In the United States, roughly one in five women between the ages of 15 and 44 uses some form of hormonal birth control1. They go on it for a variety of reasons, from preventing pregnancy and regulating the menstrual cycle to easing acne and quieting PMS symptoms.
Women who take hormonal birth control tolerate common side effects like fluid retention and breakthrough bleeding (spotting between periods). But, there are additional dangers associated with hormonal birth control methods like the pill, transdermal patch, and hormonal IUDs. For example, a recent study found that the risk of depression is 40 percent greater in women who use hormonal birth control than in those who don’t.
And mood changes are just the tip of the iceberg when it comes to deeper, darker dangers associated with birth control, say functional medicine experts.
“The liver gets taxed by synthetic hormones because it has to break them down,” says Mark Flannery, DC, a functional medicine specialist in Los Angeles, California. “This extra stress on the liver can lead to poor detoxification, increased inflammation, high cholesterol, and poor immune function.”
When the liver is overworked, it can lead to serious downstream problems. “An overburdened liver cannot detoxify estrogen properly and [the hormone] ends up back in the bloodstream in a more toxic form that increases the risk for breast cancer, endometrial cancer, and other female health problems,” continues Flannery.
Hormonal birth control also interferes with methylation, a physiological process that affects the body in several critical ways. Optimal methylation is essential for detoxification, neurotransmitter health, inflammation regulation, and more. Less-than-optimal methylation has been associated with a range of conditions, including depression, arthritis, and cardiovascular disease.
Another concern? Thyroid function. Hormonal birth control can affect the conversion of T4 (the inactive form of thyroid hormone) to T3 (the active form), meaning that less T3 is available to be used by the body.
Excess estrogen in the body can also increase the presence of thyroid-binding globulin (TBG), a protein that binds to thyroid hormones and transports them around the body. Too much TBG “can prevent thyroid hormones from entering the cells of the body, where they need to get,” says Flannery.
“So when patients have their thyroid evaluated they’re told their thyroid gland is functioning well, which is correct,” he adds. “However, the problem is occurring with thyroid hormones outside the thyroid gland, leading to symptoms of hyperthyroidism.”
Ironically, when women go off hormonal birth control — as 30 percent of women in the US eventually do, due to negative side effects — the non-pregnancy-related symptoms for which they originally started taking the pill can get worse.
For example, acne can flare up for six months after stopping the pill. Birth control suppresses the level of sebum in the skin to childhood levels, notes women’s health expert Lara Briden, ND. So when a woman stops the pill, the body produces “rebound” sebum, causing breakouts. The ovaries also start to produce androgens again, which can contribute to acne.
Women may also re-experience terrible PMS and irregular menstrual cycles with heavy bleeding when coming off birth control.
If a woman is considering coming off birth control, there are natural strategies she can use right now to ease the transition. Here’s what experts recommend:
Load up on healthy fats. High-quality, healthy fats help the body start producing its own hormones again after the pill’s synthetic interference. Think extra-virgin olive oil, avocados, pastured eggs, and grass-fed animal proteins, counsels integrative nutritionist Alisa Vitti, HHC.
Emphasize dark green veggies. Vegetables like broccoli, spinach, chard, kale, and arugula support the liver and help flush excess estrogens from the body. Supporting liver detoxification pathways is one of the best things a woman can do when coming off the hormonal birth control, says Flannery. Supplementing with DIM, a compound found in broccoli, may also help with post-pill acne.
Take vitamin B. Hormonal birth control depletes vitamin B stores in the body, notes Vitti. Women considering coming off the pill can start taking a high-quality B-complex supplement now to get ready for the transition.
Ditch sugar and cow’s dairy. Cow’s dairy contains an inflammatory protein called A1 casein, which can aggravate acne. Both sugar and cow’s dairy raise levels of the breakout-inducing hormone IGF-1 in the body, says Briden.
Consider targeted supplements. Vitex (also known as chasteberry) can help stimulate ovulation again after having the process suppressed by hormonal birth control, says Kelly Brogan, MD. She also recommends evening primrose oil, an anti-inflammatory fatty acid, to help with PMS symptoms. Briden suggests berberine for women who are especially concerned about post-pill acne. This plant compound improves insulin sensitivity, which, in turn, reduces levels of the acne-causing hormone IGF-1.
Laine Bergeson is a longtime health journalist and functional nutrition educator and coach with Healthful Elements. She believes lifestyle medicine is a blockbuster drug.