Birth control is one of those decisions—both the birth control pill (BCP) and IUD inserts. Of the options, the birth control pill is the most commonly used method of birth control in the United States with approximately 16 percent of women ages 15 to 44 using hormonal birth control pill.
The health world is full of tons of decisions we must make to choose what is best for us.
Fluoride toothpaste or regular? Bottled water or filtered? Grass-fed or regular? Organic or non-organic (and cheaper)?
While the pill is most often associated with contraception reasons (as in real birth control), more than half (58%) of all pill takers rely on birth control, at least in part, for reasons other than pregnancy prevention:
Missing period? There’s a pill for that.
Irregular period? There’s a pill for that.
Heavy period? There’s a pill for that.
Acne breakouts? There’s a pill for that.
Horrible cramps? There’s a pill for that.
Endometriosis or PCOS? There’s a pill for that.
Moreover, many take the so without ever questioning other options for addressing the underlying issues in the first place (such as the reasons why your period went missing, or is super heavy, or you have skin breakouts).
Whether you are currently on birth control (the pill or an IUD), considering going on birth control or trying to get off birth control, here are the facts you need to kno—including the side effects that many doctors or birth control ads won’t tell you about.
Understanding How Birth Control Works
The Pill
The pill is pretty straightforward: Take “the pill” and prevent pregnancy or treat a variety of other symptoms that stem from an underlying hormonal imbalance (i.e. skin conditions, missing period, irregular period, etc.). To keep things “regular,” a woman takes one pill at the same time each day for 21 days. Then she either takes an inert pill (a placebo meant to keep her in the routine of taking a pill each day) or takes nothing for seven days while she has her period.
When on the pill, the female system makes less of its own progesterone and estrogen. Pill users don’t make their own spike of progesterone, nor do they release an egg—that’s what makes the pill work as birth control.
IUD
IUD stands for Intrauterine Device — a birth control method that sits inside your uterus. A hormonal IUD is a small piece of flexible plastic shaped like a T. Plastic IUDs release small amounts of hormones into your uterus which thicken cervical mucus and prevent fertilization. Copper IUDs have the same effect, but they release small amounts of copper instead of hormones. Hormonal IUDs don’t contain estrogen, so they typically have fewer hormonal side effects than methods that do contain estrogen.
The Gut-Birth Control Connection
When the birth control pill was first introduced in 1960, it monumented a new era for sexual and reproductive health. However, similar to cigarette smoking of the 1950’s, science did not fully understand the health effects of birth control—particularly on our gut microbiome.
Excess Estrogens from Birth Control Pills Are Linked to IBD, Gut Inflammation & Dysbiosis
Two long-term studies (12)–one begun in 1976, the other in 1984–tracked more than 200,000 women who were using oral contraceptives to see the side effects on their gut health, finding that women who took hormonal birth control pills were more likely to develop IBD and associated gut conditions (inflammation, dysbiosis, bacteria overgrowth, etc.).
Poor GI Clearance & Increased Oxidative Stress is the Perfect Storm for Gut Issues Like SIBO
An increase in progesterone (the body’s version of the synthetic progestin in the pill) has been shown to slow intestinal motility and inhibit gastric emptying, both huge factors in developing SIBO (13, 14). If your intestines aren’t able to sweep food, bacteria, and other matter through your system at a normal rate, things will start to back up. And in the case of SIBO, bacteria will start to make their home in the small intestine, giving you all of those symptoms of gas, bloating, and constipation/diarrhea.
A 2014 study (15, 16) of SIBO sufferers concluded that increased cytokines (inflammatory markers) and decreased antioxidants resulted in oxidative stress, causing impaired GI motility and bacterial overgrowth. There were significant correlations between SIBO and the proper regulation of immune pathways in particular—responsible for keeping inflammation at bay. The link between birth control pills and SIBO? When the body is bombarded with excesses of any substance, toxin, or pathogen, there is a risk of developing sensitivity and/or a type of immune reactivity response. SIBO has been considered a secondary condition that develops in the setting of altered intestinal anatomy, slowed intestinal motility, or aberrant gastrointestinal function—particularly during shifts in gut function and hormones, such as during menstrual cycle phases, pregnancy or menopause. Interestingly, the ratio of women to men with SIBO symptoms and diagnoses is currently understood to be 2:1, also suggesting a strong hormone connection.
IUD’s May Also Cause Dysbiosis
IUDs may raise the risk of bacterial vaginosis (BV) and support colonies of potentially harmful bacteria in the uterus.
BV is a kind of dysbiosis—that is, an imbalance of bacteria in your microbiome. BV occurs when the proportion of helpful Lactobacillus in your vagina decreases and various other types of bacteria – including Gardnerella, Mycoplasma, or Prevotella – increase. In one study (17) 49% of patients with a copper IUD had bacterial vaginosis after 180 days of insertion, as compared to 27% of patients without IUDs. People who used copper IUDs for over a year were also significantly more likely to have Mycoplasma and yeast infections (18).
Liver Burden & Leaky Gut Can Occur
Foreign objects—be it plastic or metal—can also cause body burden upon your liver and gut microbiome, especially considering that your vaginal “microbiome” is a big part of your total microbiome. For example, ome IUD’s, such as the ParaGard IUD, are made using a small amount of copper, which is released into the uterus and works as a spermicide. Copper is toxic to sperm…and also to your own body if in excess. Excess copper also depletes zinc levels, contributing to digestive dysfunction (i.e. zinc is responsible for maintaining a strong gut lining).
Summary
There are pros and cons with birth control use. Every woman and her healthcare provider must make the best decision for themselves when it comes to using it or quitting it appropriately. Above all, understanding the connection between birth control and your gut microbiome is essential so you can take proactive measures to “love the gut” while on—and coming off—“the pill.”
