I can barely remember a time when I wasn’t on birth control.
A doctor prescribed me the pill at age 16 to ease the terrible period pains that had plagued me since I was 11. For me, getting a prescription wasn’t as simple as going to a doctor’s office and simply asking. It was an incredibly long process. My mother had a stroke at age 31, six months after starting birth control, so I underwent various blood tests to analyze the possibility of the same happening to me. From there, I was prescribed the lowest possible dose of hormones to regularize my periods.
Thus began my birth control journey.
After more than a decade, I decided I wanted a birth control method that didn’t require me to carry around a pill pack or take a little capsule at a specific time each day. My schedule was busy and constantly changing, and I didn’t want any hassle. So the best solution for me was the Kyleena IUD. Not only did my doctor downplay the intense pain of insertion (I passed out twice from the pain), but he also clearly explained the possible side effects: irregular bleeding for the first few months, breakouts due to hormonal changes, weight gain, and decreased libido. Sadly, these are normal things women have to deal with in order to take control of their sexual health.
For the most part, I have very few complaints about the IUD, but there’s one undisclosed side effect I’m still trying to come to terms with: how it’s affected my hair.
Unexpected developments
About two months after insertion, my body hair, especially in my pubic area and underarms, was thicker, darker, and growing faster than before. Even more strangely, these were the areas I had had laser hair removal in, so the dramatic change from hairless to not-so-hairless was shocking.
It wasn’t just my body hair that was damaged: Though it took me a while to notice, the hair on my head was also completely transformed. For 26 years, my hair had a slightly wavy curl pattern, but I watched with interest as type 3 ringlet curls formed along my hairline every time I went into a humid environment or let my hair air-dry.
It took me almost two years to understand the connection between my new birth control method and the changes in my hair. After hours of research and talking to obstetrician-gynecologists, endocrinologists, dermatologists, and trichologists, I learned that hormonal birth control can alter hair growth, but it was rarely mentioned as a side effect.
Unrevealed Truth
This lack of understanding stems in part from the fact that changes in hair growth are evaluated by dermatologists, not obstetrician-gynecologists: “Most obstetrician-gynecologists don’t fully understand how hormones affect hair,” says Angela Wilson, MD, a board-certified obstetrician-gynecologist at Montefiore Einstein Advanced Care in New York City. (This also explains why many of my obstetrician-gynecologists avoided my questions about hair growth, talking about hair loss instead.)
Another reason is that hair changes from hormonal contraceptives aren’t all that common: Only 5% of women taking hormonal contraceptives report hair loss, and there are no studies that definitively show the percentage of women who experience excess hair growth, explains Sheba Talebian, MD, a board-certified reproductive endocrinologist at CCRM Fertility Of New York.
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Those facts aside, here’s some helpful data: “It’s well-known that hormones affect both the hair growth cycle and hair follicle structure, which in turn determines whether hair will be curly or straight,” says Jessie Chan, MD, a board-certified dermatologist who specializes in hormones and proper sexual health habits. “Major hormonal changes like puberty and menopause can result in differences in hair pattern, texture, and density, as can, of course, birth control pills.”
While there’s no specific hormone that causes these changes, Wilson explains that progesterone and estrogen, the most common hormones found in both oral pills and IUDs, can affect hair growth and hair loss. However, Wilson notes that the effects are still poorly understood, as there have been few studies on women. What is known is that “when hormones bind to the hair follicle, not only can they change the duration of certain phases of the hair cycle, but they can also change the structure of the hair follicle itself.” As the shape of the hair follicle changes, so can the texture.
Digging deeper
So why is my hair getting thicker? Thank you, progestins. These synthetic progesterones, often found in birth control pills, trigger a major male hormone effect that leads to thicker, darker hair and more masculine characteristics, says Gretchen Freese, a board-certified trichologist at BosleyMD. “They transform tiny, straight vellus hairs — the short, thin, light ‘peach fuzz’ that covers most of the body — into larger, darker terminal hairs in gender-specific body parts,” she explains.
I’ve experienced it in my pubic area and underarms, but experts say it can also occur on the upper lip, chin, chest, and back. But what made my case odd was that it occurred in areas that had already undergone laser hair removal, which is a rare occurrence, says Freese. “Although rare, we know that hormones can stimulate hair growth in hair follicles that weren’t producing terminal hair during laser treatment, turning vellus hair into terminal hair.”
Can the effects be reversed?
That’s possible if you stop using your birth control method of choice, says Anathe Brauer, MD, a reproductive endocrinologist at RMA in New York City. You might also consider talking to your health care provider about “opting for a birth control method with less androgenic activity or antiandrogenic properties to minimize these changes,” she says. Hormonal birth control isn’t one-size-fits-all; by working closely with your doctor, you should be able to find a method that you’re comfortable using and that won’t cause any unwanted side effects.
And ultimately, “the responsibility to mitigate those effects lies with the doctor, who must listen, recognize, and do their best to mitigate those side effects,” says Jillian Lopiano, MD, a board-certified obstetrician-gynecologist and chief health officer at Wisp. So instead of suffering in silence, talk to your doctor as soon as you notice the first sign of a side effect.
Embracing the new normal
While my hair issues may seem insignificant compared to the debilitating pain and bleeding, it took a toll on my mental health. That said, I’ve since learned to accept and even embrace my new hair. But don’t get me wrong: I quickly booked in a few additional sessions of laser hair removal to get rid of my thick body hair once and for all. And if you’re wondering why I was so caught off guard, consider that while we’ve seen progress recently toward better reproductive health protocols when it comes to inserting intrauterine devices (thanks, CDC!), there’s still a lot of work to be done. “Research on women’s health conditions is underfunded, under-dataed, and under-represented in female leadership,” says Somi Javaid, a board-certified obstetrician-gynecologist and founder of HerMD. “We need more education.”
In that respect, I’ve been working on it. Learning how to style and manage curly hair has had its ups and downs, but after two years, I’m finally in the groove. Overall, this change was a small price to pay to take control of my sexual health. I hope that going forward, women will no longer be surprised by this potential change and will be prepared to make informed decisions about their reproductive options, with this side effect clearly laid out to them from the start.
Mary Honkus is a freelance writer with over six years of experience in the beauty industry. She’s served on staff at Real Simple, People, and InStyle and has also contributed to numerous publications, including Cosmopolitan, Glamour, WWD, CNN, and Us Weekly. When she’s not trying out the latest and greatest makeup and skincare innovations, you can find her lounging on a rooftop in Hell’s Kitchen or checking out the hottest new restaurants in New York City.
