Are you taking the oral contraceptive pill (OCP) and worrying about long-term health effects? We know about the common (shorter-term) side effects linked to the oral contraceptive pill such as headaches, bloating, decreased libido, mood swings, break-through bleeding and breast tenderness (to name just a few!). But the pill can also have a wider-reaching impact on our health by depleting us of important nutrients that we need for almost every function in our body.
Perhaps you’ve been on the pill for a few years and have noticed your physical, mental and emotional health going downhill (for example, less energy, weight gain, food cravings, poor sleep, less tolerant to stress, poor gut health, more susceptible to colds and infections, low moods etc. etc.). There could well be a connection to the pill, so read on to find out more.
In this post, I’m going to talk about:
- Nutrients depleted by the oral contraceptive pill
- How to tackle nutrient depletion caused by the OCP through diet and supplementation (if you want to continue taking this form of birth control)
- How using the OCP might be affecting your health in other ways such as the impact on the gut microbiome and risk for inflammatory bowel disease
Nutrients depleted by the Oral Contraceptive Pill
The OCP contains synthetic estrogen and progesterone, which alter a woman’s natural menstrual cycle to prevent pregnancy. Women taking the OCP (both the combined and the progesterone-only-pill) are at risk of nutrient depletion. This literature review summarises the nutrients that are depleted by taking the OCP.
“Nutrients are depleted by the oral contraceptive pill by increasing the excretion of nutrients from the body, interfering with the absorption of nutrients and by being used up during the process of metabolising the pill” (1)
Vitamins Depleted by the OCP
- Folate: needed for cell division and growth, repair and synthesis of DNA, and for healthy foetal development
- Vitamin B2: needed for energy production and drug metabolism. It also works as an antioxidant
- Vitamin B6: this vitamin is used in approximately 100 different enzymatic reactions in the body. It’s needed for metabolism and neurotransmitter synthesis (for example, serotonin the “happy” neurotransmitter)
- Vitamin B12: needed for energy production, cell metabolism, and works with folate for DNA synthesis, growth and repair. It also plays a role in the nervous system and production of neurotransmitters
- Vitamin C: Works as an antioxidant and regenerates vitamin E, repairs wounds, aids gum health, supports strong connective tissue and reduces bruising
- Vitamin E: Mops up free radicals which are damaging to the body. Also works as an anti-oxidant and is important for heart health, reproductive function and immune function. Anti-oxidants work together, as vitamin E protects vitamin A.
Minerals Depleted by the OCP
- Zinc: acts as a cofactor for numerous chemical reactions in the body, such as those involved in reproduction, immunity, DNA synthesis, wound healing, bone structure and skin health
- Selenium: works as a cofactor for glutathione – a major antioxidant. It is also involved in thyroid function, protects against cardiovascular disease and cancer. It works alongside vitamin E and it reduces heavy metal toxicity.
- Magnesium: crucial for energy production, detoxification, neurotransmitter synthesis (brain chemistry), bone and muscle health. Low levels are linked to anxiety disorders.
That’s a lot of important nutrients that can be depleted by the birth control pill!
“Depletion of these nutrients can have a huge impact on key functions within the body such as your metabolism, immunity, bone health, mental health and the repair or production of cells needed for healing and growth”.
Taking the OCP impacts on your health beyond the common side effects. Let’s take a look at dietary sources of these nutrients so that you can avoid being nutrient depleted and avoid further negative health consequences.
Dietary sources of nutrients depleted by the OCP
It’s important to eat the following foods to ensure that you are getting the nutrients being depleted by the oral contraceptive pill.
“Organ meats (in particular liver) can be considered a superfood for supplying the all-important B vitamins!”
