My Top 10 Favorite Low Hormone Birth Control Options and Why – Keto for Women

My Top 10 Favorite Low Hormone Birth Control Options and Why – Keto for Women

One of the most important things for paleo women to consider is what we are going to do about birth control.

Should you take hormonal birth control? Is it really all that good? Bad? What happens to you when you’re on it? Of course, non-hormonal  would be ideal for any woman who prioritizes having a natural menstrual cycle. Unfortunately, natural options are really not as abundant as they should be. Check out my top picks for low dose birth control options.


Non-hormonal birth control options

1) condoms and other prophylactics

2) pulling out

3) fertility awareness

4) the copper IUD

This last one is pretty powerful–and popular–but it carries a modest risk of copper toxicity with it and may exacerbate bleeding and cramps during your cycle. The copper IUD also costs a pretty penny… somewhere in the neighborhood of $500-$1000.

So, hormonal alternatives seem like a reasonable choice to many women. And they are. Side effects are often minimal (but again, I caution you against them), and many women are completely happy on the birth control pill.

One way to give yourself the best chance of this happening is to go on a low dose birth control option.

There are more than 60 varieties of the birth control pill available today, and every one of them is different. The dosages for the least impactful birth control pills are classified as: “ultra-low dose” and “low dose.”


Different ways higher hormone birth control can affect you

“Ultra-low dose” birth control pills are those that contain 0.02 mg of estrogen

0.02mg of estrogen is just about the lowest you can go and still prevent pregnancy. The reason many people opt for higher doses is that the side effects of spotting and breakthrough bleeding are more common with ultra-low dose birth control pills versus low dose birth control pills.

There are two ultra-low dose varieties:

Alesse (Aviane, Lessina, Lutera, Sronyx)
Contains 0.02 mg ethinyl estradiol and 0.1 mg levonorgestrel (a kind of progestin – read more about progestin types in my blog here and here)

Contains 0.02 mg ethinyl estradiol and 0.15 mg desogestrel (a kind of progestin)

Five low dose birth control pills:

Pills containing 0.02mg- 0.035mg.of estrogen fall into this category. They have a lower incidence of spotting and breakthrough bleeding.

ethinyl estradiol : 0.03 mg
norgestrel (progestin) : 0.3 mg

ethinyl estradiol : 0.03 mg
levognorgestrel : 0.15 mg

Ortho-Cept (Reclipsen, Solia)
ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg

ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg

Levlen 21
ethinyl estradiol : 0.03
levonorgestrel : 0.15 mg

ethinyl estradiol : 0.03mg
levonorgestrel : 0.15 mg


Triphasic Pills

Other favorites of women interested in natural health are low dose “triphasic” pills, which better approximate the hormonal fluctuations a woman normally experiences. They also tend to be a bit better than average for weight maintenance and even weight loss.


  • Phase 1: ethinyl estradiol : 0.025 mg and desogestrel (a kind of progestin) : 0.1 mg
  • Phase 2: ethinyl estradiol : 0.025 mg and desogestrel : 0.125 mg
  • Phase 3: ethinyl estradiol : 0.025 mg and desogestrel : 0.15 mg

Ortho Tricyclen Lo 

  • Phase 1: 0.025 mg ethinyl estradiol and 0.180 mg of norgestimate
  • Phase 2: 0.025 mg of ethinyl estradiol and 0.215 mg norgestimate
  • Phase 3: 0.025 mg of ethinyl estradiol and 0.250 mg of norgestimate

(Ortho Tricyclen and Ortho-Cyclen, each with 0.035 mg of ethinyl estradiol, contain slightly higher amounts of estrogen in each type of pill than Ortho Tricyclen Lo)


Finally, YASMIN and YAZ are two more low dose birth control pills containing 0.03 mg and 0.02 mg respectively of estrogen. What is unique about them is that they have a different type of progestin from the other pills called drospirenone (3.0 mg).

Drospirenone has the benefit of reducing acne and water retention in a lot of women. On the other hand, and this is a huge ON THE OTHER HAND, I have taken a similar substance and nearly died from a potassium overload, as well as developed a severe case of insomnia and anxiety that I am still dealing with two years later. If you take Yaz or Yasmin, please keep your potassium-containing foods to a minimum, drink plenty of fluids, and regularly check in with your doctor on your potassium levels. If you experience muscle weakness or heart palpitations, stop taking your pill immediately.

low dose birth control pills

So aside from the YAZ, those are my favorite low dose birth control pills. These are the ones I fear the least, as they are the lowest dose birth control pills I know of. If I were to use hormonal birth control (to be clear: I don’t, I use prophylactics) – these are the ones I would investigate using, or at least ask my doctor about trying.

If you happen to struggle with acne and be on a birth control pill or contemplating it, take a moment and think about it. Each type of birth control pill has a different relationship with your skin! I discuss the nuances of hormone balance and specifics kinds of pills as they relate to acne in my brand new, 50% off program on the topic, Clear Skin Unlocked: The Ultimate Guide to Acne Freedom and Flawless Skin

If you happen to struggle with PCOS, it is worth learning about the condition and how to overcome it naturally before going on the pill. I describe how  I did and how you can do it too in my manual on the topic, PCOS Unlocked: The Manual.


