood, they still reach the brain, and they're often at a high enough level that they shut down ovulation just the same way all other hormonal birth control does. So for example, when you take the pill, those progestins tell your brain, don't ovulate, and that's why you don't ovulate.

And the same thing with the hormonal IUDs. When the progestin reaches your brain, it's like, Hey, don't ovulate guys. But it is a really low dose of hormone. And so what happens is over time, women oftentimes will begin ovulating again, and then the device is working in the same way as the copper IUD, because it's also because it's in the, you know, in the uterus.

It's like causing an inflammatory event because the uterus is like, what the fuck is this? Right? Yeah.

[00:43:28] Jordan Harbinger: There's a paper clip in here. Yeah. It's like, do

[00:43:30] Sarah Hill: not implant an embryo. Like, this is terrible timing. Guys don't know what this is. So what's interesting is that women on the hormonal IUD. Some of them are ovulating, some of them are not ovulating, some of them ovulated the entire time they were on it.

Some of them never ovulate. And so it's a really heterogeneous group of women. So what, here's the question I have and you don't, probably don't know the answer to this, but I'm gonna ask you anyway, ask me. Yes. The

[00:43:54] Jordan Harbinger: expert over here on women giving Birth all, are you ready for this?

[00:43:56] Sarah Hill: Yeah. So the hormonal IUD, they put this hormone in there, right?

And it shuts down ovulation, like I said, and like 80% of the women who use it for the first year, they're not ovulating 'cause it's shutting down their brain access. But by five years about 80% of women are ovulating. So, and it still works. Okay. So it seems to be working primarily through the same mechanism, which is that, oh no, there's a paperclip in here.

[00:44:21] Jordan Harbinger: Mm-Hmm.

[00:44:21] Sarah Hill: That the other IUD works. So then it's like, why put hormones in there at all?

[00:44:26] Jordan Harbinger: I wonder if there's a pill that I can take that would have y'all tip me more, or maybe there's a pill that will get you to support the fine products and services that support this show. We'll be right back. This episode is sponsored in part by Simply Safe.

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I am happy to surface that code for you. It is that important that you support those who support the show. Now, for the rest of my conversation with Dr. Sarah Hill, my question is, why do you need the other one that has the side effects if the other one works? I don't understand. I, although,

[00:47:03] Sarah Hill: no, my

[00:47:04] Jordan Harbinger: mom's friend had a child and he was born holding that IUD, like he was won an Emmy award, so there is that.

[00:47:10] Sarah Hill: So maybe it's because it's less effective. 'cause I was like,

[00:47:14] Jordan Harbinger: I mean, I don't know, but I, I do know that if you're holding, like, like you just won an Oscar. Oh yeah. It probably didn't work when you Oh, yeah. At that point it

[00:47:22] Sarah Hill: makes me have like, and I don't have a lot of these moments 'cause I, I'm pretty, I'm a pretty practical thinker, but I'm like, they're just looking to sell their drugs.

Yeah. You know, they're just like, wanna put the drug in the, and it's not necessary and they just put it in there because probably

[00:47:36] Jordan Harbinger: 50 times more expensive. 'cause it has the Yeah. That's

[00:47:39] Sarah Hill: the drug. And, and, and the drug is what was patented. Not the device.

[00:47:43] Jordan Harbinger: I don't know if IUDs, I mean is it all medical things that go into the generic or is it just drugs?

It might just be drugs that the patent sort of expires after 15 years. That's

[00:47:51] Sarah Hill: an interesting question. You know, that's an interesting question. I don't know the answer to that, but we'll see, you know, if patents do expire on those types of devices in the same way that it does on regular medication Right.

Then my guess is they're gonna stop prescribing the hormonal IUD as much as they do now. 'cause the reason that it's been so hot is because it's still under patent. And so drug companies are making a shit load of money off of it.

[00:48:12] Jordan Harbinger: Yeah.

