If you are a woman it is highly likely that you have been on some form of hormonal birth control or at least have been recommended this medication at some point in your life. Unlike the name suggests, hormonal birth control is not solely used for contraceptive measures but it is often used to treat many hormonal conditions and symptoms. In fact, these are amongst the most prescribed medications for women since they were introduced over 50 years ago (1).
Though oral contraceptives are quite effective at preventing pregnancy, many women today are taking hormonal contraceptives for other reasons, such as to alleviate hormonal symptoms which many include PMS, acne, cysts, heavy periods, and hirsutism.
Though they may relieve symptoms temporarily, they do not address the root cause of why symptoms arise and can result in hormonal imbalances in the long run. This is because synthetic hormones found in birth control shut down reproductive function, suppress our own hormones, and affect different body systems in a myriad of ways. The reality is that we do not entirely know the long-term effects of these synthetic hormones on our health and hormonal birth control does not fix our hormones it merely suppresses our own natural hormones.
As a result after stopping hormonal birth control many women may experience symptoms and difficulty regulating their cycle or even conceiving. This is also known as Post Birth Control Syndrome and may arise within 6 months of stopping usage.
Now before we continue this isn't about being anti birth control, this medication has done a lot of great things for women however it is essential to be educated on its effects and also be aware that it is not the only option at your disposal. Our goal is to empower you to take control of your own health and make the choice that is the most aligned with your current situation.
The effects of hormonal birth control
Healthy hormones and fertility require specific nutrients such as vitamins a Unfortunately many of these essential nutrients are depleted by hormonal birth control use and include vitamin B2, vitamin B6, folate, vitamin B12, vitamin C, vitamin E, vitamin A, selenium, magnesium, and zinc (2)(3).
This is why ensuring your diet is nutrient rich is absolutely essential if you are taking or have taken hormonal contraceptives. Supplementing with a quality multi-vitamin or prenatal may also be a good idea.
HPA axis dysregulation
The use of oral contraceptives may alter cortisol levels and cause imbalances in the HPA axis (hypothalamic-pituitary-adrenal axis) (4)(5).
The hypothalamic-pituitary-adrenal axis involves the interaction between the hypothalamus, the pituitary, and the adrenal glands.
The HPA axis is mainly known as the stress response system however it also impacts many other systems such as the immune system, endocrine system, and digestive system.
A healthy functioning HPA axis is essential to having healthy hormones.
Stress management is important for everyone, especially during this day and age, but it may be even more so for women taking hormonal contraceptives.
Stress management practices that can fit into any daily routine may include meditation, nature therapy, journaling, breathwork, pilates, stretching, and yoga.
There are of course natural supplements that can provide additional support and may include ashwagandha, reishi, and magnesium.
Oral contraceptives have been shown to decrease insulin sensitivity and alter glucose levels, potentially increasing the risk of insulin resistance over time (6)(7)(8).
Insulin resistance, also known as pre-diabetes, occurs when your cells do not properly respond to the hormone insulin.
This condition is primarily impacted by diet and lifestyle however certain medications, such as hormonal contraceptives, can also alter insulin signalling and blood sugar regulation.
How can you improve insulin sensitivity and manage your blood sugar? Eating regular meals is key! Balancing them with a healthy source of fat, protein, and complex carbohydrates will help to keep your blood sugar stable throughout the day.
Hormonal birth control has been shown to elevate markers of inflammation such as serum C-reactive protein and homocysteine (9)(10).
Higher levels of inflammation may worsen symptoms such as PMS and even impair fertility by affecting egg quality and disrupting ovulation. These synthetic hormones may also impact the immune system and have been correlated with an increased risk of autoimmune disease development as well as inflammatory conditions (11)(12)
The best way to start to address inflammation is through your diet. Start by removing the offending foods, such as the obvious processed foods, fried foods, refined sugars, vegetable oils, refined carbohydrates, and alcohol. Other foods that may cause inflammation include dairy, gluten, wheat, corn, and soy. Then of course you want to add in the good stuff! Particularly anti-inflammatory foods include leafy greens, turmeric, wild fatty fish, ginger, and brightly coloured fruits and vegetables.