9 important nutrient deficiencies caused by the pill: an ultimate guide

9 important nutrient deficiencies caused by the pill: an ultimate guide

I have often warned about the dangers of birth control. I have also on the other hand said that I don’t think it’s all that much of a big deal.

Because here’s the thing: birth control is complicated. Obviously the most ideal situation is for no one to be on it. Hormonal birth control very obviously interrupts natural hormonal processes.

But as women today we have to make choice. Sometimes, especially in the context of a healthy body and a healthy diet, hormonal birth control is the best we can do (just, I hope, consider getting on the lowest dose possible).

That being said, we need to be cognizant of the risks we take, and what we can do to mitigate them.

There are 9 crucial nutrients that can be depleted by using hormonal birth control (see an extensive review of which here; free pdf here; you can also find all the source papers for this post listed in that paper’s bibliography).

For the most part, I believe that a nutrient-dense diet such as paleo in the context of a healthy gut and a healthy body will ameliorate many of these potential risks for many people.

But if you struggle with your health in any other way, are on a high dose pill, or are on the pill for a long time, you may want to seriously consider upping your intake of the 9 nutrients I discuss below.

Birth Control Risk Nutrient 1: Zinc

Zinc is an essential mineral that is not only found in several enzymes–which makes it crucial to lots of bodily functions–but it also, notably, is critical for immune system function. It also plays a key role in the metabolism of RNA and DNA, and promotes plasticity (flexibility) in the brain. It is important for immune health, hormone health, insulin modulation, and brain health.

The zinc status of women using birth control has been of concern since the mid 1960s, when scientists noticed that women on the pill has lower zinc levels than women who were not on it. These results have been extensively replicated. The thought is that birth control pills inhibit zinc absorption into the relevant tissues. This is a very big deal – the importance of zinc cannot be overstated.

Zinc foods:

The best sources of zinc are oysters (by almost a factor of ten), followed by liver, beef, and lamb. Turkey and shrimp also have good amounts of zinc. From plants, zinc can be obtained from lentils, quinoa, chick peas, and many kinds of seeds including pumpkin and sesame seeds.

High quality Zinc supplement

Birth Control Risk Nutrient 2: Magnesium

Magnesium iis one of the most abundant minerals that plays a role as a catalyst. That is–it is necessary for chemical reactions in the body to take place–more than 300 of them, in fact. For instance, ATP (adenosine triphosphate), the main source of energy in cells, must be bound to a magnesium ion in order to be biologically active.

It has been repeatedly shown that women on the pill have lower levels of magnesium than women on it. Interestingly, some researchers hypothesize that this is one of the reasons certain pills have been associated with risks of thrombosis. The pill can disrupt the magnesium / calcium balance in the blood and ergo lead to blood coagulability.

Magnesium is important for many other body functions such as blood sugar and insulin management, adrenal health, bone health, and mental health.

Magnesium foods

As important as magnesium is, it unfortunately is no long abundant in the human diet. Research estimates that at least 48% of Americans do not get nearly enough magnesium in their diets. This is in part because magnesium has been depleted from American soils.

Unfortunately for paleo dieters, the majority of foods high in magnesium are not on the typical paleo menu. High magnesium foods include mostly legumes, nuts and seeds: soybeans, pumpkin seeds, sesame seeds, quinoa, black beans, cashews, navy beans, sunflower seeds, almonds. Grains are also reasonably high in magnesium.

Fortunately for paleo dieters, kale, swiss chard, and beet greens are all great sources.

Nevertheless, magnesium is probably one of the greatest “risk” minerals for paleo dieters, which is why I typically recommend supplementing.

High quality magnesium citrate supplement

Blog about different types of magnesium to take


Birth Control Risk Nutrient 3: Selenium

Selenium is a micronutrient that functions as cofactor for reduction of antioxidant enzymes. This makes it incredibly important for detox processes. It also plays a role in the functioning of the thyroid gland and in every cell that uses thyroid hormone. It is incredibly important for managing thyroid disease, and specifically Hashimoto’s.

Hormonal birth control inhibits selenium absorption. For example; Heese et al conducted a study involving 200 female students, half of whom had been taking low-dosage triphasic pills for at least 3 months. They had significantly less selenium than control students. The amount of studies conducted on selenium is not as robust in other areas, but it points to a serious issue worth considering. This is especially important considering that selenium has been suggested to have a beneficial role in the prevention of cancer, especially breast cancer.

Selenium foods

Fortunately for paleo dieters, many animal sources of protein are great sources of selenium, particularly seafood. Shrimp, sardines, tuna, and salmon all have whopping doses and can meet a whole days need; other protein sources like chicken, turkey, beef, eggs, and lamb are also good sources.