Folate: Organ meats, green leafy vegetables, legumes and eggs
Vitamin B2: Organ meats, brewer’s yeast, almonds, wheat germ, wild rice and eggs
Vitamin B6: Tuna, liver, walnuts, salmon, lentils, buckwheat, brown rice
Vitamin B12: Beef, poultry, fish, dairy and eggs
Vitamin C: Green vegetables, citrus fruits, peppers, tomatoes,
Vitamin E: Sunflower seeds, almonds, olive oil, spinach, oatmeal, fruits and vegetables
Zinc: Oysters, red meat, other shellfish, whole grains, legumes and nuts
Selenium: Butter, smoked herring, Brazil nuts, whole grains, shrimp, oats
Magnesium: Wholegrains, almonds, cashews, Brazil nuts, pecan, spinach, collard greens
It can be helpful to top up your nutrients with high-quality supplements. What do I mean by high-quality supplements? High quality means supplements that:
- Contain the most bio-available (usable) form of a nutrient so your body can use the nutrients easily and get the most out of the supplement
- Contain the least amount of excipients (bulking agents and additives) so your body has fewer (unnecessary) substances/toxins to process which can interfere with the absorption of nutrients
“A B-vitamin complex, an anti-oxidant formula and a magnesium supplement would give you excellent coverage of all the nutrients depleted by the OCP”.
Below are a few of my favourite high-quality supplements to consider:
B Vitamin Complex
Cytoplan Multi B Extra if you prefer a wholefood supplement with lower doses.
Cytoplan Antioxidant if you prefer a wholefood supplement with lower doses.
Ease Magnesium Spray – applied topically (good for those of us with a sensitive stomach) or
ReMag – an excellent oral form of magnesium which doesn’t cause stomach upset which can be a side effect of some oral forms of magnesium for some people (not all).
How does the OCP affect the gut?
The oral contraceptive pill has been associated with an increased risk for inflammatory bowel diseases such as Crohn’s Disease and ulcerative colitis. Although the exact mechanism is unknown, there is evidence that the oral contraceptive pill can cause an increase in intestinal permeability (aka “leaky gut”) which is a critical step in the development of inflammatory bowel disease (2).
The OCP has been shown to increase estrogen levels by 60% whilst reducing testosterone by 50%. These alterations in sex hormones are thought to influence the risk for Crohn’s Disease and autoimmunity (2).
The OCP is also associated with modified gut bacteria which is also a risk factor for developing autoimmune disease (2).
Furthermore, the OCP has been associated with reduced insulin sensitivity and increased insulin secretion, which is a factor in the development of insulin resistance and type 2 diabetes (3). These factors may also be the reason why many women gain weight and experience more food cravings or low blood sugar whilst on the pill.
The nutrient depletions that have been discussed in this post can also have an indirect effect on the health of our gut because we need these nutrients to maintain a healthy gut lining, to protect us against inflammation and for healing and repairing the gut.
If you’re continuing to take the OCP, it’s important to make sure that you’re eating foods which contain the nutrients depleted by the pill. This includes eating good quality protein (which would ideally include eating liver once a week), oily fish such as salmon and herring, an abundance of leafy green vegetables, legumes, nuts, seeds, whole grains such as oats and wild rice (if tolerated) and citrus fruits. It may also be necessary to supplement to replenish these nutrients. We want to make sure that any medication we take isn’t depleting us of nutrients and causing our health to deteriorate.
It’s not my role to advise you against taking the OCP. Some people get on well with this form of birth control and notice no ill-effects from it. Either way, it’s still important to top up those depleted nutrients. And if you do feel like your health has become worse since being on the OCP, then you could consider coming off it and looking at non-hormonal and more natural alternatives such as the increasingly popular, fertility awareness method (FAM). It can take quite some time for the body to re-balance itself after taking hormonal birth control so do allow for a period of re-adjustment rather than expecting things to miraculously improve overnight!
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- Palmery, M., Saraceno, A., Vaiarelli, A. and Carlomagno, G., 2013. Oral contraceptives and changes in Nutritional Requirements. European Review for Medical and Pharmacological Sciences, [online] 17, pp.1804–1813.
- Khalili, H., 2015. Risk of inflammatory bowel disease with oral contraceptives and menopausal hormone therapy: Current evidence and future directions. Drug Safety, 39(3), pp.193–197.
- Cortés, M.E. and Alfaro, A. a., 2014. The effects of hormonal contraceptives on glycemic regulation. The Linacre Quarterly, [online] 81(3), pp.209–218. Available at: <http://www.maneyonline.com/doi/abs/10.1179/2050854914Y.0000000023>.