The combination of estrogen and progestin found in oral contraceptives has been associated with an increase in venous thromboembolism, myocardial infarction, and stroke (13). It is more particularly the synthetic estrogen found in combination pills that is associated with the increased risk of blood clotting.
This risk is largely dependent on the dosing and type of synthetic hormones used which means certain birth control pills have a higher risk than others.
Though blood clots from oral contraceptives are considered rare they can cause serious health problems which is why it is important to be aware of the risks and to discuss the best options with your health care provider.
Hormonal contraceptives are classified as endocrine disruptors as they introduce synthetic hormones into the body. This means they can alter hormone levels in the body and disturb their balance (14).
Due to the suppression of ovulation, there is an imbalance of progesterone to estrogen, as ovulation is needed for progesterone production. This can result in a state of estrogen dominance as the body is flooded with synthetic progesterone and estrogen which are not the same as our natural hormones.
It's not uncommon for women to report their libido tanking while on the pill as well. Loss of libido may be experienced due to lowered testosterone production and increased production of sex hormone binding globulin (SHBG) (15)(16). SHBG binds onto hormones leaving them unavailable for use in the body. Decreased testosterone can also result in decreased muscle mass, bone loss, and mood imbalances.
OC's can also affect the thyroid. Not only does it deplete nutrients needed for optimal thyroid function but it can also increase Thyroid Binding Globulin, a protein that binds onto thyroid hormones making them unavailable to the body for use. Low thyroid function can promote unwanted weight gain, fatigue, and a variety of hormonal symptoms.
The use of oral contraceptives has been linked to an increase risk of recurrent vaginal yeast infections, also known as candidiasis (17). This may occur due to the imbalance of hormones created by the introduction of synthetic hormones into the body. Hormonal birth control can create a state of estrogen dominance due to lack of ovulation and the extra estrogen delivered. This state of estrogen dominance is closely associated with yeast overgrowth. In fact, a study found that the risk of yeast overgrowth was almost doubled for oral contraceptive users (18).
The gut has also been shown to be impacted by oral contraceptives by promoting intestinal permeability, increasing inflammation in the intestines, disrupting the microbiome, increasing the risk of inflammatory bowel diseases, and promoting a pathogenic environment such as yeast overgrowth (19)(20)(21). This means we need to take extra care of our digestive system while on hormonal birth control and post birth control usage.
Removing inflammatory foods is an essential part of gut healing while choosing whole nutrient dense foods will help to promote repair and healing.
Some of our favourite gut healing foods include bone broth, turmeric, aloe vera, ginger, pineapple, apples, papaya, and fermented vegetables.
Can hormonal birth control affect the brain and emotions? Apparently, it can.
The use of OCs has been correlated with mood disturbances, including anxiety, and depression (21)(22). Research has shown that women using hormonal birth control were more likely to be diagnosed with depression and given anti-depressant medication, especially among adolescents (23).
Studies have also shown that the risk of suicide significantly increased among women using oral contraceptives compared to those who have never taken the medication (24). This is especially important to discuss with your health care provider if you do have a personal or family history of depression.
The conclusion? Hormonal birth control has enabled many advancements for women and we are lucky to have it available however every woman deserves to be educated thoroughly in order to make her own choice for what is right for her own body. Women should be informed of the potential risks of oral contraceptives but also given the necessary support to reduce any long-term effects.
About the Author
Laurence Annez is a Certified Nutritional Practitioner and Health Coach, specializing in PCOS and women's hormones. She also holds a degree in Creative Writing and has extensive experience writing on health and wellness topics. Laurence's mission is to inspire and motivate individuals to take control of their own health and reach their ultimate health goals.