Birth control

Are you using any form of hormonal birth control? Contemplating which form is best for you? There are many types such as the pill, IUDs, depo-provera injections, and the NuvaRing.  Some can inhibit ovulation and therefore stop you from getting your period while others may induce a period but keep it very light.

Nowadays women are not just opting for the birth control pill for preventing a pregnancy but also so that they don’t have to deal with heavy, painful and horrendous periods.  But makes sense, it would suck to be at work or school and leak through your underwear or be in so much pain that you pass out or throw up.  In today’s society, we also cannot afford to be taking sick days off every month to deal with our period.

I’m going to let you in on a little secret …. Pain, cramps, clots, and heavy bleeding are very common but not normal.  These can be a sign of inflammation, insulin resistance, adrenal dysregulation, estrogen dominance, another hormonal imbalance or something else.  Dietary and lifestyle modifications can go a long way especially with the addition of key nutritional supplements or herbs where needed and maybe a little bit of acupuncture.  Interested to know what works for you? Book a FREE 15-minute meet and greet and let’s discuss how I can help you.

Nevertheless, sometimes birth control may be necessary for some time to help your periods OR if you are actually using it for what it’s meant to be for – birth control. If you are using birth control, here are a few key points to be aware of.

Oral Contraceptive Pill and "The Period"

UterusWhen you are on the pill, you don’t ovulate.  This means you wouldn’t have a real period.  The bleeding you experience ever month is known as a withdrawal bleed because it occurs after you are done taking the hormone-containing pills in your cycle.  The period when you don’t take any or take sugar pills allows estrogen and progestin to drop which allows for the endometrial lining to be shed.

The withdrawal bleed means that your cycles are programmed so you know when you are going to be bleeding and adds regularity.  The PMS, cramping and flow may not be as bad either.

The problem is that the estrogen and progestin in the pill suppress your own body’s ability to make FSH and LH which reduces your own estrogen and progesterone production (no ovulation = no progesterone from the ovaries).  This can often leave one in a state of estrogen dominance.  Due to this phenomenon, when you decide to stop the pill, it can take a few months to regulate your period/hormones or even have a period again and you may still be in a state of estrogen dominance.  There are interventions we can implement to help with hormone regulation once you come off the pill and minimize the estrogen dominant signs and symptoms.

If you are looking to come off the pill to conceive, I would recommend to plan and come off the pill at least 3 months before trying to conceive and work with a naturopathic doctor to support your hormone balance including ensuring you have optimal progesterone to reduce the risk of an early miscarriage.

What can Estrogen Dominance Look Like?

  • Bloating
  • Constipation/loose stools
  • Breast tenderness
  • Anxiety
  • Low mood
  • Low motivation
  • Spotting before your period when you come off the pill if your progesterone is low
  • Acne
  • Heavy flow
  • Insomnia
  • Weight gain around the hips
  • Mood changes before your period

Isn't Progestin Progesterone Though?

Progesterone

Unfortunately, the progestin in the pill or other forms of birth control doesn’t raise or support maintaining optimal progesterone levels.  Progestin in the birth control is there to help thicken the cervical mucus so sperm has a difficult time entering the uterus and fertilizing an egg if you did happen to ovulate.  Depending on the dose of progestin, it may also suppress ovulation further preventing birth control.  It’s typical to not ovulate on the pill, with the Mirena IUD, the Depo injection, and the NuvaRing.  The Kyleena IUD may promote a period in some people as it is a lower dose of progestin compared to the Mirena IUD but the flow is typically very light.

Anytime ovulation doesn’t happen, this sets you up for estrogen dominance because most of our progesterone is made from the corpus luteum (follicle remnant after ovulation).  Only a very small amount of progesterone comes from our adrenal glands.

Low Mood and Depression on Birth Control?

Some women report feeling horrible – more anxious, sad, weepy and depressed on birth control.  This could be a drop in estrogen and estrogen does help make serotonin.  Another reason is because progestin increases an enzyme known as MAO (monoamine oxidase) [1].  This enzyme breaks down serotonin, dopamine, adrenaline.  This could create feelings of being depressed, low motivation, and have more anxiety.  The effects can be worse if you are on progestin-only birth control.

Progestin induced depression

Nutrient Depletion

Nutrient depletion

According to mytavin.com, the pill or the NuvaRing can increase your susceptibility to candida/yeast overgrowth, dysregulation of your cortisol rhythm, and deplete certain nutrients like B12, folate, B6, magnesium, zinc, selenium, vitamin C, and vitamin B2 [2]. No nutrient depletion was seen by the IUDs or the Depo-provera options.  In order to replenish these vital nutrients, it’s important to ask your healthcare professional for the best formula to take on and off your chosen form of birth control method.  I like to recommend a supplement with active forms of the nutrients for better bioavailability.

If the reason for being on birth control is to avoid horrendous periods, and you would like to come off, please know that it’s possible and there are things that can be done to minimize your menstrual symptoms.  If you want to stay on birth control, there are still things we can do to help minimize some of the adverse effects and prepare your body for when you are ready to come off it.

Reference:

  1. Wise J. Hormonal contraception use among teenagers linked to depression.  BMJ. 2016;354:i5289
  2. Mytavin.com to determine nutrients depleted on Nuva Ring and oral contraceptives.
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