Birth control pills (aka the pill) are an extremely common medication used by women. Whether it be as a form of contraception or to treat hormonal symptoms such as PMS, heavy periods or hormonal acne, over 100 million women worldwide are using the pill.
Unfortunately, too many women are prescribed the pill without being told about the potential ramifications on their body and hormones. In this article, we’re going to take a look at some of the consequences that arise from the use of the pill so that you can make an informed choice about whether or not it is right for you.
- Gut Dysfunction. Birth control pills are known to have mild antibiotic activity. As a result of this, the pill disrupts your normal gut flora, reduces the robustness and diversity of your microbiome, and produces an environment that allows for overgrowth of more harmful bacteria and yeast.
In addition to this, the pill also vastly impairs your gut integrity. The synthetic oestrogens contained within the pill cause increased levels of inflammation that can lead to the development of intestinal hyperpermeability, or leaky gut.
Intestinal hyperpermeability is a condition that leads to widespread inflammation and hormonal disruption throughout the body. Leaky gut occurs when the tight junctions between the cells of the intestinal lining are compromised. These tight junctions regulate what is allowed in and out of the intestinal wall. The gut is naturally permeable to very small molecules so that the body can absorb the nutrients it needs. That’s the way it’s supposed to work. However, factors such as oral contraceptive pill use, stress, consumption of foods you’re intolerant to, gut infections, NSAID use and antibiotics use, disrupt the tight junctions between the cells of the gut lining, causing them to separate and become ‘leaky’. This allows larger proteins and molecules from food, bacteria, yeast, toxins and other organisms get through the intestinal lining. When these toxins, microbes, and undigested food particles make their way through your intestinal lining, your immune system becomes activated because it recognises these particles as foreign and ‘non-self’.
The result? An inflammatory attack by your immune system that can lead to an array of uncomfortable symptoms. This can pave the way to a variety of conditions such as food sensitivities and autoimmune disease.
- Nutrient Depletion. Pretty much all medications come with a nutritional cost and the pill is no exception. The pill depletes the body of vitamin B2, vitamin B6, folate, vitamin B12, vitamin C, vitamin E, zinc, selenium and magnesium. The pill also lowers levels of CoQ10, a crucial antioxidant in the body.
Eating a diet that’s rich in all of these nutrients is essential for good health as well as for assisting in combatting the losses caused by the pill. However, even the most nutrient-dense cannot fully compensate for the nutrient depletions that result from the use of the pill.
- Inflammation & Metabolic Syndrome. The pill has been shown to increase levels of systemic inflammation, as indicated by increases in serum CRP, fibrinogen & ceruloplasmin.
Inflammation plays an underlying role in the development of various conditions. Firstly, inflammation disrupts insulin-signalling pathways, thereby meaning your cells become less responsive to insulin. This can lead to the development of insulin resistance, high blood sugar levels and ultimately, an increased risk of metabolic syndrome.
Metabolic syndrome is a group of conditions that can increase your risk of heart disease, stroke and diabetes. They include abdominal obesity, high blood sugar, high blood triglycerides, low HDL cholesterol and high blood pressure.
The pill can contribute to weight gain/abdominal obesity through various mechanisms such as reducing testosterone, increasing inflammation and causing insulin resistance. Further to this, use of the pill has been shown to cause elevated total cholesterol, high LDL cholesterol and elevated triglycerides in some women. Finally, the pill can also increase blood pressure, and this is often listed as a side effect right on the packaging.
To make matters worse, the pill depletes many nutrients (see my previous point) that are vital for metabolic health. For instance, a deficiency of vitamin B6 is independently associated with an increased risk of heart disease and diabetes whereas a depletion of the antioxidants vitamin C, vitamin E and CoQ10 can increase oxidative stress which can damage the lining of arteries and contribute to the development of high blood pressure and atherosclerosis.
- Thyroid Dysfunction. The pill has several detrimental effects on thyroid function. Firstly, the pill depletes vital nutrients that are required for thyroid hormone production and utilisation. The pill depletes selenium & zincwhich are needed to produce the inactive form of thyroid hormone (T4) and to convert it to its active form (T3). Zincis also required as a signalling molecule so that the thyroid knows when it needs to produce more thyroid hormone.
The pill additionally depletes several of the B vitamins which are also essential for the synthesis of thyroid hormone (among hundreds of other bodily functions).
Secondly, the pill increases thyroid-binding globulin (TBG). TBG binds to thyroid hormones and makes them unavailable to your cells. You will therefore not only have less thyroid hormones, but a high percentage of those that you do have will be unavailable to your cells.
Finally, as I mentioned previously, the pill is inflammatory. When inflammation is high, your converts the inactive form of thyroid hormone (T4) into reverse T3 (rT3) rather than the active form of thyroid hormone (T3). rT3 binds to T3 receptors on your cells and prevents T3 from binding. This prevents T3 from exerting its physiological effects throughout the body, thereby leading to symptoms of low or hypo-thyroidism.
Inflammation additionally makes your cells less responsive to all hormones, including thyroid, insulin & progesterone, to name a few.
- Depression & Anxiety. The pill can contribute to mood changes in various ways. As we discussed previously, the pill depletes nutrients crucial for brain health, lowers testosterone, disrupts your thyroid and adrenals, causes leaky gut, and damages your microbiome – each of which can contribute to depression and anxiety.
With regards to depression, research is now showing that women on the pill experience an alteration in the processing of an amino acid called tryptophan. When tryptophan metabolism is functioning optimally, your body produces serotonin and melatonin as well as kynurenic acid, which protects your brain and assists in boosting your mood. Women on the pill, however, have elevated levels of inflammation. This shifts the tryptophan pathway towards quinolinic acid production, which is inflammatory and harmful to the brain. This has been shown to play a role in the development of depression.
The pill can additionally contribute to the development of anxiety through its impact on the activity of GABA. GABA is a neurotransmitter that elicits a sense of calm & relaxation. Without enough GABA, the central nervous system fires too rapidly, causing effects such as anxiety and worry.
At around day 14 of your menstrual cycle (i.e. ovulation), your body begins to secrete progesterone. Progesterone induces a sense of calm by stimulating GABA receptors. Unfortunately, when you’re under stress, your body prioritises survival over fertility and thus downregulates progesterone production. One major form of stress that can lead to reduced progesterone production is inflammation and the pill is a major instigator of inflammation. Further to this, the pill also shuts down ovulation. This means you don’t make progesterone while on it. Unfortunately, the synthetic form of progesterone contained in the pill (aka progestin) doesn’t stimulate GABA receptors, thereby meaning it doesn’t have the mood-boosting benefits as progesterone. As a result of this, women using the pill are far more likely to develop depression, anxiety and other mood disorders.
The pill clearly can have wide-ranging consequences for your health. However, I completely understand that sometimes coming off the pill isn’t an easy decision to make. If you are on the pill and would like to put measures in place to counteract the negative effects it has on the body, or if you would like to discuss alternative measures of contraception to help you come off the pill, get in touch so we can start your journey towards optimal hormonal and overall health.