About 13 percent of women between the ages of 15 and 49 who use contraception report being on the birth control pill, according to key findings from the CDC’s 2015–2017 National Survey of Family Growth. Assuming you can remember to take it at the same time every day, oral contraception pills are pretty reliable at preventing pregnancy. (They’re up to 99 percent effective when used as directed.) The downside? The pill can come with side effects, most notably spotting, tender breasts, headaches, and cramping, per the National Institutes of Health (NIH). And, research shows that the pill may deplete the body of some nutrients (including B vitamins and magnesium), affect gut function and increase risk of inflammatory bowel diseases, cause mood changes, and more.
The nutrient depletion alone is enough to wreak havoc on your well-being. “Many symptoms can be associated with low levels of certain vitamins and minerals,” explains naturopath Kiera Lane, N.M.D., MSAc, L.Ac., Dipl. Ac., director of Arizona Natural Medicine. “For example, depletion of folic acid can affect memory, energy, and focus, while low levels of vitamin B6 can be associated with neuropathy, brain fog, and fatigue.”
Not to mention, taking oral contraceptives also means more work for your liver. “When we take exogenous hormones (those that are made outside of our own body) on a daily basis, the drug needs to be broken down and excreted by the body each day,” explains NYC-based naturopathic doctor Lana Butner, N.D. “The liver is responsible for this task by metabolizing and breaking down that pharmaceutical drug.”
Not everyone on the pill us aware of these potential impacts, let alone told how to help balance them out, according to integrative gynecologist and functional medicine doctor Anita Sadaty, M.D., OB/GYN. That’s why she and other integrative health experts recommend women do the following to support their bodies and well-being while using oral contraception.
1. Do a lifestyle Check
This might sound like a no-brainer, but one of the best ways to support your body when you’re on the pill (and when you’re not) is by maintaining an overall healthy lifestyle. “This would include some form of physical activity that you enjoy and can do on a regular basis, getting enough sleep, managing stress, eating a whole foods diet, quitting smoking, and drinking plenty of water,” says naturopathic doctor Sarah Connors, N.D. “Women over 35 who smoke and take the pill are at higher risk of thromboembolism, so quitting smoking, for example, would lower their risk of health issues like blood clots.”
2. Eat a diet rich in leafy Greens
Research, including one study published in the journal Contraception, shows that birth control pills can alter the levels of various B vitamins in the body, so it’s especially important to make sure you get your fair share if you’re on the pill. “Green leafy vegetables contain many of the B vitamins that oral birth control can contribute to deficiencies in,” says Lane. “Spinach, kale, broccoli, chard, string beans, and asparagus are rich in these needed vitamins.” She recommends aiming for two servings of these nutrient-dense foods per day. (If you can’t make that happen, consider supplementing.)
3. Take a multivitamin that contains an active form of folate
Folate is one of the most important nutrients that childbearing individuals need, as it plays an integral role in the formation of red blood cells and has also been shown to lower birth defects in pregnancy, per the CDC. Unfortunately, not all multivitamins contain the necessary amounts of this nutrient—and many people may not be able to properly process folic acid, the synthetic form of folate often used in supplements. “Folic acid has to be converted to its active form, tetrahydrofolate or MTHF, in your body—but an estimated 50 percent of the population has genetic mutations that affect folic acid methylation,” says Lane. “If you don’t know whether you have a mutation, it’s best to use a vitamin that contains the methylated form of folate.”
Opt for a multivitamin that contains MTHF instead of folic acid, Lane suggests. Look for 400 micrograms (or 800 to 1,000 micrograms in a prenatal). Another perk here: Products that intentionally include MTHF will likely also contain high-quality, highly-absorbable forms of other nutrients in them, too.
4. Supplement with magnesium
Magnesium plays a role in more than 300 biochemical reactions in the body, including regulating muscle and nerve functioning as well as maintaining blood sugar levels, per the NIH. It’s also a key nutrient of concern for individuals taking the pill as it is involved in regulating normal blood clotting activity, explains Connors. Unfortunately, though, one study published in the Canadian Medical Association Journal showed that women taking birth control pills had significantly lower levels of serum magnesium levels.
To ensure you’re meeting the mark on this important mineral, Sadaty recommends taking 200 milligrams of magnesium per day. Go for a more bioavailable form, like magnesium malate, magnesium glycinate, or magnesium l-threonate, as other forms, like magnesium oxide and magnesium citrate, tend to be less absorbable.
5. Tend to your gut
Because oral contraceptives can lead to imbalances in the beneficial bacteria in your digestive tract, gas, and bloating are not uncommon for those on the pill, notes Sadaty. In fact, research including one study published in the journal Drug Safety, has linked oral contraceptives with inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis.
In addition to eating lots of high-fiber vegetables to support digestive regularity, Sadaty also recommends adding a probiotic supplement to your routine. She recommends looking for a supplement that is broad-spectrum and combines several strains of beneficial bacteria, such as Lactobacillus and Bifidobacterium.
6. Test Your Nutrient Levels
If you take birth control pills, Sadaty recommends asking your doctor, whether your primary care provider or OB/GYN, to test your blood for nutrients annually. “Folate, vitamins B2, B6, B12, C, and E, and the minerals magnesium, selenium, and zinc are commonly depleted by oral contraceptives,” she says. You want to be at the middle-to-upper end of the reference ranges. If lower than that, make a plan with your provider for getting those levels up.
7. Talk to your doctor if your mood is being affected
While it isn’t crystal clear as to why oral contraceptives, as well as other forms of hormonal birth control, can affect your mood, the connection is well documented. “This is partly related to nutrient depletions, partly related to how an individual responds to high doses of synthetic hormones, and partly related to the pill’s impact on testosterone levels and other hormones,” explains Sadaty. “The type of progestogen in the oral contraceptives is thought to be related to the mood component, as is the amount of estrogen in the pill.” In fact, changes in mood are the number-one reason people choose to stop taking birth control pills, research shows.
If you’re experiencing changes in mood since starting oral contraceptives, speak with your doctor about potential alternatives, as well as supplements, that may help support your mental health.