Here's What You Need To Know About Birth Control & Gut Health

Denise consulted me because she struggled with post-birth-control syndrome (PBCS) after she made the difficult decision to go off the pill. Reviewing her health history, I noticed Denise’s doctor had recently prescribed several rounds of antibiotics for a urinary-tract infection (UTI). Also, Crohn’s disease ran in her mom’s side of the family and her father’s side had a history of severe depression. As a doctor who helps women treat autoimmune disease and balance their hormones, I drew the parallel between Denise’s symptoms and her gut health.

“Studies show that even a short round of antibiotics can create gut chaos for up to two years,” I told her. That wasn’t even the shocking news. “Just like antibiotics, birth-control pills can totally wreck your gut,” I said. “The pill creates mayhem on your gut that can manifest in numerous not-so-pretty ways.”

Among those problems, studies show1 that oral contraceptives impact gut flora, adversely affecting estrogen metabolism1, with all its detrimental consequences, including weight-loss resistance. The pill also increases2 your risk for inflammatory bowel diseases like Crohn’s disease; in fact, two large prospective cohort studies of American women linked oral contraceptive use with Crohn’s. (For the record: These women had a history of smoking.) We’re unsure exactly why oral contraceptives seem to trigger inflammatory conditions like Crohn’s, but researchers speculate3 that impaired immune function, an out-of-balance gut bacteria, and increased intestinal permeability (AKA leaky gut) are potential causes.

And then there’s leaky gut. When tiny particles that aren’t supposed to slip through8 your gut wall do, an immune reaction results and among its havoc includes—you guessed it—inflammation.

Fixing Denise’s problems took a few months and several consultations, but I found these five strategies worked for her and numerous other patients:

Studies show9 that a Western diet—high in added sugars, inflammatory vegetable oils, and other processed junk—becomes a surefire way to ramp up chronic inflammatory diseases, causing you to pack on weight and feel miserable. I asked Denise to keep a food diary and we pinpointed several sneaky sugar sources including almond milk. (Some varieties contain sugar, so read those labels and choose brands without added sugar!)

Studies connect10 psychological stress with IBS and other inflammatory gut diseases. Everyone has different strategies to de-stress; for Denise combating stress meant frequent coffee dates with her best friend and 10 minutes of morning yoga each day. Yours might be deep breathing, meditation, or unwinding with a hot bath and chamomile tea after a tough day.

Wild-caught fish is an anti-inflammatory rock star, and Denise wasn’t eating enough of it. (“Yuck,” she replied when I asked her to eat more wild salmon.) So I had her ramp up other anti-inflammatory foods like leafy and cruciferous veggies as well as spices like turmeric, plus I put her on professional-quality fish oil supplements. Studies show11 that the anti-inflammatory omega-3 fatty acids in fish oil could benefit inflammatory bowel disease (IBD) and other inflammatory gut diseases.

Studies add12 impaired immune function and increased inflammation to the numerous issues poor sleep habits create or exacerbate. Getting 8 hours of solid shut eye initially felt like a challenge, but after a few weeks Denise became a believer in the good-sleep-fixes-nearly-everything mantra.

If you're looking for an alternative to the pill you might want to read this about birth control apps or this one the IUD.