Weight Gain: Is it Your Birth Control Pill?
Approximately 6 in 10 of women of reproductive age currently use some form of contraception the pill, the patch, the ring, etc.) to prevent unwanted pregnancy—with the vast majority of those women on “the pill” (birth control pill-BCP) as their contraception of choice.
However,aside from using “the pill” for straight-up birth control, there is another group of women, 1.5 million women to be exact, who use “the pill” for purposes other than contraception—things like acne and skin breakouts, hormonal “balance,” PCOS and amenorrhea.
In fact, this non-contraceptive group makes up more than half (58%) of all pill users.
The “pill” is often prescribed like Advil for a headache, or Tums for a bloated tummy—an “easy fix,” right?
It’s often the “obvious” choice for many docs to help you:
- Prevent unwanted pregnancy
- Get your period back
- Clear up your skin
- Alleviate horrible PMS
- Or “cure” PCOS
All good things in theory…
However, the prescription label doesn’t always tell you about the side effects—many of which may surface years later.
What happens to your body—namely your hormones, your metabolism, your digestion and gut health on the pill?
The short answer? A LOT.
As a nutritionist and functional medicine practitioner, I have a bit of a skewed perspective when it comes to the birth control pill (BCP), as I’ve seen many women come to me, suffering with side effects from BCPs.
From weight gain, to infertility, PCOS, micronutrient deficiency to breast cancer, “slowed metabolism,” loss of hunger-fullness cues, anxiety and low mood, I’ve seen it all, and the overall consensus is:
While the pill does a fantastic job at actual birth control (99.6 percent for error-free users and 91 percent in typical users), the laundry list of long-term side effects from the pill may not be worth it.
Whether you’ve been on the pill 10 years, 10 days or you’re thinking of going on the pill, here is:
1.) An overview of what happens in your body (and health)—on the pill;
2.) A list of the pros and cons of the pill;
3.) Two personal stories from women who have been on the pill
4.) And a weaning protocol (how to come off of it if you’re thinking of turning over a new leaf)
—A few things your doc may not review with you
YOUR BODY (AND HORMONES) ON BIRTH CONTROL
Pop question: What does the pill do for your hormones?
“It makes you able to start having a regular period.”
“It stops a really heavy cycle.”
“It helps you suppress fertility.”
Most people can know the results of birth control pill use, but when it comes to the internal workings of your hormones,(behind the scenes) many are stumped.
Even if you are not a scientist or doctor, this is your body we are talking about, and it’s important to know what’s going on (behind the scenes) inside.
As a female, you have a delicate balance of hormones. In the case of reproduction, we are primarily talking about estrogen and progesterone—the two main female hormones that both balance each other.
Estrogen gives us you your creativity, ambition, your mood (happiness or down times) and most importantly, ovulation (ability to birth new life). Progesterone helps balance out estrogen in between our cycles. After ovulation, progesterone steps in to counter the natural elevation of estrogen during ovulation with “rest” and serenity (i.e. the reason why after your period, you are less moody, weepy or irritable).
Most hormonal BCPs contain synthetic (fake) versions of estrogen and progesterone (called “progestin” in the pill).
When you take the pill, your body thinks it has more than enough estrogen and progesterone for “that time of the month”, and stops working so hard to produce your natural estrogen and progesterone.
Consequently, the pill “tricks” your body into not having a normal monthly cycle by preventing natural ovulation (i.e. preventing the release of your body’s own hormones that would typically signal the growth and release of an egg).
The pill also stops the signal to build up the lining of your uterus to get ready for a fertilized egg.
While on hormonal birth control you don’t have a true menstrual period because the lining of the uterus stays thin and there’s no egg to expel (you only have light bleeding or a “pill period”).
Unwanted pregnancy is ultimately prevented because your natural estrogen production is increased and progesterone is suppressed (and often thrown out of normal balance).
Even if you don’t take birth control for pregnancy prevention (such as for acne or amenorrhea), birth control “messes” with your natural hormone levels to give your body a fake punch of estrogen and progesterone to “cure things in the short term.”
All things considered, the “benefits” of birth control sound great on paper.
- No period?! (And no tampons?! No white-pant ban days?! No crazy chocolate cravings?!)
- No acne?!
- “Getting your period back” (if you haven’t had it for awhile)
Sign you up!
However, remember what’s going on under the hood—and this is something that is rarely discussed.
