Just in case you missed it – pop on back here to read part 1 – which outlines the latest research and deciphers what exactly might be going on when it comes to hormonal contraceptives and your mood.
My role as a naturopath is never to tell you whether or not you should be using medications, nor is it to pass any judgement should you choose to use medications. Medications are important and can be lifesaving. I completely understand and appreciate that there are circumstances where using hormonal contraceptives are necessary or coming off them is simply not in alignment with where you are at in your life and health journey right now. And that is OK! My role rather, is to educate you in what these medications do, what side effects they might have or how they might impact your health, and to support you and your body while you use them (or while you transition off them).
First of all, the most important thing to do if you have a history of depression, or are feeling any symptoms of anxiety, depression or low mood please speak to your prescribing practitioner, your GP or your gynaecologist. This is so, so, SO important. You can have a discussion around whether hormonal contraception is right for you and what other options you have – because you always have options.
Replace Lost Nutrients
Given that hormonal contraception depletes you of those nutrients required for neurotransmitter synthesis, thyroid hormone synthesis and utilisation, healthy brain function and a balanced mood – replacing those nutrients is essential. Eating a wide variety of vegetables, fruits, legumes, whole grains, wild caught fish, shellfish, grass fed meats, mushrooms, and nuts and seeds will start to replenish those nutrients lost to the pill. If you are eating a balanced, whole foods diet you should be covering all of your bases, but just to break it down a little further here are some specifics:
- Folate – leafy greens, broccoli, cauliflower, brussels sprouts, liver, wholegrains, legumes, mushrooms, nuts and seeds, and brewer’s yeast.
- Vitamin B2 – meat, fish, chicken, liver, eggs, brewer’s yeast, nuts and seeds, leafy greens, broccoli and mushrooms.
- Vitamin B6 – meat, fish, chicken, liver, eggs, whole grains, brewer’s yeast, nuts and seeds, potatoes, bananas and avocados.
- Vitamin B12 – meat, fish, poultry, shell fish, dairy, and eggs If you are vegetarian or vegan B12 supplementation at the very least is likely to be necessary.
- Vitamin C – citrus, rosehips, acerola cherries, strawberries, black currants, rockmelon, papaya, capsicum, broccoli, brussels sprouts, cabbage, tomatoes and leafy greens.
- Vitamin E – nuts and seeds, wholegrains, and fatty fish.
- Magnesium – leafy greens, nuts and seeds, dark chocolate/cacao, avocado, legumes and soy.
While I prefer to treat with food first, I tend to find that supplementation is often required to either correct or prevent deficiency. This is especially important for those of us who have been using hormonal contraception long term or wish to continue using it long term. It is always worth having a chat to your GP and requesting some basic blood work to check for any deficiencies. And I strongly recommend you speak to a naturopath, nutritionist or integrative doctor as we can 1) tailor your supplement plan specially to you and 2) there are some wonderful ‘practitioner only’ supplements that combine all of those nutrients lost to the pill specifically – and taking one supplement rather than five is always a much nicer experience. Be mindful of self-supplementing, as there are herbs and nutrients that may negatively interact with hormonal contraception.
Take Care Of Your Gut
We now know that the pill can change our gut flora and an imbalance in specific bacteria is linked to poor mental health, so taking care of your tummy is imperative. A diet high in fibre is a great place to start, as those who consume a diet rich in fibre have been shown to have a greater diversity of gut microflora when compared to those who consume a low carbohydrate diet (1). So, think legumes, whole grains, fruits, starchy vegetables like potatoes and sweet potatoes, nuts and seeds. Prebiotic foods such as bananas, onion, garlic, artichoke and asparagus are important to include as these provide fuel (or food) for our beneficial bacteria. Fermented foods can be helpful too, as they act as a natural probiotic. And supplementing with a broad-spectrum probiotic may be of benefit.
That being said, if you are experiencing significant tummy troubles or if any of the above mentioned foods cause you issues it might be worth chatting with your practitioner about taking a deeper look at your microbiome. If there are certain imbalances in gut bacteria, pre and probiotics may not be right for you until you correct those imbalances.
Move Your Body
There is strong evidence that exercise is effective in reducing the symptoms of anxiety (2) and depression (3), so moving your body on a regular basis may help keep any symptoms resultant of OCP use at bay.
Talk To Someone
While there may very well be a physiological component to anxiety and depression, as mentioned earlier there may also be a psycho-social or trauma aspect involved. While we support your body from a nutritional perspective, it may also be helpful to chat to a psychologist or counsellor – especially if the nutritional interventions aren’t quite cutting it.
So there you have it – hormonal contraception is not the benign medication we have been led to believe it is. My hope is that you use this information to empower yourself. Take it as your call to action. If you have symptoms of anxiety and/or depression and are using hormonal contraception talk to your prescribing practitioner. And if you would like some support while either using or transitioning off hormonal contraception please reach out.
Face to face appointments are available here. Online appointments available here.
Are you a woman who has used hormonal contraception and has anxiety or depression? I’d love to hear about your experience in the comments below. x
If you are feeling suicidal, in an emergency or at immediate risk of harm please contract emergency services on 000. You can also contact lifeline on 13 11 14 or the suicide call back service on 1300 659 467.
References
(1) Kuo, S. M. (2013). The interplay between fibre and the intestinal microbiome in the inflammatory response. Advances in Nutrition, 4, 16-28.
(2) Anderson, E. & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in Psychiatry, 4(27).
(3) L.L. & Perna, F. M. (2004). The Benefits of exercise for the clinically depressed. Primary Care Companion to the Journal of Clinical Psychiatry, 6(3), 104-111.
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