[00:48:13] Sarah Hill: And so it really gets pushed by the drug companies. After I learned the magnitude of women who are not ovulating on it for, you know, after a couple years, I'm like, then why have it?

Like, why are the hormones in there at all?

[00:48:26] Jordan Harbinger: Yeah. That doesn't make any sense to me. And it's not

[00:48:28] Sarah Hill: necessary. I don't, I don't think it's necessary.

[00:48:31] Jordan Harbinger: We've seen a lot of media on the left and the right, like you said, one side will say one thing isn't extreme and the other side will say, the other thing is an extreme.

There's almost like this weird agenda on each side. Like one side doesn't want birth control to be fallible because they don't want people to stop taking it because it limits the new liberties that women have. But then you'll see right-leaning media, that's like, it's gonna make you infertile some.

Right-leaning media has said that women have been silenced and shamed by legacy media, the pharmaceutical industry, and in many cases by their own doctors who sort of gaslight them about their experiences with hormonal birth control. And it sounds, that actually sounds pretty reasonable if you have doctors telling people that the IUD is only local and you don't have to worry about it.

Or, or like. It can't possibly do these things when we know now that it can. I mean, it seems like there's an element of truth to some of what each side is saying, which makes this thing all the more frustrating and irritating to deal with, right.

[00:49:26] Sarah Hill: Well, yeah, I mean, yeah, because I don't think that it, well, a, I don't think it should be politicized.

I think this just like way too important. It is. Yeah. And I think that it's something, you know what I mean? That it's like everybody, we should all agree that this is an important issue. Um, and I think we should all agree that, and I shouldn't even say agree, we should all recognize that women have been mishandled by medicine for a very long time.

And that the birth control pill, in a lot of ways is no exception to this. And, and not that the birth control pill is evil and make you grow a tail and you shouldn't be on it. And doctors have been poisoning women. Um, but rather that, you know, we, I, I think for a really long time, doctors weren't listening to women when they were talking about like the seriousness of their side effects.

And I also think that there is a tendency to trivialize. The types of side effects that we have from the pill. 'cause you know, when you look at some of the most, like the most frequently occurring side effects, it's things like depression, like a complete absence of sex drive. And doctors are like, oh yeah.

You know, well, a little bit of, and it's like, that's a person's life. Mm-Hmm. You know, it's like, as far as the medical profession is concerned, it seems, unless it causes cancer or gives you a heart attack, you're fine. It's fine. Right. If

[00:50:32] Jordan Harbinger: it doesn't kill you, then it's just a minor thing. Like, oh, you'll be fine.

Just buy some sexy underwear and that'll fix it. Right. Just brought some dirt in it. Yeah. Yeah. Watch, watch Cinemax.

[00:50:41] Sarah Hill: Yeah. And so I, I think that it's too important to be politicized and it, and I think that we can, and again, it's like part of this, the nuance of the conversation is the conversation is, is an incredibly important tool for women.

Like having birth control is incredibly important for women. And we all need to be champions of making sure that women have access to this. We also need to be sure that women are, um, being championed for access to. Information about what they're being put on. Yeah. And having doctors that are going to be willing to listen to them and their range of experiences.

The fact of the matter is because hormones affect, I mean there are receptors for sex hormones on almost every cell in the female body. Just simply because pregnancy requires almost every system that we have to have a workaround.

[00:51:28] Jordan Harbinger: Yeah. Row in the same direction or shut off.

[00:51:30] Sarah Hill: Right. Exactly. And so it's like all of our cells are very sensitive to sex hormones 'cause they have to kind of do something special depending on what our sex hormones are doing.

And so when you take a drug that changes this, you know, it causes these big sweeping changes in the body. It's gonna be very

[00:51:45] Jordan Harbinger: right,

[00:51:45] Sarah Hill: idiosyncratic. I mean, there's gonna be a lot going on and everybody's body responds to things a little bit differently. And all of us has different preexisting levels of hormones, and all of us have different ability to adapt to hormonal changes.