Mushrooms, barley, mustard, and asparagus are the best plan sources of selenium.


High quality chelated selenium supplement

Birth Control Risk Nutrient 4: Vitamin E

As an antioxidant, vitamin E helps protect the body against oxidizing damage. This can come from inflammation, from radical oxygen species, from trans fats, from the combination of eating too much fructose and PUFAs, and from consuming burned food, to name a few examples. Antioxidants help protect against this truly destructive damage.

Most of the studies conducted on hormonal birth control and vitamin E have so far been conducted on rats. It significant lowers their serum vitamin E levels. One of the few studies done on humans noticed a significant decrease in the health of platelet clotting in women on birth control pills; this problem went away once they supplemented with vitamin E.

Vitamin E Foods

Vitamin E is unfortunately another one of those nutrients dominated by seeds and legumes. Sunflower seeds top this list, with wheat germ, hazlenuts, almonds, and peanuts also on it. Avocadoes are a great source of vitamin E and probably one of the best for paleo dieters. Leafy greens are also very high in vitamin E. A salad topped with avocado slices is a haven of vitamin E.

Vitamin E supplement (made with safflower oil)

Birth Control Risk Nutrient 5: Vitamin C

Vitamin C is crucial for immune system health, for the manufacture of neurotransmitters, and for adrenal (stress system) health.

Scientists hypothesize that birth control pills — and especially ones containing estrogen — increase the rate of vitamin C metabolism, which decrease its quantity in the blood.

This is probably the nutrient least at risk by birth control pill usage, but it is still important to make sure you get enough, especially if you have gut issues or other health problems.

Vitamin C foods

Leafy greens, other vegetables, and all fruits (yes, citrus, but others too!) all have high quantities of vitamin C. If you are a paleo dieter but don’t go heavy on the veggies you may want to consider upping your dose.

vitamin C supplement

Birth Control Risk Nutrient 6: B6 (pyridoxine)

Vitamin B6 coenzymes are crucial for many bodily functions, most especially protein metabolism. It also helps synthesize neurotransmitters, and is especially crucial for the production of serotonin.

Hormonal birth control has been under fire with respect to B6 since the 60s, when it was found that women taking pills has evidence of a vitmain B6 deficiency — in fact, 75% of women taking birth tcontrol pills may have insufficient B6.

Since low B6 is associated with thrombosis, this is another reason (along with zinc) that birth control pills may be associated with blood clotting and other coagulation risks.

B6 foods

Many sources of animal protein, such as turkey, chicken, beef, tuna, eggs, and salmon, are all high in B6. Plant based sources are sweet potatoes, potatoes, spinach, other leafy greens, bananas, peppers, and garlic.

High quality B complex supplement

Birth Control Risk Nutrient 7: B12 (cobalamin)

Vitamin B12 (also known as cobalamin) is an essential nutrient for many things, but perhaps most of all liver support and detox.

Several  studies have found low mean serum vitamin B12 levels in women using birth control pills, even though the mechanism is not yet understood.

B12 foods

Vitamin B12 is fortunately very rich in pretty much all animal protein sources, especially liver. But beef, lamb, poultry, seafood, and eggs all have fairly abundant B12. Dairy also has a reasonable amount of B12 in it. If you are a vegetarian, and especially if you are a vegan, you will need to supplement with B12.

High quality B complex supplement

Birth Control Risk Nutrient 8: B9 (folate)

As early as the 1960s, folate status has been a concern for birth control researchers. Women who are on hormonal contraception tend to have lower levels of B9; it seems as though when they start taking it folate levels decline linearly – but then levels do bounce back up. The mechanism for this is not quite known, but it seems as though excretion of B9 may be an issue, or malabsorption.

Folate probably is not an issue by itself on the pill–it will not cause anemia all on its own; but if you have other health issues (especially anemia) then this is cause for concern.

B9 foods

It is important to get foods with real folate in them –  folic acid is a synthetic compound added to foods and is not as supportive of real health as true folate is. To that end, good sources of folate include seafood, beef, and poultry. Legumes come second on this list, as do asparagus, spinach, broccoli, and other leafy greens.

High quality B complex supplement

Birth Control Risk Nutrient 9: B2 (riboflavin)

Vitamin B2, also known as riboflavin, is necessary for energy production and normal cell function and growth.

Riboflavin deficiency is common in women of child-bearing age and of a low socioeconomic level. Using hormonal birth control exacerbates that problem. Studies have shown that vitamin supplements remediate riboflavin issues in women taking the pill.

Altogether, these findings suggest that vitamin B2 supplementation in women taking OCs may be important where vitamin nutrition is poor.

B2 foods

Greens, eggs, turkey, other sources of animal protein, and plant protein sources such as beans and legumes tend to be good sources of vitamin B2. With a diet rich in animal products, vegetables, and fruits, B2 should probably not be a problem to obtain enough of. Not many sources of B2 are excellent sources, but there is a wide variety of foods which contain a decent amount of it.