Pros of Birth Control
1. Safe Sex.
It’s true, 99% effectiveness with contraception if used correctly.
2. Lowers Androgens.
Hence why pills may help reduce acne and skin breakouts (a stressor) in the short term.
3. Alleviation of PMS.
Short term relief makes it seem like it’s too good to be true. (Unfortunately, it’s not addressing or healing the reason why you got that PMS in the first place, but instead, bandaging the symptoms).
Cons of Birth Control
1. Hormone Imbalances.
Regular use of the pill promotes continuously high levels of estrogen in a woman’s body.This is not natural. Your natural hormone cycle is comprised of both rising and falling levels of estrogen and progesterone. Birth control pills work by keeping estrogen at a sufficiently high level that they fool the body into thinking it is pregnant, therefore another pregnancy cannot occur (or it ‘over-boosts’ your ovulation if you have not been ovulating to trick your body into having a ‘regular’ period). Since birth control essentially acts as a ‘hormone therapy’ it completely throws your body’s gauge of ‘what is normal’ out of sorts—often leading to things like:
- Estrogen Dominance. (linked to the host of side effects from mood swings to weight gain, bloating, decreased sex drive and headaches).
- Elevated cortisol levels (stress levels) as your adrenals try to adjust to the unnatural balance
- Loss of cues to ovulate naturally
2. The Body Decreases Natural Hormone Production.
After months or years on the pill—being subjected to hormones—the body can stop producing its own (or as much of its own) simply because it doesn’t have to. This can make it tricky to come off the pill or rebalance hormones when and if pill use stops. Some women might go several months or up to a year before they begin ovulating and menstruating again.
3. Crazy Sugar & Caffeine Cravings.
Sugar and caffeine cravings are highly intertwined with hormone imbalances, and as we take the pill to address estrogen and progesterone balance, one hormone we are not addressing is our cortisol levels (stress hormones). As cortisol slides under the radar, it remains alive and well—for some super elevated, and others depleted. Cortisol feeds off stimulation though—like sugar and caffeine—and signals to your body it’s need for food (sugar or caffein) as it seeks to find balance and ‘nourishment.’
4. Unwanted Weight Gain.
As hormones shift with the use of contraceptive use, so does your metabolism and internal stress levels—and often times with that, weight reserve as the body becomes more physically stressed as well.
5. Disrupted Gut Microbiome.
SIBO, IBS, constipation, diarrhea and dysbiosis have all been linked to synthetic hormones and altered hormones. If hormones are necessary after you’ve focused on the foundations to hormone imbalance in the first place (i.e. gut health, HPA Axis, immune and blood sugar dysregulation), the aim would be to use birth control as a short term therapeutic protocol. While on the pill or IUD, optimizing gut health is also crucial with probiotics, prebiotics, digestive enzymes and addressing underlying pathologies.
6. Robs Nutrients.
Birth control pills rob many nutrients from your body and impair the assimilation of the nutrients you consume:
Deplete folate – Lack of folate disrupts DNA metabolism
Deplete B Vitamins (B1, B2, B3, B6 and B12) – The lack of these “energy vitamins” can cause irritability, depression, insomnia and fatigue.
Strip zinc – Lowering the immune system and encouraging insulin resistance
Deplete magnesium – Leading to mineral imbalances in the body
Impairs healthy bacteria in the digestive tract Leading to reduced digestion, nutrient and absorption.
How to Quit Birth Control Safely
Before you quit, there’s something you should know: The transition may not be easy or symptom-free. Unfortunately, while birth control is often prescribed as a “treatment” for issues ranging from acne to PMS, it’s nothing more than a band-aid. Although your original symptoms may have seemed to decline when you started birth control, they haven’t really gone anywhere.
Even if you didn’t have any problematic symptoms before starting birth control, listen up: By destroying your micronutrient stores and compromising your microbiome, birth control has actually set you up to start experiencing problems post-breakup.
The good news? You can sidestep these hormonal repercussions and set yourself up for success by taking the right steps right now:
Step 1: Before quitting altogether, begin tracking your cycle.
Get an app to help you. This process will be a lot less nerve-racking when you’re armed with the right knowledge. Record your first day of bleeding (your withdrawal bleed)—i.e. the first day of your cycle, along with any symptoms you experience emotionally and physically.
Step 2: Track your basal body temperature along with charting your cycle.
This will help you pinpoint exactly when you actually ovulate again for the first time.
Step 3: Support your liver.
The body eliminates hormones and toxins through your liver – it’s like your own personal recycling and processing plant. Many women complain of horrible skin breakouts, water retention and bloating once they come off the pill and it’s likely due to poor phase 1 and/or phase 2 liver detoxification. Support your liver with your nutrient dense diet—including plenty of greens, lemon water, organ meats (or capsules) and fresh herbs—along with supplements like:
- N-Acetyl Cysteine (NAC) to boost production of glutathione (a powerful antioxidant and detoxifier)
- Milk Thistle
- Liposomal Curcumin
- Dandelion
Step 4: Go cold turkey (during a hormone-free interval)
Unlike other long-term medications, there’s no need to taper off of hormonal birth control. The ideal time to discontinue birth control is following a hormone-free interval—like after having your period, you can simply stop taking the pills. (Note: quitting mid-cycle increases the risk of irregular bleeding).
Step 5: Continue optimizing the basics
Nutrient dense foods, gut love, daily sweat, sleep, rest and stressing less will get you (and your hormones) far.
Step 6: Protect Yourself
“Protection” is a two-way street. Remind your man of his role in contraception.
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