For instance, in the case of pill use for actual birth control, your body’s hormones may have been perfectly healthy before, but now, the synthetic replacement of extra estrogen and progesterone in the system can be like stirring a wasp’s nest (leaving you with side effects to deal with years later, such as suppressed natural ovulation when you come off the pill).
And, in the case of using the pill for reasons other than birth control, remember, there was a reason why you had acne, amenorrhea (low estrogen) or whatever else in the first place.
Birth control is not addressing that—the real root of the imbalance, but instead masking it.
In short: Fake estrogen and progesterone trick your body into thinking it has hormones that it really doesn’t, consequently, doing things like:
- Reduces your natural testosterone—another sex hormone (Which, yes, helps clear up skin, but also throws your testosterone out of balance—another topic for another day)
- Delays normal ovulation when you go off of the pill (For women who stop the BCP they’ve been taking to become pregnant, often discover return to normal ovulation may be delayed since their hormones have been tricked).
- Tricks your body into jumpstarting a fake cycle (Sometimes doctors will prescribe the pill to “start” your period if you’ve had amenorrhea, and because of the high dose of estrogen in the pill, it works! However, this is not a “real start” to your period as it is not addressing the underlying reasons why your natural hormones are out of balance in the first place for a regular period, and can throw your other hormones further out of balance, or make you rely on the pill for years to come)
- Elevates cortisol. (Birth control pills increase estrogen and suppress natural progesterone production, setting your body up for a chronic state of stress. Since progesterone—your balancing hormone—decreases, and estrogen goes up dramatically (4 times higher than what a normal woman has without the pill), it irritates your nervous system and consequently also spikes your cortisol (stress hormones). This keeps you in a constant state of “estrogen over-drive” and “progesterone under-drive,” not allowing progesterone in to help ‘keep the peace’)
- “Causes” unexplained weight gain or a “slow metabolism.” “Stress” is the number one reason many women experience weight gain or a “slowed metabolism” on birth control. Often times women who experience unwanted weight gain or a “slowed metabolism” on the pill turn to cutting calories more or exercising harder—which only drives up your stress levels more, keeping you in a perpetual cycle of stress.
- Disrupts Your Gut Health. It has been well-studied and known that medications, like antibiotics, severely disrupt our gut health. However, what if I told you that birth control pills are just as bad as antibiotics for your gut? Well, they are. When we take any medication or outside toxin long term (be it Coca Cola, artificial sweetener, Tylenol, or the pill) that our body does not recognize as real (it’s synthetic), it does the same—often leading to what is often referred to as a “leaky gut” or digestive issues. Birth control in particular affects both your hormones and your gut. Your gut is home to hundreds of hormonal receptors. However, when your body’s natural hormonal production is disrupted by the pill—so are these receptors—and your gut takes a hit. In fact, get this: For women who take birth control for greater than five years, there is a three-fold increased risk of Crohn’s disease (a severe disease associated with gut health). In short: The pill further disrupts your micro biome.
THE BOTTOM LINE
When we take birth control with synthetic estrogen and progesterone, we suppress our body’s own natural estrogen and progesterone production, and mask many of the underlying causes or roots of “disease” and imbalance in the first place—leaving us with more of a “mess” or side effects later with long term use.
SUMMARY: PROS & CONS
Let’s talk about some pros and cons of taking the pill you should be aware of:
Pregnancy Prevention. BCPs are 99% accurate if you’re not ready for pregnancy right now.
Skin Clarity. BCPs are also widely used for acne reduction and clearer skin.
Low Cost. Of contraceptive methods, the pill is one of the cheapest (and accessible to most through your primary care physician).
PMS Considerations. For some, the pill can help calm raging PMS symptoms.
Get your period back. The pill can offer those with histories of disordered eating or amennorhea (false or short-term) hope that their period and hormones are back to “normal” as it helps upswing low estrogen levels in the opposite direction as long as you’re on it.
Metabolic Imbalances. Weight gain, “slowed” metabolism or insatiable appetite may arise as hormones are thwarted on the pill.
PMS Considerations. For others, the pill heightens PMS symptoms—moodiness, emotions, and depression are common side effects.
Hypo-Thyroid. The pill can interfere with proper thyroid function—lowering it (consequently impacting your “metabolism”).
Depleted B-Vitamins & Essential Nutrients. The pill can suppress the B-vitamins that help amp up energy and your neuro-endocrine system, and is also connected to decreased micronutrients like vitamins C and E, copper, magnesium, selenium, and zinc.
