Post Pill Nutrition | The PNW Clinic

There are many reasons why people use oral contraception. There are also many reasons why people stop using oral contraception, including to fall pregnant.

Discontinuing the contraceptive pill can be a daunting and overwhelming experience. Sometimes with unwanted or unexpected side effects. A common side effect of the pill is nutrient deficiencies.

In this article, we will break down the important nutrition focuses after coming off the pill.

 

Nutrients at risk

Research since the 1970’s has shown us that oral contraception affects the metabolism of certain nutrients. In particular, 9 main nutrients depleted by the pill include:

 

Selenium:

A mineral responsible for thyroid functioning and protecting against cell damage and inflammation. It also plays an important role in reproduction (1). 

Foods high in selenium include:

• Brazil nuts
• Fish and shellfish
• Meat and poultry
• Eggs

 

Zinc:

Plays a key role in immunity, growth and development. 

Research since the 60’s has shown that the oral contraceptive pill is associated with lower zinc levels (3).

Zinc can be found in (4, 5):

• Meat, poultry and eggs
• Fish- especially oysters
• Nuts and seeds- pumpkin seeds, cashews and almonds
• Legumes- lentils, kidney beans, peanuts
• Wholegrains- quinoa, rice and oats

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Magnesium:

Magnesium plays many roles in the body including bone mineralisation, immunity and energy production. It is also important in muscle relaxation and sleep. 

Research hypothesises that the risk of blood clots associated with the pill is related to reduced magnesium levels (3). 

Dietary sources of magnesium include:

• Dark leafy greens
• Beans and legumes
• Nuts- almonds, cashews
• Seeds- pumpkin seeds, chia seeds
• Dark chocolate

 

 

Vitamin C:

Vitamin C is an antioxidant that supports the immune system and assists collagen formation and iron absorption. 

Research suggests that the oestrogen in oral contraception decreases Vitamin C levels, but deficiency is rare with adequate fruit and vegetable intake.

Foods high in Vitamin C include:

• Fruits- citrus, blackcurrants, kiwi fruit
• Vegetables- brussel sprouts, broccoli and green leafy vegetables

 

Vitamin E:

A group of antioxidants effective in preventing disease and inflammation (7). 

Several studies have found that Vitamin E has a role in improving female fertility and reproductive health.

Vitamin E can be found in foods such as:

• Vegetable oils
• Leafy green vegetables
• Nuts and seeds

 

Riboflavin (Vitamin B2):

A vitamin essential for converting nutrients into energy. Riboflavin is also important for normal cell growth and development (3). 

Vitamin B2 deficiency is common in women of child bearing age and the pill increases risk of deficiency (3).

Foods that contain Vitamin B2 include:

• Milk and dairy products
• Fortified breads and cereals
• Leafy green vegetables

 

Pyridoxine (Vitamin B6):

Vitamin B6 is responsible for protein metabolism and conversion into energy.

Pyridoxine levels are lower in those using the pill, and may contribute to the risk of blood clotting associated with the pill (3). 

Maternal Vitamin B6 deficiency is linked to increased pregnancy complications and affects foetal neurological development (3).

Vitamin B6 can be found in foods such as (13):

• Fish, meat and poultry
• Liver and other organ meats
• Potatoes and starchy vegetables
• Non-citrus fruits

 

Folate:

The contraceptive pill has shown to impair folate metabolism, which is critical for DNA synthesis and metabolism. 

It is critical to maintain folate levels in women of child bearing age, particularly as pregnancies may occur when ceasing the pill contraception (10). Folate deficiency is particularly dangerous during pregnancy as it is of utmost importance for cell division and preventing neural tube defects in foetal development. 

Dietary sources of folate include:

• Bread and wheat flour bread products are fortified with folic acid in Australia (this excludes gluten free and organic options)
• Green vegetables- asparagus, spinach, brussel sprouts and broccoli
• Legumes- red kidney beans, chickpeas and lentils
• Fortified cereals and juices
• Vegemite

 

 

Vitamin B12:

Vitamin B12 is essential for creating DNA and energy production. 

It is not fully understood how, but blood B12 levels are lower in those on the pill, despite dietary intake (3, 10). 

Vitamin B12 is only found naturally in animal products, however can be fortified into plant based sources.