And all of us have different ways of metabolizing hormones. And so there's all these different ways that women differ from one another. We're all given these drugs and there's like a hundred different variations of hormonal birth control. So there's all these different drugs. And then, you know, they do a study where they compare a group of women who's on the pill or whatever, to a group of naturally cycling women, and they don't find average differences between the group.

And they say, oh look, no side effects.

[00:52:20] Jordan Harbinger: Right?

[00:52:20] Sarah Hill: But it turns out that when you look at the nuances of the data, oftentimes what you get is you get these huge differences among individual women in the birth control group, but when you average them all together, it just looks like nothing happened.

[00:52:32] Jordan Harbinger: Oh, that's interesting.

Right. So just

[00:52:34] Sarah Hill: to give you an example of this, there was a study that was published not that long ago looking at weight changes. Which is something that many women report. They're like, I'm gaining weight on the pill, and their doctor's like, no, you're not. 'cause there's no differences in weight gain among women who are on the pill.

Right. Just you're eating too much and you don't notice it. You're just eating too much. Yeah, exactly. You're just getting lazy or whatever terrible thing that they're saying to women. But when you look at the actual research studies, what you find, if you divide up the weight changes among heavier women and lighter women, what you find is that the heavier women in the sample who are on, on the pill.

They lost weight and the lighter women gained weight. And so when you put all these women together and you just average, their weight changes at zero.

[00:53:16] Jordan Harbinger: Right? Okay. But

[00:53:17] Sarah Hill: what you get are real differences that matter to women. And for some women it's gonna make them very happy. And for other women, it's gonna make them very unhappy.

Right? Instead, you just have the doctor saying, oh, well no differences. 'cause you know, we looked at these two groups. It's like the world is so much more complex than you can do. Like really simple statistics, like they're oftentimes used in a lot of biomedical research. It's just like not gonna capture the nuanced way that our bodies respond to medication.

[00:53:43] Jordan Harbinger: Yeah. They've gotta show the Abso, what is it called? ab? It's been a while since we've been in math class. Absolute value, whether it's plus or minus, it doesn't matter. And so weight change of up to 15 pounds or 25 pounds or whatever it is, is more accurate than weight gain of x Oh, weight gain of X zero.

Perfect. Well, that's, yeah. Like you said, if somebody loses 10 pounds and the other person in the group gains 10 pounds, the weight change is zero. It's

[00:54:06] Sarah Hill: zero. Oh,

[00:54:07] Jordan Harbinger: man. And that's scary because I'm not an average. I'm the person taking this particular medication. Maybe not the pill in this case, but Right.

That's really scary. I would want the complete info. This is so fascinating. I mean, like I said, I needed another hour to get through everything. I thought I, and I've got notes where I'm just like, okay, I'm gonna cover it in the show close, because there, there's so much here. I think it's really interesting.

I think from a guy's perspective, I'm very fortunate that I can look at this and just be interested in the science, but if I'm a, a woman listening to this. I've got stuff I've gotta do. If I'm on that pill or thinking about taking that pill, there's action that needs to be taken in one direction or another, even if that action is just doing research and reading your book, and maybe rewinding to the beginning of this, if I'm jogging and not really paying attention because there's so much in here and it's just, it's kind of scary because if the birth control pill is this complex, probably every other medication that we take is really this complex.

It's just not been around for 60 years. Studied a bunch and affect maybe our personality as much, but it's, it doesn't make sense that the pill is more complex than other medication that we're taking, like, I don't know, ozempic or whatever.

[00:55:14] Sarah Hill: Right. Yeah. It's gonna be really interesting to see, um, how all of that unfolds as well.

[00:55:19] Jordan Harbinger: Yeah.

[00:55:19] Sarah Hill: I think in some ways hormones are kind of uniquely systemic for women, just again, just because of how many cells have to sort of march in a different direction in response to pregnancy. But I, I think like with things like GLP for example, like with Ozempic, I mean that's something that helps to regulate metabolism and glucose and all of that affects the whole engine of the body.

