The Truth About Birth Control and Gut Health
I’ve said it before, and I will say it again… I’ve never had a client come to me with hormone struggles who did not also have digestion issues, and this is especially true for my post-pill clients. Cramps, acne, headaches, weight gain… lots of these hormone imbalance symptoms can be influenced by gut health. These systems are interconnected and addressing digestion can often be the key for many people struggling with post-pill symptoms… I know it was the key for me in terms of finally clearing up my post-pill acne and hair loss.
I often have clients come to me to “balance their hormones” and they’re hoping this means just eating more veggies and taking a few supplements. But usually it’s more involved, and digestion work is a foundational piece of that puzzle. Addressing digestion issues can be challenging because it takes real long-lasting behavior change that may require, along with other things, adjusting what you eat (even if temporary, it’s still hard), and the way you eat, which is more ingrained than you may think.
Why Does Digestion Matter?
To put it simply, in order to absorb nutrients from your food, you have to digest it first. If we don’t fully digest our food, not only do we miss nutrients we could have absorbed, but sometimes small particles of food make their way into parts of the digestive system where they should not be, which can cause an immune response and, over time, lead to things like leaky gut.
You could be eating the most nutrient-dense diet EVER, but if your digestion is suffering, you won’t get the full pay off of all of those great foods. Certain nutrients from our food play a big role not only in producing the hormones you need, but also eliminating those that you don’t. To summarize, having a happy and regular gut is so important for making hormones and moving those hormones out of your system, both essential parts of hormone resilience.
The Pill Takes a Toll on Your Digestion
Whether it’s gas, bloating, constipation, diarrhea, undigested food in your stool, a growing list of food sensitivities… the list goes on. If you’re on the pill, or have recently come off of the pill, that could be part the problem.
Studies have shown that the pill can negatively affect gut flora, increase your risk for developing Crohn’s disease, and negatively impact estrogen metabolism.
In terms of the impact on hormonal health, when digestion is not working properly and you can’t shuttle estrogen out of your body, you can end with too much estrogen (this is called estrogen dominance), which I will talk about at length soon. Estrogen dominance can often show itself as bad PMS like bloating, cramping, irritability, and heavy periods, among other things.
Digesting/absorbing, and having healthy formed poops every day, is important for hormone health, and this may take some work to fully address after coming off of the pill.
How Do I Know if My Digestion Needs Work?
You would think digestion symptoms are obvious, but something I experience a lot in my practice is individuals who have been dealing with certain symptoms for so long that they don’t even realize that it’s not “normal.” I’ve had clients say, “Oh…. not everyone has diarrhea every day??”
I’m here to tell you that just because you’ve “always gotten really bloated after eating,” or “always had diarrhea every day,” that doesn’t mean it’s normal. And those symptoms tell me that we have work to do!
This is by no means an exhaustive list, but here are a few potential digestion signs/symptoms to keep an eye out for:
Diarrhea, constipation, or alternating diarrhea and constipation
Bloating, gassiness, and/or belching after eating
Acid reflux or heartburn
Food sensitivities
Trouble passing stools
Having Crohn’s, IBS, ulcerative colitis, etc.
Needing stimulants to poop (yes, this means coffee)
Taking acid blockers
Feeling nauseous often
Skin issues like acne and eczema
Undigested food, mucus, or blood in your stool
Regular NSAID use
Having taken antibiotics multiple times in the past few years
Are taking, or have recently come off of, birth control pills
How to Improve Digestion
Whether you just came off of the pill, or maybe you’re even still on the pill, focusing on digestive health is crucial. I’ll say this multiple times, but digestion struggles are an incredibly individual thing and what might help one person, might hurt another. So don’t waste time troubleshooting on your own! Find a provider you trust and get to work.
In addition to working with a provider, here are a few things you can do to support digestion:
Incorporate nutrient dense, gut-nourishing foods
Fermented foods
Bone broths
Foods rich in omega-3 fatty acids (salmon, mackerel, sardines, etc)
Foods rich in zinc like oysters, shellfish, other meats, some legumes/nuts/seeds (if these don’t cause digestive issues), and eggs
Foods rich in fiber, especially veggies. For some people, certain vegetables are hard on digestion immediately after the pill, so again, work a provider who knows your situation personally.
Eliminate foods you have a sensitivity to, at least temporarily
If you know certain foods bother you, consider eliminating them temporarily (~30 days) and reintroducing one at a time to see how you feel. I will cover more about elimination diets in the future.
The most common irritants are gluten, dairy, grains, soy, sugar, caffeine, and alcohol. I will never tell someone to cut every one of these out right away, although that is often helpful - you have to find an approach that feels realistic for you. Often times a temporary reduction in these foods is enough to provide some relief to your gut.
Important note: consistently eating foods that trigger an immune response is not helpful for reducing inflammation and feeling better long term, and often can be the limiting factor for people who have made many other changes but are still struggling.
Focus on HOW you’re eating
Sometimes it’s not what, but how. Or as a colleague of mine used to say, sometimes it’s not what you’re eating, but what’s eating you. Digestion is a parasympathetic process, meaning we need to be relaxed for it to function optimally.
Take 2-3 deep belly breaths before starting your meal, and eat slowly and mindfully, chewing thoroughly.
Avoid multi-tasking while eating as often as possible. There is a reason we feel bloated after eating our lunch while simultaneously sending a stressful email!
Avoid drinking lots of fluid while you eat. Especially notice if you’re using water to help you eat faster. Let your saliva do that job - it has important digestive enzymes!
Avoid exercising within the hour after eating to give your system time to rest and digest.
Work with a provider to make a supplement plan
Yep, I said it again. Work with a provider!! They may suggest supplements like l-glutamine, NAC, digestive enzymes, HCL, bile support, probiotics, etc. which can be helpful for restoring gut health. But it’s important to let these suggestions come from a professional, because even things as seemingly harmless as probiotics can be counterproductive depending on what’s going on.
So there you have it! The pill can absolutely disrupt your gut health, and addressing hormone health after coming off the pill requires addressing digestive health.