High quality B complex supplement

And thus with vitamin B2 I bring this list to a close.

All in all, for many of these nutrients, a healthy diet will be enough for many people.

But if you suffer from other health conditions, are a vegetarian, have a history of health problems, or otherwise suspect you may be deficient in any of these nutrients, it may be wise to eat strategically or to consider a low dose supplement.

Above I linked to several of my favorite supplements. Here they are again:

High quality Zinc supplement

High quality magnesium citrate supplement

Blog about different types of magnesium to take

vitamin C supplement

Vitamin E supplement (made with safflower oil)

High quality chelated selenium supplement

High quality B complex supplement

It isn’t easy as a woman in today’s world, trying to navigate birth control options while also taking the best care of yourself possible. I hope very much so that this list will help.

I would love to hear what you think of !

Does the birth control pill cause weight gain?

Does the birth control pill cause weight gain?

Whether or not birth control causes weight gain is a topic of gigantic controversy in the health literature. More than 50 percent of women think that it does, and up to 20 percent change their pill or go off of the pill because of this belief (hereherehereherehereherehere and here.).

Yet most researchers don’t believe these women!!

Really, they don’t. It is possible that they are right to do so. Most studies indicate there isn’t much of a statistical effect on weight maintenance in the long term at all.

Nonetheless, even if there is not a statisitcal significance for the population as a whole, individual women can and often do suffer from weight gain when on the pill. Whilemany call weight gain a “myth,” I do not. I simply know too much about the biochemical theory and have talked to too many women about their experiences to do so.

My book “Birth Control Unlocked” can help you find a form of birth control that will work best for your body and my book “Weight Loss Unlocked” can help you healthfully bring your weight back into balance.

The means by which weight gain happens, I believe, are multi-fold, and I’ll go through all of them below. First, a quick primer on birth control will get us set up to understand how it all fits together.


How birth control works

Almost all forms of birth control contain hormones. There are a few that do not. Prophylactics such as condoms are obvious exceptions, as are the methods of tubal ligation — getting your “tubes tied” — and the Fertility Awareness Method, which basically helps you chart your fertility cycle so you know when to avoid unprotected sex in order to avoid pregnancy. The final and most popular form of non-hormonal birth control is the copper IUD. The copper IUD is expensive, however, and it comes with risks of copper toxicity as well as side effects of cramping and heavy bleeding.

Most women therefore end up on hormonal birth control. The way that it works is quite simple: the body cannot ovulate if there is progesterone in the bloodstream. Therefore, all hormonal birth control options contain some form of synthetic progesterone. Some of them have estrogen added into the mix because some women need it in order to achieve the best possible hormone balance. These options are most popular in pill form, but can they also be found in the form of a patch, an injection, an implant, a vaginal insert, or an IUD.

Why weight gain is not quite as much of a problem as it used to be

Back when the birth control pill was first invented in the 1960s, there was nearly 1000 times as much progesterone and estrogen in the pills as there are now. This is an extraordinary comparison. Back then, all of the side effects including weight gain were much more severe and much more common, simply because the amount of hormones were that much higher.

Moreover, many women today experience a “normalization” after starting on the pill. There may be an initial period of weight gain, but after three months of use the symptoms lessen. Biochemically, this makes some sense, as the pituitary gland learns to accomodate the exogenous hormones.

Finally, as I stated before, even though most women think birth control causes weight gain, statistically, it doesn’t really seem to. Meta-analyses of dozens of investigations have concluded that hormonal birth control does not significantly affect body weight or composition, at least not without statistical significance (here).

Why weight gain is still a concern today

Even while most women do not experience weight gain while on the pill – and especially if they find the “right fit” for them – some still do. Moreover, certain formulations of birth control may be more antagonistic to maintaining a healthy weight than others. For example, in one study, Depo-Provera users gained ten pounds on average over the course of 18 months.

So far as I can tell, there are three ways exogenous (exo = “from the outside”) hormones can influence your weight:

1) By increasing appetite,

2) By causing water retention, and

3) By increasing the rate of fat deposition

What does science have to say about each of these categories?

1) Appetite increase

Contrary to what you might otherwise guess – and to that which is broadly opined on the internet – estrogen is an appetite suppressant.  How is not totally understood, though it is widely thought that estrogen spontaneously decreases calorie intake by increasing the potency of the satiating actions of some gut peptides, especially cholecystokinin. The more cholescytokinin produced by the gut, the more full the brain feels. Moreover, estradiol stimulates anorexigenic (stop eating) POMC/CART activity and inhibits orexigenic (keep eating) NPY/AgRP neurons.

Estrogen appears to boost all of of these things, in both rodents and humans. Rats that have had their ovaries removed, for example, spontaneously eat more and gain weight. When injected with estradiol, their normal feeding and weight behaviors are restored.

Progesterone on the other hand appears to stimulate appetite. This is the case with rodents as well as with humans. First it blocks estrogen’s satiating effects, since estrogen and progesterone often act as counter-balances to the body. It also stimulates appetite all its own.  This could be why you want ALL THE DESSERT as it gets close to your period.