And so that, that one may end up being like really sort of widespread as well. You know, I, I've always wondered this with all of these psychotropic medications that they're putting folks on, especially kids like my kids, I mean, I'm telling you, so my kids are both high school age and half of their peers are on drugs of some sort for psychotropic medication.

And so both my kids are like, well, you mean like Ritalin or something? Yeah, like that or something for depression or something for anxiety or something for, I mean, it's kind of what happens when you have. I don't know. I've got my own hypothesis we can talk about off camera. I was gonna say, you going a private

[00:56:14] Jordan Harbinger: school, it feels like the parents are just like, you know what?

I don't really want a parent. And look, not that only private schools do that,

[00:56:20] Sarah Hill: right? Yeah, yeah, yeah. I'm just

[00:56:21] Jordan Harbinger: noticing a trend.

[00:56:22] Sarah Hill: Right. But I mean honestly though, but so they're always like, well, I feel like I need to, and I'm like, you aren't going on anything. Like I'm not letting nothing touch your brain other than like vitamin D, your vitamin D supplement and that's it.

Yeah. You know,

[00:56:35] Jordan Harbinger: can have Flintstones vitamins. That's it. Yeah.

[00:56:36] Sarah Hill: Teenagers, nobody studies them and they're such a vulnerable group. Right. Because their brains are developing still and they pain in the ass. And so everybody wants to give them drugs to try to get them to, you know, do something different because there's such a pain in the ass.

That's

[00:56:51] Jordan Harbinger: right. That's right. We just have to

[00:56:52] Sarah Hill: roll with it, you know, it's just like we have to learn to put up with them.

[00:56:54] Jordan Harbinger: They're just toddlers that can drive. That's true. Exactly. It's frustrating.

[00:56:58] Sarah Hill: Exactly,

[00:56:59] Jordan Harbinger: man. I will say there's a whole section in your book about birth as well, or different sections. Talk about this.

Do you ever just wish y'all laid eggs? It might be a lot easier. I feel like it would've been a lot easier that way.

[00:57:11] Sarah Hill: Probably would be a lot easier that way. It probably would be a lot easier that way. I. I'd love to say some like, you know, sweet things about pregnancy being this amazing experience and it kind of was, but I don't know that the benefit of all that amazingness is, would like outweigh the amazingness of just being able to lay an egg and have somebody else sit on it for a little while.

Yeah, yeah. You sit on

[00:57:30] Jordan Harbinger: it, you probably couldn't feel that kicking or anything, but yeah, that's, you're right. The trade off is there. Right. It's

[00:57:36] Sarah Hill: like I might give that, I might give that off to be able to just like take a break from it for a little bit. That's right.

[00:57:41] Jordan Harbinger: That's true. Thank you so much for coming on the show.

Really appreciate this. Again. So fascinating all around.

[00:57:47] Sarah Hill: Great. Thanks so much for having me. I.

[00:57:51] Jordan Harbinger: You are about to hear a preview of the Jordan Harbinger Show with North Korean defector Yomi Park

[00:57:56] Clip 1: in North Korea, birds and M can hear your whisper. It's the only place that modern hasn't touched 90, 70% North Korean whales are not paved in the hospital.

They use one needle to inject everybody. It's very common to have a surgery without painkiller. The worst torture is being starved, and before you die from starvation, you hallucinate. You lose your mind. So some mothers eat their children 'cause they thought their children were dogs 'cause they go crazy and you don't eat.

And then they wake up and they're like, what happened to my child? If somebody challenging the party ideology, they don't just go after killing you or your son or grandma, they really go after age generation, like get rid of entire clan. That's how they prevent the revolution. And that's how they became like Almighty God.

Every front newspaper in North Korea is a Kim's photo. So sometimes you do not see the front page and then you rip it. That's how you get executed.

[00:58:54] Jordan Harbinger: How do they prepare you to escape?

