In this episode, Dr. Lisa and Dr. Toni discuss: the reasons why women take the birth control pill; some potential negative side effects and nutrient depletions to be aware of and look out for; post birth control syndrome and what may happen after you stop taking it; other forms of contraception; and what to do to help minimize any side effects if you are taking the pill.

Why you might be on or thinking about starting the Pill:

  • To prevent pregnancy
  • To treat acne
  • To reduce symptoms around period like:
    • Heavy bleeding
    • Cramping
    • Irregular periods

How does the Pill work?

The synthetic estrogen (ethinyl estradiol) and progesterone (progestin) in the Pill suppresses your natural cycle of ovulation, menstruation and hormonal fluctuation. The use of placebo pills for the last 5 days or so of your period (or stopping the Pill briefly) leads to a breakthrough bleed, not a true menstrual period.

The downsides of the Pill include:

  1. Increased risk of clots, leading to deep vein thrombosis (DVT) or pulmonary embolism
    • Each year, 1 in 1000 women taking birth control pills will develop a clot
    • The risk of developing a clot increases significantly with a history of thrombosis or clotting disorder like thrombophilia
  2. Shuts down your natural hormone rhythm
    • You could lose the experience of times in month when you are more creative, want to exercise more, are more social
  3. Choosing a mate on the Pill vs. off the Pill
    • Would you still be attracted to them if you stop or start the pill?
  4. Acts only as a band-aid solution to mask your natural hormonal imbalances
    • Your problem can still be there, or even be worse than before you started the Pill 
  5. Nutrient depletions
    • Vitamin B2: deficiency can cause you to experience fatigue, dermatitis, headaches, migraines, indigestion, eye irritation, sensitivity to light
    • Vitamin B6: deficiency can cause you to experience fatigue, carpal tunnel, irritability, depression and confusion, weakened immune function, dermatitis with cheilosis (scaling on the lips and cracks at the corners of your mouth) and glossitis (swollen tongue)
    • Vitamin B12: deficiency can cause you to experience fatigue, weakness, constipation, loss of appetite, weight loss, numbness and tingling in your hands and feet, difficulty maintaining balance, depression, confusion, dementia, poor memory, soreness of your mouth or tongue
    • Vitamin C: deficiency can cause you to experience fatigue, poor wound healing, depression, iron deficiency, asthma, increased cancer risk
    • Folic acid: deficiency can cause you to experience brain fog, heart disease, poor appetite, shortness of breath, tongue inflammation
    • Magnesium: deficiency can cause you to experience muscle pain, hypertension, migraines, headaches, personality changes, PMS, constipation, insomnia, irritability, osteoporosis
    • Zinc: deficiency can cause you to experience poor wound healing, lower immunity, hair loss, diarrhea, white spots on your fingernails
    • Tyrosine: deficiency can cause you to experience low body temperature, hypothyroidism, dry hair, weight gain, flu-like symptoms, fatigue, depression
  6. Low libido
  7. Mood changes and depression
    • A research study from Denmark looked at women aged 15 to 34 between 2000 and 2013 found that all forms of hormonal contraception (including the Pill) were associated with an increased risk of developing depression
    • Higher risks of depression were associated with synthetic progesterone only forms, including the IUD

You need to consider an alternative to the Pill if you:

  • Are older than 35 years of age and smoke
  • Have poorly controlled blood pressure
  • Have migraines with aura
  • Have a history of deep vein thrombosis or pulmonary embolism
  • Have a history of stroke or heart disease
  • Have a history of breast cancer
  • Have diabetes-related complications, such as nephropathy, retinopathy or neuropathy
  • Have liver disease
  • Have unexplained uterine bleeding
  • Will be immobilized for a prolonged period of time

Common symptoms after stopping the Pill:

  1. Irregular or skipped periods 
    • due to disruption of communication between your ovaries and hypothalamus in your brain
  2. Heavy menstrual bleeding
    • Pill limits the growth of the uterine lining and blocks ovulation 
    • When you go off the Pill, heavy bleeding can return if you had it before or you can experience it for the first time as your body establishes its own natural hormone balance
  3. Ovulation pain and menstrual cramps
    • Ovulation is suppressed by the Pill
    • The Pill also suppresses your body’s production of prostaglandins, which is the natural substance that contributes to menstrual cramps 
  4. Acne breakouts
    • The Pill reduces the amount of testosterone produced by your body (testosterone is associated with acne)
    • Common if you started taking the Pill to reduce acne, but also possible if you’ve never experienced acne prior to taking birth control
  5. Bloating
    • Progestin acts as a diuretic, so you can retain fluid after coming off the pill
    • You might also have more bloating while on the Pill, which could improve when you stop taking it
  6. Mood Swings
    • You can be more moody while your body moves away from a carefully controlled daily dose of hormones from the Pill to your own ebbs and flows of your natural hormones
  7. Hair loss
    • From nutrient depletion and/or disruption in thyroid function

What can you do about symptoms from taking or coming off of the Pill?

  1. Replace missing nutrients
    • nutrient-dense foods at every meal: dark leafy greens and other colourful phytonutrient-rich vegetables, low-glycemic fruits like berries, pastured and organic animal protein, beans, nuts, and seeds
    • consider taking a high-quality multivitamin and mineral supplement plus tyrosine
  2. Balance your blood sugar
    • Research has linked use of the Pill with imbalanced blood sugar and insulin resistance
    • For tips on blood sugar balance, see 
  3. Support your beneficial bacteria
    • Healthy gut flora contain bacteria that break down and eliminate estrogen
    • Estrogen-processing organisms form their own community called the estrobolome and play an important role in transforming plant compounds called lignans from vegetables and legumes into phytoestrogens, which protect your body against the risks of excess estrogen
    • For more info on gut health, see
  4. Support estrogen metabolism and elimination
    • Foods that help healthy liver function include berries, beets and cruciferous veggies like kale, cabbage, broccoli, Brussels sprouts
    • Herbs and nutrients that support your liver’s detoxification pathways include N-acetyl cysteine (NAC), calcium-d-glucarate, green tea extract, curcumin (from turmeric), DIM, I3C, schisandra
    • Get plenty of fibre from vegetables and ground flaxseed to bind up and eliminate your used hormones and other garbage with regular bowel movements
  5. Support your natural hormone balance with herbs like vitex, peony and licorice 

If you’re taking the Pill or thinking about taking the Pill, then consider:

  • Getting baseline lab work done, along with regular follow-up testing including complete blood count, thyroid panel, nutrient status, inflammation and autoimmune markers, ultrasound
  • Tracking your basal body temperature
  • Getting genetic testing for clotting factors
  • Taking regular blood pressure readings
  • Tracking your cycle and any symptoms before starting and while on the Pill

What are some alternatives to the birth control pill?

  1. IUD (2 main categories/options)
    • Copper – non hormonal, can cause heavier bleeding and cramping in some women
    • Progestin-containing like Mirena or Kyleena with possible side effects including:
  • Headache
  • Acne
  • Breast tenderness
  • Irregular bleeding (which can improve after six months of use)
  • Mood changes
  • Cramping or pelvic pain

2. Barrier methods like condoms

3. Vasectomy

4. Tubal ligation

5. Fertility awareness 

Today’s Mama Must Have:

Dr. Lisa is a big fan of a good quality basal body thermometer.

Dr. Toni can’t live without one of the many apps for tracking her period, like the basic Period Tracker or MyFlo.

Thank you for joining us today! 

Connect with us at our website, on Facebook and on Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe and healthy everyone!