For the record, testosterone increases appetite, too – which is relevant for women who have PCOS or elevated testosterone levels. It also tends to promote fat storage in the abdomen rather than in “female fat” areas like the hips and thighs. Minimizing testosterone levels by minimizing stress and overcoming insulin resistance is a great way to help lose weight and regulate food cravings.

Hirschberg, 2012.

Hirschberg, 2012. Click to zoom.

2) Water retention

Formulations of the pill that have high quantities of estrogen and progesterone or that are especially high in estrogen may cause water retention.

Estrogen causes tissues to reabsorb sodium, which increases sodium levels in the body’s fluids. Elevated sodium causes water weight, because the body balances the extra sodium with extra water. The more sodium you have floating around in intercellular space, the more water your body is going to send to that space.

Estrogen can puff you up a whole pant size based on water weight alone.

Progesterone, on the other hand, also causes sodium retention, but it doesn’t store it in the same free-floating space as estrogen it does. Instead, it  tends to work more on regulating other important hormones in this process, which down the line causes extra excretion of fluid rather than retention.  Thus, progesterone is somewhat of a diuretic.
A low-dose, well-balanced pill should not cause water retention. High-dose and especially high estrogen pills can.

3) Fat deposition


Again, estrogen is commonly blamed for the birth control problem. This is somewhat fair. Estrogen promotes fat storage, and particularly in the female areas of the buttocks, hips, thighs, and breasts.

However – the true villain in this story is a certain class of progesterone.

Not all hormones are created equal. One major component of this whole discussion I’ve so far glossed over is the fact that the “hormones” in birth control pills are not actually natural female hormones. They are synthesizsed in laboratories, normally out of plant proteins. Yams are a favored estrogenic contributor to birth control pills, used to synthesize the most popular form of estrogen, “ethinyl estradiol.”

So hormones are synthesized in labs, and not all of them are created equal. There are eight classes of “progestins.” They can be broken down into three broad categories: progestational, estrogenic, and androgenic. Those which act more like male hormones in the body are androgenic.

Research suggests that older varieties of the pill that used more androgenic progestins caused the greatest weight gain. Newer formulations with less androgenic progestins may cause less weight gain according to several studies, such as herehere, here,here and here.

Some more androgenic varieties – ones you might want to avoid, are levonorgestrel and norgestrel. It’s worth noting that levonorgestrel is the most commonly proscribed progestin worldwide.

The three least androgenic forms of progestin and the ones you may want to keep an eye out for if weight gain is a problem are norgestimate, desogestrel, and drospirenone. (But drospirenone has its own risks – read about them here and how they almost killed me here.)

Androgenic progestins like levonorgestrel are still in use for a few reasons. One is that they simply are not a problem for weight gain for the majority of people. Another is that these specific progestins are better at mitigating the risks of estrogen-containing pills than other progestins. They provide better balance. Better balance appears to decrease the risk for vascular thromboembolism and stroke – which is why androgenic progestins are the progestin of choice in most countries. Whichever kind of progestin is right for you is your and your doctor’s own decision.

In sum

To sum up my research:

-Pills high in progesterone – or that do not have estrogen at all – may increase appetite and therefore cause weight gain at least in the short term

-High quantity pills may cause water retention

-Pills high in “androgenic” progestins appears to cause more weight gain than others (norgestimate, desogestrel, and drospirenone)

So does the birth control pill cause weight gain?

In the majority of women, the birth control pill does not cause weight gain, especially if she is on the pill for more than three months. However, studies are conducted on hundreds if not thousands or tens of thousands of women at a time, so even if the average experience is to maintain a steady weight, there will be women who are not average and who do not maintain a steady weight.

Weight gain is listed as a side effect for birth control for a reason. It doesn’t happen to everyone but it does happen to some. Androgenic pills may cause the most weight gain, and water weight and appetite can also come into play. In order to best navigate these options and minimize the side effects you experience on the pill, aside from purchasing my book on the topic, continue reading on this topic in the next installment, How to go on birth control without gaining weight.

More on weight loss for women!

This kind of insight and information is super rare to find online. Rarely do websites that talk about hormones go this in depth into personal experiences and deal with the possibilities of side effects and how to mitigate them (Women to women, or webmd, anyone?). Fortunately, I am one of the few researchers interested in them, and from a paleo perspective!

And many kickass paleo authors are, too!

As luck would have it, 20+ of my favorite paleo weight loss revolutionaries… Diane Sanfilippo, Chris Kresser, Dr Sara Gottfried, me… are getting together for the next three weeks and sharing all their new tricks and tips and their own particular insights (I give a talk on birth control that contains information much like this!)… in a series of FREE talks.

While the event is going on, it’s 100% free. It’s a summit on weight loss, for women only.

Check it out and find more sweet info like this, if you’re into this sort of thing, @


And if you’re interested in a great resource that you can read and benefit from today, check out my excellent book on women’s weight loss “Weight Loss Unlocked” here.