Decreased Libido. Fact of the matter. Some women experience a lower sex drive, again because their natural hormone levels (and cortisol levels) are off.
Disrupted Gut Health & Digestion. Longterm use of any outside medication can wreak havoc on the “good gut bacteria” in your gut—as they force your liver (your “waste-eliminator and detox organ”) to often work harder to eliminate toxins from your body, as well as can kill off “good gut bacteria” in the first place. And excess estrogen—as in birth control pills—particularly disrupts your digestion. Normally, any excess estrogen is detoxified in the liver and transported to the gall bladder for elimination through the colon. However, in the case of birth control (four times as much estrogen as a ‘normal’ woman has), this process is expedited—and overworked. When this happens the liver takes a hit estrogen is freed back into the system which can further cause digestive and hormonal imbalances—such as disrupting the natural hormonal receptors in your gut. With excess estrogen in your system, and potentially not enough receptors to intercept them, gut balance and health is “thrown off”—leading to things like constipation, IBS symptoms, ulcers and general unhealthy gut flora. (Choijookhuu, 2016).
Lowered Mood. The pill is linked to feelings of depression according to a recent study (Skovlund, 2016). Among all hormonal birth control users in the study, there was a 40% increased risk of depression after six months, compared to women who did not use hormonal birth control thanks to the imbalance created in natural and synthetic hormones.
The pill CAN be a total “godsend” to some—especially again for unwanted pregnancy; and it is by far the most popular form of contraception among 62% of women in the U.S. who use some form of “birth control,” but are the side effects or cons worth it? It’s ultimately up to you.
It’s one thing to read the science and even evaluate research of unknown participants who were part of a larger (often seemingly biased) study—on both ends of the spectrum.
However, it’s another thing to read and hear the stories of individuals who have experienced both life on and off the pill (and lived to tell about it).
These two testimonies, ironically, come from nutritionists themselves. Two “experts” in the field of health who were part of the 6 in 10 women on the pill, what they learned about it—and their bodies, and now the work they do with clients who are both on and off the pill themselves.
Here are their first-hand accounts:
Stacy: 3-Months Too Long
Stacy went on the pill because it was the “thing to do.” A young, married girl at age 21, Sarah opted for the pill to ultimately prevent pregnancy at her age.
Here’s her experience:
- What side effects–if any did you experience while on the pill, if any?
Stacy: Immediate nausea, heart burn, over-all felt horrible…as I look back now the symptoms were like that of a “mini-pregnancy”
2. How long were you on it, and what prompted you to come off of it and what was your experience?
Stacy: I was only on for about 3 months because I felt so bad. I wasn’t even very healthy back then and definitely didn’t come off of it for those reasons. My intuition was just screaming at me to get off.
3. What did you learn about your body/hormones as well as health in general (nutrition, etc.) in the process?
Stacy: Back then I basically just learned that my body didn’t like fake hormones. I honestly was not educated at all about what I was taking…nor did I really care to do my own research. Sadly, I think this is most often the case today.
4. In your work with clients, any stories or experiences working with women on birth control who came off of it worth mentioning?
Stacy: No..but I have been dealing with my college aged daughter and this topic. She says that every girl she knows is on it and that no one thinks of it as not being good for you. Luckily, she has gained some of my view in the past few years about eating healthy and avoiding toxicity. Many think that the pill “regulates” their period when it actually doesn’t do this but rather give you a “fake” period. We have been looking into lots of methods of ovulation tracking, etc. It seems that in our society we avoid teaching young women how their bodies work, empowering them to take control and make better choices. Instead, we SO quickly prescribe every young girl the pill.
Cameo: 10 Years Too Long
Cameo had a similar but opposite experience of Sarah. While she never felt 100-percent like herself on it, she stayed on some form of contraception…for 10 years.
- When and why did you start taking birth control?
Cameo: I initially began birth control when I was around 16 because my doctor said it would help me lose weight and have lighter periods. It did neither! I switched from the pill to a hormonal IUD at 23 years old in order to avoid pregnancy.
2. What side effects–if any did you experience while on the pill, if any?
Cameo: I didn’t realize the strong affects of birth control until after I came off of it. When I was on the pill, I was at a very sick point in my life. It was when I switched to the IUD that I really noticed side effects. I was healthy in all other areas of my life but still had some signs of estrogen dominance – things like fatigue, weight gain around my tummy and hips, hormonal acne. I also seemed to have a jump in thyroid dysfunction, even though my numbers were “normal”. The most noticeable symptom is that my libido tanked and sex wasn’t super enjoyable or desired.
