4 Ways The Birth Control Pill Affects Gut Health
More than 15% of women aged 15 to 49 use some form of hormonal birth control. Since the 1960s, The Pill has had significant social impacts for women in many areas including education, workforce, and personal relationships.
However, have these freedoms come at a cost? Research is starting to take a look at hormonal contraceptives and their impact on the gut microbiome, and the current evidence suggests that it may.
In part-2 of my 3-part series on common medications that affect your microbiome, we take a closer look at how the birth control pill could be keeping you stuck in a cycle of poor gut health.
(Here’s the link to part-1 in case you missed it: 10 ways to protect your microbiome if you need to take antibiotics.)
The microbiome is the community of microorganisms that lives in your gut. There are more than 1,000 bacterial species that make up your microbiome – this results in 360 bacterial genes for every single human gene in the body.
The microbiome serves multiple functions:
It digests parts of food that our body is unable to handle on its own, such as tough plant fibers and resistant starches.
It regulates metabolism and plays a role in hormonal regulation. (It stores more than 90% of the body’s serotonin!)
It trains and regulates the immune system to protect us against invading pathogens.
Most of the microorganisms living in the gut serve us in beneficial ways. A healthy gut is one that is rich in a variety of beneficial bacterial species. More diversity and abundance equates to better health outcomes. An unhealthy gut is one that lacks abundance and diversity.
In addition to the beneficial bugs, there are opportunistic ones that can contribute to poor health when the environment is right for them to thrive. These might be microorganisms that normally reside in your gut in smaller numbers, or they might be something that you pick up from your external environment if you eat contaminated food. When there is an imbalance between the beneficial and the harmful bacteria, it is referred to as dysbiosis.
Factors that affect the health and wellness of the microbiome include: diet, stress, sleep, certain medications, and lifestyle factors like exercise, meditation, mindfulness, alcohol, and smoking.
Signs of dysbiosis may include excessive gas and burping, bloating, constipation or diarrhea, food sensitivities, allergies, frequent colds, brain fog, recurrent yeast or urinary tract infections, anxiety, depression, sugar cravings, obesity/overweight, and autoimmune disorders.
Unfortunately, many commonly used medications can disrupt the microbiome and have lasting impacts. While using the birth control pill is a personal choice, it is important for women to understand potential effects so they can make an informed personal choice.
Here are 4 ways birth control can affect your gut health:
1. It may affect the diversity in your microbiome.
A small study from 2021 looked at the effects of combined hormonal contraceptives (estrogen plus progesterone). They found that the group taking birth control had significantly lower gut microbiota richness compared to the control group.
2. It makes your gut leakier.
A scientific review from 2015 shared that oral estrogen affects intestinal permeability, otherwise known as leaky gut. A leaky gut occurs when your gut barrier allows bacteria and toxins to pass through from your intestinal tract and enter the bloodstream. A leaky gut also makes you more susceptible to dysbiosis, bloating, food sensitivities, and inflammation.
3. It robs you of essential nutrients.
Oral contraceptives and hormone replacement therapy are associated with nutrient deficiencies for B vitamins, vitamin C, zinc, and magnesium. Here is how this could relate to digestive complaints:
B vitamins are essential for digestion and absorption of carbohydrates, fat, and protein. B12 and folate are also necessary to form new red blood cells, synthesize DNA, and repair tissues and cells (like those in your gut wall).
Zinc is important for producing adequate stomach acid.
Vitamin C, zinc, and magnesium are important for bile production.
Incomplete digestion of nutrients, and inadequate stomach acid or bile production are common causes for chronic bloating, gas, heartburn, and constipation.
4. It could increase your chances of developing an inflammatory condition or autoimmune disease.
A meta-analysis of nearly 14 studies in 2008 showed that use of oral contraceptives is associated with a nearly 50% increase in risk of Crohn’s, a type of inflammatory bowel disease. The risk increased with longer duration of use and diminished following discontinuation.
Using the birth control pill is a personal choice, but it is important for women to understand the implications of their choices so they can take action to mitigate possible risk.
For those who choose to use oral contraceptives as their preferred method of birth control, consider ways in which you can support a diverse microbiome and healthy gut barrier:
1. Consume probiotic-rich foods such as fermented vegetables like kimchi or sauerkraut, kefir, cultured yogurt, miso, and kombucha.
2. Eat a variety of vegetables and fiber-rich plant foods to feed the beneficial bacteria in your gut.
3. Reduce consumption of refined carbohydrates, processed sugars, and animal fats.
4. Make hearty soups, stews, and bone broths a regular part of your diet as they nourish your gut barrier and help to decrease leakiness in your gut.
5. Stay well hydrated – this supports an environment where your good gut bugs can thrive.
6. Consider using a daily probiotic supplement to help maintain a balance of healthy bacteria.
7. Consider using a daily multivitamin to replace lost nutrients.
If you have chronic bloating or other gut issues, the birth control pill on its own is not likely going to be the sole contributing factor. However, small consistent daily habits, whether good or bad, can compound to have a significant impact on your health (and the health of your gut) over time.
If you are struggling with chronic bloating and looking for additional support, I can help! Click here to learn more about how I help women understand the root cause of their symptoms so they can decrease the belly ache, relieve constipation, and improve digestion.