You can find Vitamin B12 in:

• Animal meat and fish
• Eggs and dairy products
• Fortified cereals, nutritional yeasts, and plant based milks

 

What to do after coming off the pill

You may notice a variety of symptoms when stopping oral contraception. Everybody is different and will be affected in different ways. Here are some practical tips and recommendations for when you stop taking the pill:

 

Get a blood test

It is a good idea to get a blood test after coming off the pill. This way you can know which nutrients you are deficient in, if any.

Especially if you are trying to conceive, it is particularly important to check your folate, Vitamin B12, zinc and Vitamin E levels.

 

 

Start taking supplements

If your blood test shows nutrient deficiencies, it is important to correct these. Supplements can help boost these levels and work to alleviate symptoms.

If you are trying to conceive, it’s strongly encouraged to start taking a prenatal vitamin or consume at least 400µg of folate per day from food folate and fortified foods (12).

 

Increase foods rich in affected nutrients

Nutrient deficiencies can come with many different symptoms including fatigue, weakness and impaired immunity. It is important to correct these deficiencies for optimal health.

The good news is, you can elevate the affected nutrient levels with the food you eat.

While it may be confusing and overwhelming to know which foods to eat to increase these nutrients levels, it’s helpful to understand that simple whole foods are a great source of nutrients.

 

Some great tips to focus on include:

• Enjoying mixed nuts and seeds daily. This can be in the form of salad and toast toppers, or as a handy snack. They provide your body with magnesium, selenium, zinc and Vitamin E
• Having at least 2 servings of green vegetables a day. Vegetables such as broccoli, brussel sprouts, spinach and asparagus are a great source of folate, magnesium and Vitamin C
• Including a source of wholegrains at each meal can boost your B vitamins, zinc and magnesium levels. Examples include oats, brown rice, quinoa and wholegrain bread.
• Eating lean protein rich foods at each meal such as lean red meat, poultry, seafood, tofu, legumes and eggs. This can help elevate your zinc, Vitamin B12 and Vitamin B6 levels.

 

The great thing about focusing on these foods is that they don’t need to be a temporary solution. Incorporating wholegrains, lean protein, vegetables, nuts and seeds is ideal for optimal health and wellbeing.

Working with an online dietitian from The PNW Clinic can help provide guidance and support in ensuring a healthful diet that increases foods rich in affected nutrients.

 

Consider other birth control if you still need contraception

If you are at chance of falling pregnant unwantedly or unplanned, it may be helpful to consider other contraception options. Speak to your doctor to discuss other options.

 

Track periods

It can be useful to track your menstrual cycle after ceasing the pill, to ensure regular cycle commences.

For many women, your period can return within one to three months of coming off the pill. It is common for it to be irregular or to experience different period symptoms post pill. This is why tracking your cycle and symptoms can be important to identify any issues of concern.

It is recommended to see your doctor if your period has not returned within three months of stopping the pill (13).

 

 

Prenatal check up

If you have stopped taking the pill in an effort to try and conceive, it is important to see your GP for a prenatal check up. This is to see if your body is ready for pregnancy or if any issues need to be addressed.

 

Book in to see an online dietitian from The PNW Clinic

An online dietitian from The PNW Clinic can work with you to assess your nutritional needs and provide strategies to address these. The PNW Clinic can develop a nutrition plan to boost any nutrient deficiencies associated with the pill.

 

This may look like:

• Recommending certain foods to include in your diet to boost a certain or group of nutrients
• Educating you on how to read food labelling to identify fortified vitamins in foods.
• Assessing whether supplementation is necessary
• Implementing strategies to restore hormone balance and encourage return of regular menstrual cycle
• Supporting your body for healthy conception and pregnancy if you are trying to conceive.

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Summary

Coming off the pill can be an overwhelming experience with unexpected symptoms.

However, post pill nutrition for optimal health and wellbeing doesn’t need to be complicated!

Getting a blood test and checking your nutrient levels post pill is an important step to determine your nutrition focus. 

Focusing on foods rich in affected nutrients is a key step in ensuring your body is provided with all the vitamins and minerals it needs to function.

 

If you are looking for guidance to support your post pill nutrition or would like to learn more, the team of online dietitians at The PNW Clinic are here to help. Book in a free 15-minute discovery call to see if they are the right fit for you.

 

Written by: Student dietitian Claudia Torrisi

Reviewed by: PNW Clinic dietitian Jade Wrigley