Hormonal Contraception – Could Nutrition Decrease the Unwanted Side Effects?

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How Hormonal Contraception Hinders Pregnancy

Hormonal contraception employs several mechanisms that collaborate to prevent pregnancy. The primary mechanism is to obstruct ovulation. The hormones contained in contraceptives – estrogen and progestogen – affect the pituitary gland and decrease the production of gonadotropic hormones (FSH and LH). A lack of adequate levels of these hormones prevents the maturation of the ovarian follicle and the release of the egg. Furthermore, progestogen in hormonal contraception can thicken the cervical mucus, which hinders the movement of sperm through the cervix to the fallopian tubes, where fertilization can occur. Hormones also affect the endometrial lining of the uterus (endometrium) and make it less hospitable for the implantation of a fertilized egg. A thin and unprepared endometrium is not conducive to the implantation of the embryo. Moreover, progestogen can influence the peristaltic movements of the fallopian tubes, which makes the progression of the egg and potential sperm to the site of fertilization more challenging.

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Potential side effects of employing hormonal contraceptive agents

The consumption of synthetic hormones in the form of birth control pills is indisputably a convenient and highly effective method of averting pregnancy. Regrettably, this is not inconsequential for the body and is associated with numerous side effects.

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The influence on body weight

In the introductory phase, there may be an accumulation of water in the body, which is brought about by the effect of estrogens. Consequently, many women observe an increase in the number of kilograms on the scale, but this trend diminishes after a few days or weeks (M. F. Gallo et al., 2014).

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Painful breasts

They usually arise during the initial phase of hormonal contraceptive use and are caused by the accumulation of fluids in the tissues by estrogen and a transformation in the structure of the breast glands brought about by progestogen (B. Salzman, E. Collins, L. Hersh 2019).

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Lowering of mood

Estrogens and progestogens exert a negative influence on the neurotransmitter levels in the brain, primarily serotonin, dopamine, and norepinephrine, which are responsible for an individual's mental condition. As a result, an increased susceptibility to irritability, anxiety, emotional instability, and depressive states can be observed with the use of hormonal contraception (T. Robakis et al. 2019).

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Experiencing headaches

Hormonal constituents of contraceptive medications can influence the frequency and severity of headaches and migraines, particularly in women with a propensity towards such manifestations. This is attributable to the enlargement of blood vessels instigated by estrogens and variations in hormone levels (R. E. Nappi et al., 2013).

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Decrease in sexual desire

Progestins can exert a negative influence on hormonal receptors in the brain, thereby impacting the level of sexual desire (R.. Guennoun 2020).

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Elevated risk of blood clot formation

Particularly in the case of dual-component birth control pills, there is a minor but significant increase in the risk of blood clot formation, which can result in a worsening of venous thrombosis, pulmonary embolism, or stroke. This is especially relevant for women who smoke tobacco and individuals with genetic predispositions for thrombophilia (L. Morimont et al. 2021).

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Load borne by the liver

Considering that the liver is responsible for estrogen metabolism, consuming birth control pills can result in an imposition of burden on it (E. Chane et al. 2023).

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Decreased responsiveness to insulin

Female hormones, namely estrogens and progestogen, exert a negative impact on the process of glucose metabolism and insulin receptor function, which may result in the development of insulin resistance (F. Mauvais-Jarvis 2017).

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Increased risk of breast and cervical cancer associated with hormonal contraceptives

Estrogens can result in stimulation of cell growth in unsuitable tissues, which contributes to an increased risk of mutations and cancer development. At the same time, hormonal contraception can reduce the risk for other cancers, such as ovarian cancer and endometrial cancer, by increasing hormonal stability and reducing the frequency of ovulation (C. L. Westhoff, M. C. Pike 2018). Hormonal contraception can also lead to a decrease in the diversity of gut bacteria and an increase in the number of harmful microorganisms (Z. Zhou et al. 2024).