Birth Control Unlocked – now available for $8.99!

Birth Control Unlocked – now available for $8.99!


Today is October 18! This is exactly 365 days from the day I first released PCOS Unlocked! It is also my own birthday — so I am swimming in celebration and contemplation and symbolism this week.

To that end, since I recently finished writing and uploading Birth Control Unlocked, I figured why not go ahead and release it on the birthday of PCOS Unlocked.  Now I get to have three birthdays this week, which might call for more tequila and dancing this weekend than I had initially prepared for.*

To that end, you can now purchase the ebook Birth Control Unlocked: Your Body, Your Options, Your Guide here on this website, @, which is one of the pages listed in the navigation bar “Birth Control.”  The sales page not a fancy sales page. It’s not designed to entice you. It just is. Birth Control Unlocked is a map to the world of birth control, and while charting all of the territory, I also highlight the best tools you can have on your journey (for example, liver health!) of choices, wellness, fertility, and kickass womanhood.

It’s only sale now for $8.99. That might change in the coming months – I have listed its value elsewhere on the web at $14, but for now I am going to sell it for $8.99.

Below is the table of contents, and below that I have attached the introduction to the book to give you a feel for how it reads.



table of contents






Welcome to birth control unlocked! My name is Stefani Ruper, and I am the author of PCOS Unlocked: The Manual as well as the forthcoming Sexy by Nature: The Whole Foods Solution to Radiant Health, Life-Long Sex Appeal and Soaring Confidence. I also write at, and I have been working in the field of women’s health for several years. Throughout those years, I have traversed the landscape of birth control options more times than I could count. I haven’t done any serious experimentation on a personal level.  Aside from a few brief forays into hormonal birth control for health reasons, I haven’t used anything other than prophylactics. I have made these choices entirely on the basis of my extraordinary depth of knowledge in the field, my allegiance to natural womanhood, and of course the particular needs of my own sexual activity (which is not, to be fair, all that great.)


If my need for serious birth control increased, I would probably re-consider my current path. But I would not share my decision with you in this format. Birth control is an entirely subjective matter and needs to be treated as such. Each of us has different psychological needs, different physiological needs, and different negotiations to make with her partner – as well as differing financial needs. I do not delve into the finances of different birth control options here, nor do I discuss any psychological factors that may go into decision making. This is a guide that focuses on the physiological implications of all of the different options available to you, so that in the context of the rest of your life (on which you are a much better resource than I), you are empowered to use the information as best you see fit.


While none of the birth control options I discuss here are 100 percent effective – none of them are – they are largely effective and supported by all the major health institutions. It is also important to note that the majority of the ineffective cases are due to human error, not to faulty product design. Faulty product design exists, again, of course, but it is far and away more important that you act realistically and choose a birth control method that fits with your psychological and logistical needs. If you can remember to take a pill every day at the same time, great. If you cannot, I highly recommend looking elsewhere to meet your birth control needs.


My knowledge of the depth and breadth of birth control practices comes from years of helping women try to optimize their health in the context of their birth control choices. To that end, I share with you a significant depth of knowledge regarding different birth control options, but perhaps more importantly, I share with you the best theories I know out there on why birth control has certain effects on women while on it and while coming off of it. Many women wrestle with significant side effects, the least of which being infertility, after coming off of the pill. Why does this happen? What organs in your body are affected by birth control? What can you do while on the pill to mitigate damage, and what can you do afterwards to regain your fertility and hormone balance as soon as possible?


I wish you all the best moving forward with this information. This guide is not meant to share everything about diet, everything about birth control, or everything about how you need to make this decision with you. It is, instead, just one tool in your pocket. It’s the one for knowing your body, knowing your options and the risks, and doing your best to be as healthy as possible no matter which option you choose.


Go to to purchase the guide for $8.99, or click the button below!


Fullscreen capture 2013-10-02 PM 044456.bmp



*This is a rhetorical device. I almost never drink alcohol.

Announcing: Birth Control Unlocked (!!!!)

Announcing: Birth Control Unlocked (!!!!)


Ladies! I am SO EXCITED to bring you Birth Control Unlocked: Your Body, Your Options, Your Guide. 

This is the first, and it is the only, and it is the holy crap its about damn time resource for paleo women who are looking to be on birth control, who are currently on it, or who have been on it before and are reeling with consequences.

It is a map to the world of birth control, and it shares with you all the information you need to navigate it safely and happily.

(At least I tried.)

Anyway. This book details:

All birth control options, both hormonal and non-hormonal, and details all the side effects, benefits, and risks.

The health impacts of different hormones

How to minimize the negative health effects of birth control while on it

How to recover fertility and manage symptoms when coming off of birth control

How to have happy and healthy hormone balance no matter which birth control method you choose


Birth Control Unlocked is going to be available from this website soon enough (but honestly I’m not sure when I’ll get around to it), but before that it is a part of the Harvest Your Health Bundle Sale RIGHT NOW, and I can guarantee you can get it right now, through the end of this week!  The Harvest Your Health sale is, legitimately, the biggest bundle sale that has ever hit the natural health world. 71 ebooks. 3 magazine subscriptions. 14 fitness plans.  (Check it out at

The value? A whopping $1037.

