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Making an informed decision about 'The Pill'

Updated: Nov 14, 2019

The Oral Contraceptive Pill (OCP) is touted as being one of the great inventions of the 20th century, and it’s true in that it has led to huge social changes due to women having better control over their fertility; or so it seemed when it became available during the 1960’s. It is one of the most prescribed drugs in developed countries and is increasingly being used for much more than contraception.

So, if you or your teenage daughter have been prescribed the OCP do you know what it is and how it works? Are you also aware of the effect that it has on key nutrients and the effect that potential deficiencies can have on health?

The OCP includes many different configurations but it is most frequently a combination of oestrogen and progestin (a form of progesterone). There are other forms of contraceptives used including Intrauterine Devices (IUD) however these are not included in this article.

The OCP works as a contraceptive by disrupting the normal hormonal fluctuations in a woman’s menstrual cycle and specifically by preventing ovulation. The menstrual cycle is regulated by feedback loops of specific hormones including Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), Oestrogen and Progesterone. The Synthetic hormones in the OCP prevent the levels of FSH to increase enough to trigger a surge of LH required for ovulation. As you can see from the diagram below, it is a sophisticated symphony of hormones, and when you increase oestrogen and progesterone with the addition of synthetic hormones in the OCP, this will change the levels of all the other hormones and knock the cycle out of balance.

Although you may have a bleed when you take the OCP, this is not a period. A normal period occurs when levels of endogenous (made by your body) oestrogen and progesterone decline, and it is a sign that your ovaries are functioning well. When you take the pill, a bleed occurs if you stop taking the pills containing the steroid hormone leading to lower levels of drug. A lot of women are now advised that it is fine to continually take the synthetic hormone and avoid having any bleed at all. The rationale for this:

· Less iron deficient anaemia

· More convenient

One of the risks with this is that it may lead to long term ovarian dysfunction and associated problems with fertility once the OCP is stopped.

Although the hormones in the OCP are designed to mimic your natural ones, they are chemically slightly different, and this means that their effects are also different, and this is why some women experience side effects such as fluid retention and weight gain.

There are also several nutrients that are displaced by OCP use. These include folate, vitamins B2, B6, B12 and vitamin C. These nutrients are vital for multiple body functions including healthy nervous system function, cardiovascular function as well healthy cell production and growth. Vitamin C is essential for adrenal function as well as being a major antioxidant required to neutralise toxins. It is also a vital component of collagen that is an ingredient in skin, bone, cartilage and tendons. Fat soluble vitamin E is also a powerful antioxidant in the body that becomes depleted with OCP use. It is important for cardiovascular health including maintaining the health of blood vessels and preventing blood clots.

Minerals such as zinc and selenium are vital for healthy thyroid hormone production. Selenium is also another powerful antioxidant needed in the body. Deficiencies in these nutrients can lead to thyroid dysfunction and problems with normal metabolic processes as well as infertility. Magnesium is another important mineral that may become depleted with OCP use and lead to increased symptoms such as muscle spasms. It is also a vital cofactor in glucose metabolism as well as the regulation of normal blood pressure.

Often the reason that young females are prescribed the OCP is to treat acne. It does this by reducing the amount of androgen hormones (testosterone). This has the effect of reducing sebum (oil) production on the skin and reduces inflammation and bacterial colonisation. The OCP often produces positive results but it’s really important to weigh up the risks of nutrient depletion, future ovarian dysfunction and increased exposure to synthetic steroid hormones before deciding on this course of treatment.

Another important consideration associated with OCP use, particularly when it is commenced in adolescence to treat acne and continued for contraception, is the long-term exposure to oestrogen. The body has ways of regulating the amount of oestrogen in circulation, but they can become overloaded leading to an oestrogen dominance and increased risk of conditions such as certain hormone dependent cancers, uterine fibroids that are benign growths and can lead to problems with fertility, as well as heavy menstrual bleeding and iron deficiency in perimenopausal women.

The Oral Contraceptive Pill may end up being the choice that you make for your contraceptive needs or to manage your acne. The important thing is that you make an informed decision by understanding its effects and potential risks to your health.

If you would like more information about how you can support your hormonal health, reduce the impact of nutrient deficiencies from OCP use or other options available to treat acne, please make an appointment for a naturopathic consultation with Larissa Jane Naturopathy. Bookings can be made on my website

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