3. How long were you on it, and what prompted you to come off of it and what was your experience?
Cameo: came off all forms of hormonal birth control about three months ago at the age of 26, so almost ten years later! I had a nagging feeling that I felt awful solely because of my birth control method. I could FEEL my hormones were off balance, I didn’t have a normal period, just a “Mirena Bleed”, and I wanted my libido back! Literally the day I had it removed I felt like a new person and I continue to feel amazing! I have constant energy, my skin looks the best it ever has, lingering depression has lifted, I’m losing my estrogen dominance tummy, and my libido is AMAZING. I feel more confident, in charge, empowered, and excited about life! I cannot even put into words how much better I feel. Thanks to nutrition adjustments, I was able to go from a hot mess to a perfect cycle in three months.
4. What did you learn about your body/hormones as well as health in general (nutrition, etc.) in the process?
Cameo: I began using the Fertility Awareness Method, or FAM, as my form of birth control. With this method, I track my BBT and cervical fluid every day and chart it on this super user friendly app. By understanding those charts, I could see that my suspicions were correct. my estrogen was great but dominated over my oh-so-little progesterone. Despite being told “everything would be back to normal” post IUD-removal and I could “conceive that night”, my progesterone function was little to none meaning I couldn’t sustain a pregnancy if I wanted to! This began a ton of learning on my part about how our hormones should look for a healthy cycle and strong fertility. When I could see exactly what my body was doing each day, each week, and each cycle, I could determine where to make adjustments to my nutrition and lifestyle. I had no idea that you could SEE what your body is doing and what it needs. I feel more connected to myself, my body, my food, and my spouse!
5. Anything else you want to add?
Cameo: I never knew how much impact hormonal birth control could have on the body. I was simply uneducated! It’s something I hope to make a primary focus of my practice in the future.
TO BIRTH CONTROL OR NOT BIRTH CONTROL?
For some women, the BCP is the most convenient or easiest choice, and above all else, it is completely your right to choose. Other options for actual birth control include non-hormonal forms of contraception like the copper intrauterine device (IUD), cervical caps, diaphragms, and condoms, but for some, they are not always possible, affordable, or appropriately effective.
If you do choose to stay on birth control, it’s imperative you amp up your nutrition with plenty of real foods to increase the vitamins and minerals that often decline on BCPs, as well as support your overall gut health with:
- Probiotics (daily) and Fermented foods (sauerkraut, kimchi, kefir, yogurt)
Foods that contain:
- Vitamin B (Chicken, turkey, leafy greens, grass-fed dairy)
- Vitamin C (Spinach and dark greens, citrus, berries)
- Zinc (Oysters & seafood, soaked beans, raw nuts, grassfed and pastured meats/poultry)
- Magnesium (Dark chocolate, dark leafy greens, raw nuts/seeds, grass-fed yogurt, soaked black beans)
- Vitamin E (Dark leafy greens, olive oil, avocado oil, raw nuts/seeds)
- Selenium (Brazil nuts, wild-caught tuna, grass-fed beef, pastured poultry and eggs, spinach).
However, if you are open to coming off birth control, it is important to first consult with your PCP who prescribed your birth control, as well as potentially partner with a nutritionist or functional medicine practitioner who can help guide you in helping your body re-balance and restore (gut health, hormone balance, and nutrition).
In addition, addressing any underlying imbalances that may have set you up to “need” birth control in the first place for say, acne, amenorrhea or unwanted weight gain, can also be accomplished when you work with a practitioner who can help you address the roots of these imbalances not the symptoms (like birth control may have done).
Some of the things I often work with my clients on include addressing a “leaky gut”, bacterial overgrowth other gut pathogens, suppressed or elevated cortisol levels, and other hormonal imbalances—all of which can often be restored through a customized approach to your nutrition, smart supplementation, stress reduction and overall lifestyle approach.
For more information on restoring your hormones (and underlying imbalances) in a “healthy way,” make an appointment with Dr. Lauryn today by contacting Thrive to make an appointment for a 1:1 consult and initial intake.
All new inquiries have the option to book a 15-minute free consult if you like more information.
Also, stay tuned for tomorrow’s post on “Quitting Birth Control: The Right Way”