The price we pay? $37.

That’s 44 cents a piece.

So anyway.  Birth Control Unlocked, which is probably retail at the outside somewhere around 10 dollars, is going to be a part of this 37 dollar package with a bajillion other sweet books.  Not too horrible a deal, IMHO.

Plus, don’t forget: if you haven’t yet heard: if you purchase the bundle through me, email me at, and I will send you a half off discount code for PCOS Unlocked, too.  Seriously.

In the meantime, Click here the download the table of contents or view below:

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birth control unlocked

Again, for more on the bundle and getting this book through this ridiculous sale, click here: or the button below.

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On the fertility awareness method, getting intimate with your cervix, and how long a sperm can set up camp in your vagina

On the fertility awareness method, getting intimate with your cervix, and how long a sperm can set up camp in your vagina

Writing about birth control these past few months, I’ve covered a wide variety of options.  The thing is, however, that nearly every one of them interferes in the process of a woman’s natural hormone signalling.  Those that don’t, such as the copper IUD, still as yet pose serious health concerns.

Smaller side effects such as headaches, nausea, weight gain, acne, mood changes, and sleep disturbances are nothing to laugh at.  Scarier risks such as blood clots, heart palpitations, muscle weakness, and sudden death even less so.  Some hormonal options of birth control are rightfully scary in the eyes of women concerned with natural, healthful womanhood.

So a lot of women turn to the fertility awareness method.  FAM has a bit of a bad rep.  It’s regarded in many circles as inconsistent and unpredictable, and therefore subject to high failure rates.  In other circles, it’s disregarded as that silly thing overly religious people do.  Neither of these could be farther from the truth.  Yes, some people practice FAM for the sake of their religious beliefs.  And yes, some people mess up and get pregnant.  But when practiced properly, FAM has success rates that equal and even surpass some of the conventional birth control methods.  1 percent is about the going rate.

So what is fertility awareness, and how does it work?

FAM is the practice of avoiding unprotected intercourse during the period in which a woman can become pregnant.   For this reason, the whole trick of FAM is identifying physiological markers of ovulation.  Ovulation is the time in which a woman’s ovaries release an egg, and so it is around ovulation that women need to step carefully.

The first day of a menstrual cycle is the first day of bleeding, and ovulation generally occurs ~two weeks later.

There are many significantly advanced methods for detecting ovulation. Hundreds of dollars can easily be spent on costly and precise methods such as analyzing saliva for ovulation-indicative molecules, or monitors that track changes in electrical resistance in vaginal fluid. This makes sense. Lots of people are trying very hard to conceive children.  Yet more natural, and mostly free, methods also exist, and are quite effective.

1)  OPK Urine tests

Luteneizing hormone spikes in the urine around ovulation, so increasing LH levels can predict fairly accurately when a woman is on the precipice of ovulation.  Most test strips predict the onset of ovulation within 12-36 hours.   If you are interested in FAM but are either not quite comfortable with touching your cervix or enjoy confirmation that comes from computers and scientific tests, this might be a good method to have in your arsenal.

2) Basal body temperature

One way to detect ovulation is to monitor basal body temperature levels.   Tempreatures rise with progesterone levels, and will spike about 24 hours after ovulation.  They should remain this high until your next period.

The way to do so is to check your temperature (in your mouth is fine– just always be consistent with where and how you do it) the moment you wake up.  Chart your temperature over time, and notice the spike that occurs just after the middle of your cycle.  It should be between .4 and 1.0 degrees F.   You won’t feel the shift, but you can detect it by using a basal body temperature (BBT) thermometer.  BBT thermometers are just more precise than others, but still they come as cheap as ten dollars.

You are most fertile in the two or three days before your temperature hits its high point. A few experts think you may have an additional 12- to 24-hour window of fertility after you first notice the temperature creep up, but most say that at that point, it’s too late to make a baby.  At the very least, however, it becomes statistically less likely.

For this reason, it is best to chart your temperature for a few cycles, and start counting ovulation as the two days or so previous to your spike.  You can also use other ovulation-detection methods to confirm.

3)  Cervical mucus release

The appearance of cervical mucus and vulvar sensation are generally described together as two ways of observing the same sign.  In a menstrual cycle, it’s appearance, or thickening, marks the start of ovulation.

The production of fertile cervical mucus is caused by estrogen, the hormone that also prepares a woman’s body for ovulation.  Cervical mucus is produced by the cervix, which connects the uterus to the vaginal canal. Fertile cervical mucus promotes sperm life by decreasing the acidity of the vagina, and also helps guide sperm through the cervix and into the uterus.