[00:58:56] Clip 1: Pray and fasting? You need a miracle to do it because you are gonna go across the Gobi Desert, into Mongolia from China in the minus four degrees.

That's why they make you pray. They just give you a compass. Why don't you walk? Follow the north and the west and then cross eight wire fences and hopefully that's gonna Mongolia. Very unique thing with North Korean Sea. Whenever you ask. Stem in their dream is always North Korea. You never escape in your subconscious.

You are there forever. Every night. Every night. I'm there like nobody escapes in your dream

[00:59:30] Jordan Harbinger: to hear more about the bizarre mind games that generations of North Koreans have had to endure under the current regime. Check out episode 5 78 and 5 79 of the Jordan Harbinger Show. Woo, what a marathon. In the end, the pill is more good than bad, but it's never as simple as take it and forget it.

When it comes to our bodies, I find it fascinating that the pill might make it hard to pick a partner. Guys might look good on paper, but you let chemistry and the pill, it blunts this instinct and keeps women from flagging mates. There's depression because the brain doesn't feel as excited about people or opportunities as it did before.

50% increased risk of depression, especially in younger women. So these are, you know, serious side effects that could potentially happen and do happen to a few people that you need to pay attention to. You need to take breaks from the pill so you get to know yourself off of it, especially when you're making big decisions or changes, marriage, career, et cetera.

And if you're not having sex and you don't have any other medical reason to be on it, talk to your doctor about getting off of the pill. I know a lot of social media influencers are recommending natural alternatives, like timing, sex to menstrual cycles, which is a less effective birth control method that doctors of course warn could result in unwanted pregnancies.

In a country where abortion is now banned or restricted in nearly half the states, and I know. That a lot of you disagree with whatever decision, but it doesn't matter what you think about abortion, right? Left center, I think we can all get behind not increasing unwanted pregnancies. That is a good thing, right?

Come on folks. Let's at least agree on that. Distrust among women of color in terms of the medical community has just has the trusting influencers a lot more, which is really unfortunate. Younger Gen Z folks are more likely to trust random nobodies online because of poor media literacy and health education, and many young women are turning to these quote unquote natural methods, which can have an up to 23% failure rate.

This is not good. So while we might have to pay attention to what goes on in our bodies with the pill, we also have to pay attention to the fact that you might have a kid and not be able to do anything about it, which is horrible depending on where you are in your life. The algorithms behind TikTok, YouTube, and Instagram, they are designed to surface content similar to what viewers have already watched, which experts say leads, viewers to believe that more people suffer complications than they actually do in reality.

Now, all that said, all forms of medication, including hormonal birth control, can have side effects. Some are rare, but serious birth control pills that contain estrogen, they can lead to blood clots and strokes. IUDs can perforate the uterine wall. So talk to your doctor. Pay attention to this stuff. Don't stay on it for a zillion years.

I care about y'all and we should care about each other. Folks, share this with every woman in your life. Any doctor that treats women, anyone in a relationship, anyone who wants to be in one, basically share this with everybody. I think this stuff is fascinating, but it is super, super important as well. All things Dr.

Sarah Hill will be in the show notes@jordanharbinger.com. Advertisers deals, discount codes, and ways to support this show, all at Jordan harbinger.com/deals. Please consider supporting those who support the show. Also, our newsletter wee bit wiser, a practical bit every Wednesday. The idea is it gives you something specific, something that'll have an immediate impact on your decisions, your psychology, your relationships in under two minutes a week.

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So if you know somebody who has a body or is related to somebody who has one. And they might put this stuff in it, or they're interested in interesting things. I know that's vague, but this episode is, is it warrants it. I'm telling you, this stuff is super freaking interesting and if you don't agree, you wouldn't have made it this far.

Share it with them. Share this far and wide. In the meantime, I hope you apply what you hear on the show so you can live what you learn, and we'll see you next time. This episode is sponsored in part by some more news podcast. In a World War news is omnipresent. How about a fresh spin? Dive into some more news.

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