The oral contraceptive pill (OCP) or ‘the pill’ is something most of you are probably very familiar with taking. In fact, 1 in 4 women use the OCP at some point throughout their reproductive years. However, there is probably a lot of uncertainty when coming off the pill. There can be a number of things you may need to be aware of.

Metabolic changes may take place in women who are on the pill compared to those who are not. These changes could potentially alter general health as well as nutritional status.

Long term use of the pill has the potential to deplete a range of nutrients in your body. When stopping the pill, I always focus on replacing the vitamins and minerals which may be at a level lower than usual. 

I am reluctant to say this (because so many doctors and health professionals are amazing at understanding women’s health) BUT so many women I work with say they feel unsupported to come off the pill. Even though they feel they are ready to. I say LISTEN TO YOUR BODY. After-all, the pill does bloody amazing things as far as being an effective contraception and helping with symptom management. It is also taking over your natural menstrual cycle, disrupting your natural hormone regulation AND often suppresses symptoms that can tell you a lot about what is going on in that body of yours. 

Have a look at my IG post touching on this subject -

Back to the focus of this blog post… long term use of the pill has the potential to deplete a range of nutrients in your body. When stopping the pill, I always focus on replacing the vitamins and minerals which may be at a level lower than usual. The key nutrients include: 

B VITAMINS - B6, B12

Most of your B Vitamins help your body make healthy cells and produce energy that you can use for your daily activities. 

Blood levels of B6 have been found to be lower in those women who take the OCP versus those who do not (75%!). 

B12 levels seem to be consistently lower in women taking the OCP despite dietary intake.The reason behind B12 levels being lower whilst taking the pill is not completely understood. 

It is a good idea to make sure you are including enough B12 containing foods in your diet when on the pill and when coming off. You can find B12 in beef, lamb, dairy products, eggs and B12-fortified plant based proteins such as mock meats.

FOLATE (vitamin B9)

Although the pill alone will not reduce folate levels, it can reduce absorption of the vitamin. If your diet does not contain enough folate to counteract the possible lower levels that are taken up by your body, you may find you need to increase your intake after stopping the pill. You can find folate in leafy greens, fortified bread and grains or legumes.

MAGNESIUM

Also important in the production of energy, magnesium tends to be a mineral that decreases in the blood with long term use of the pill. Eat your nuts, seeds, legumes and dark choc! 

VITAMIN C

If your diet includes plenty of foods rich in vitamin C, there is no need to be concerned about your body’s vitamin C levels. For some of us, the pill can change the way we absorb vitamin C from the foods we eat and store it in the body. To avoid this, make sure your diet has lots of fresh fruit and veggies like strawberries, kiwi, orange, capsicum and tomato.

VITAMIN E

Vitamin E is an important antioxidant in the body that helps to protect cells from damage. Healthy fats such as olive oil, nuts and seeds are rich in vitamin E. Lower levels of vitamin E have been observed in women taking the pill, and supplementation or increased consumption may lower the risk of potential cardiovascular side effects associated with the pill. 

SELENIUM

Use of the contraceptive pill may interfere with selenium absorption. Selenium plays a role in the function of the thyroid gland as well as the nervous system and repair of your body’s DNA, among other things. Selenium is an important nutrient to include in your diet and replace if absorption has been affected by the use of the pill. You can find selenium in brazil nuts, wild-caught fish (be mindful of mercury intake), poultry and eggs.

ZINC

Zinc is an important nutrient found in many cells throughout the body and helps to support your immune system. It is thought your body’s utilisation of zinc when on the pill and therefore negatively affect zinc levels in the blood. Good sources of zinc include nuts and seeds, eggs, oysters and quinoa.

As you can see, the research is there! The OCP can most certainly deplete your blood levels of many essential vitamins and minerals. This has been evident in research for quite a long time. 

This only further highlights the importance of nutritional preconception care, particularly if you are planning to conceive as soon as you can after coming off the pill.

My advise - think ahead of time!  Start focusing on your nutrition 3 months before coming off the pill (in an ideal world 6 months would be even better!). Have a blood test completed checking your levels of important nutrients, chat with your women’s health/fertility dietitian and come up with a plan for creating a plan to enable you to have the smoothest transition possible off the pill. 

This gives your body the opportunity to restore any depleted nutrients, better prepare your body for reestablishing and regulating your menstrual cycle and give yourself the best chance at being able to conceive sooner if your are coming off the pill to start trying for a bubba.

Please note: Always be sure to see your doctor and dietitian to organise a blood test before beginning any supplementation. 

Wanting some extra support and guidance for coming off the pill? ‘The Post Pill Plan’ is designed for exactly that! This is 100% focused on empowering you to quit the pill the right way. You will work with me 1:1 and have at tailored plan designed specifically for you. Find out more about it click the button below! 

Love always. 

Laura - The Fertility Dietitian xx 

This blog was co-written by Alexandra Stokes, a Master of Dietetics student at Deakin University.

References

Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in

nutritional requirements. Eur Rev Med Pharmacol Sci. 2013;17:1804-1813. 

Fenasse R, McEwen B. Impact of the oral contraceptive pill on health and nutritional status. J Aust Tradit Med Soc. 2019;25(4):197–203. 

Wakeman MP. A Review of the Effects of Oral Contraceptives on Nutrient Status, with Especial Consideration to Folate in UK. J Adv Med Med Res. 2019;30(2):1–17. 

McArthur JO, Tang HM, Petocz P, Samman S. Biological variability and impact of oral contraceptives on vitamins B6, B12 and folate status in women of reproductive age. Nutrients. 2013;5(9):3634–45.