By observing her cervical mucus, and paying attention to the sensation as it passes the vulva– that is, as you can actually feel it coming out of your vagina, a woman can detect when her body is gearing up for ovulation, and also usually when ovulation has passed.  This is because when ovulation occurs, estrogen production drops slightly and progesterone starts to rise. The rise in progesterone causes a distinct change in the quantity and quality of mucus observed at the vulva.

For some women, cervical mucus persists throughout the following week and its hard to tell precisely the difference.  Regardless, the start of ovulation has now become quite clear.  Your most significant discharge is your ovulatory period, and the start of it is the start of ovulation, which lasts 12-36 hours.

Your libido may also spike at this time (!).

4) Cervical position

The cervix changes position in response to the same hormones that cause cervical mucus to be produced and to dry up–estrogen and progesterone.

When a woman is in an infertile phase of her cycle, such as the first two weeks, the cervix will be low in the vaginal canal; it will feel firm to the touch (like the tip of a person’s nose, says Wikipedia); and the opening in the cervix will be relatively small, or ‘closed’.  As a woman becomes more fertile, the cervix will rise higher in the vaginal canal; it will become softer to the touch; and the opening surface will become more open. After ovulation has occurred, the cervix will revert to its infertile position.

The only way to track this is to feel around and see what’s up for a whole month.  It may take longer.  But as estrogen levels rise and drop, the whole vaginal environment changes, and– really, I can’t describe it nearly as well as you can interpret it as you feel it yourself– you can really sense the difference in your cervix.  The trick is to find it, but basically you just press as far back and up into your vaginal canal as it goes until you feel a change in tissue.   If the cervix is too high up there when you try, check again in a few days– perhaps you were ovulating or your estrogen levels were spiking.  If you cannot reach your cervix, ever, then it’s entirely possible you just have a high cervix, and you’ll have to rely on the other three methods discussed here.

5)  Your sex drive may rise during ovulation.

This point is self-explanatory, I think.


These are the primary methods by which women detect ovulation in their cycles.   One by one, you may be worried that they are inaccurate or you are reading the signal improperly, but together, you have pretty powerful evidence that ovulation is occuring in your body.   And over time, as you become more and more used to this method, you become more and more familiar with the shape of these feelings and fluctuations, and become more and more intune with yourself and accurate with your predictions.

These are wonderful ways to avoid the problems of hormonal birth control.  This is why FAM is so widely practiced by naturalistic and paleo-oriented women.   When done correctly, it really does prevent pregnancy.  You cannot get pregnant unless a sperm has met the egg in the fallopian tubes.

If you are looking for more information on tracking your ovulation, Toni Weschler has an excellent book available called Taking Charge of Your Fertility. I recommend all women, weather trying to conceive or avoiding conception, read through it and get to know themselves a bit more.

But how long can a sperm survive inside the vagina?

So a woman can only conceive once her egg has dropped into her fallopian tubes, and met with sperm there– and the egg is only there for 12-36 hours, yet ovulation is not the only time of having sex that she can get pregnant.    This is because sperm usually die off between 1 and 2 days after release into the vagina, but they can actually survive up to 5 (or on the safe side, 7) days. (!)

Human sperm travels at the staggering rate of up to 4 millimeters per minute, but many are as slow as 1 millimeter per minute.  You have to put this into perspective; human sperm are only 55 millionths of a millimeter or 55 microns in length, so a millimeter is a pretty big deal to the mini-me’s.

The average length of the journey to the fallopian tubes is 175 millimeters, which means the Road Runners of the team can get there in 45 minutes, but in practice the journey takes anything up to 3 days if they can make it that long.

For this reason, marking back from ovulation, women need to stop having unprotected sex 7 days beforehand, then count two whole days for ovulation, and then give it as many as seven days afterwards.  If she feels a bit risky she can push it on the edges of fertilization, but most women do not.

In this period, some women abstain from sex.  Others use barrier type birth control such as condoms, diaphrams, or sponges.

Unfortunately this blocks out about half of the woman’s cycle.  It is, however, the only way to have unprotected sex while being certain to prevent pregnancy.

Your chances of getting pregnant

A perfectly fertile and healthy couple statistically has a 1 in 4 or 1 in 5 chance of conceiving with every given act of intercourse during a woman’s fertile period.  This means that the vast majority of these couples conceive within a year.

That’s actually a pretty high statistic, so many women are very serious about the boundaries of their fertility awareness practices.

STI’s, etc.

And as a final caveat– note that all birth control methods outside of the condom do not prevent STIs.  They only prevent pregnancy, so get tested!  Both of you.

And best of luck moving forward figuring this out.  It’s a lot of fun–and a lot of women really love–getting in touch with your body and your cycle. Don’t forget to check out Toni’s book as well if you’re considering FAM or trying to conceive.


What’s your experience?!  Your hopes?  Your doubts?  Your concerns?  Share away!  FAM is such a diverse and widely / differently practiced art.  I am super excited about hearing more about your personal experiences.

You can find everything I find relevant about birth control in my book, Birth Control Unlocked, available here.