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Insufficiency of nutrients - vitamins and minerals

Estrogen and progestogen can have a negative impact on the processing and absorption of certain nutrients, including B vitamins (especially B6, B12 and folic acid), vitamin C, vitamin E, magnesium, zinc or selenium, which may lead to deficiencies (K. Szczechowiak et al., 2016). However, it is important to note that certain side effects, such as headaches, depressive states or decreased libido, occur only in individuals with genetic predispositions. The key to reducing the risk of these side effects is regular visits to a gynecologist and diagnostic tests, based on which the doctor can select the appropriate method of contraception.

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Nutritional regimen during hormonal contraceptive use

During the use of hormonal contraceptives, the diet should primarily be of high quality, balanced, anti-inflammatory, rich in key minerals and vitamins influencing the nervous system, promoting liver function, maintaining a healthy microbiota, and supporting the elimination of excess estrogen.

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Diet that is balanced and has anti-inflammatory characteristics

A diet that is balanced and has anti-inflammatory characteristics should include nutrients such as protein, fat, carbohydrates, and fiber. Protein should come from a variety of sources, such as lean meats, fish, eggs, grains, legumes, nuts, or seeds. The best source of fat in this case would be unsaturated fatty acids, which can be found in various oils, avocados, nuts, seeds, and fatty seafood, rich in omega-3 fatty acids that have anti-inflammatory properties and support brain function. Carbohydrates should primarily come from whole grains, vegetables, and fruits, which also contain fiber, important for digestive health. It is also recommended to include products with high antioxidant content, such as colorful vegetables and fruits (e.g., berries, grapes, spinach, carrots, bell peppers), herbs and spices (especially cinnamon, turmeric, ginger, garlic, onion), and green tea. Regular consumption of these products, combined with avoiding processed foods, refined sugars, and trans fats, can significantly improve overall health and reduce the risk of chronic diseases associated with inflammation (K. Szczechowiak et al. 2016).

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Supporting the liver and excreting surplus estrogen

All of the above-mentioned components of a healthier diet will certainly also contribute to supporting liver function and thus excreting surplus estrogen. To further enhance this effect, it is advisable to include cruciferous vegetables such as broccoli, cabbage, Brussels sprouts, cauliflower and others in the diet, which contain indolo-3-carbinol. It is a component that, in addition to having a positive effect on the body's detoxification process, has the ability to convert estrogen into less harmful products for the body.

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Beneficial for bacterial flora

In order to promote the condition of the intestinal flora and increase its diversity, it is important to include various fermented products such as yogurt, kefir, kimchi, sauerkraut, miso, or tempeh in the diet. They are a source of probiotics that support digestion, strengthen the immune system, and can reduce inflammation by having a positive effect on the variety of microorganisms in the gut. Similarly important is to consume foods rich in prebiotics, i.e., a type of fiber that serves as a nutrient source for beneficial bacteria. This includes products such as garlic, onion, leek, asparagus, bananas, oats, or barley (K.. Szczechowiak et al. 2016).

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General source of minerals and vitamins that are essential for proper nervous system functioning

As previously mentioned, the use of hormonal contraception can lead to deficiencies in B vitamins (especially B6, B12, and folic acid), vitamins C, vitamin E, magnesium, zinc, or selenium. Therefore, it is important to provide the body with products that are rich in these nutrients: - Vitamin B6: yeast, meat, fish, eggs, cereals (particularly liver), legume seeds, bananas, avocado, starchy vegetables; - Vitamin B12: animal products, especially offal, meat, dairy, fish and seafood; - Folic acid: green leafy vegetables, legume seeds, egg yolk, yeast, and nuts; - Vitamin C: bell peppers, parsley, cabbage, sea buckthorn, wild rose fruit, black currants, kiwi, strawberries, or citrus fruits; - Vitamin E: plant oils, nuts, cereal products, avocado, sprouts; - Magnesium: cereal products, legume seeds, nuts, bananas, potatoes, cocoa; - Zinc: oysters, meat, offal, cheese, eggs, whole grain products, nuts and seeds; - Selenium: meat, whole grain products, dairy, fish and seafood, Brazil nuts. In order to support the body while using hormonal contraception and reducing the risk of side effects, a varied and balanced diet is essential.