The Pill (OCP) & Your Fertility: What you should know before trying to conceive
The oral contraceptive pill (OCP) is of course an effective method of contraception. Understanding the risks, the nutrients depleted by taking it, and how to support your body coming off the pill to restore hormone balance and fertility is helpful for making informed and empowered decisions when trying to conceive.
Numerous studies have shown there is some delay in the time it takes to conceive after stopping taking the pill.
The first 3 months after stopping the pill showed the greatest difference in being able to fall pregnant, compared to women who weren’t taking the pill. Other studies also show lower rates of conception in the first year after stopping the pill compared to IUD (Intra Uterine Devices) and barrier methods (e.g. condoms and diaphragms).
The pill works by suppressing Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) to stop ovulation. This interrupts the HPA axis, a pathway between your brain, adrenal glands and ovaries that signals hormone production and secretion and regulates your menstrual cycle. After stopping the pill, your body has to work on reconnecting this pathway to get you ovulating again.
The pill also masks menstrual cycle irregularities, PCOS and other hormone conditions which impact fertility. Meaning although the OCP gives the illusion of having a “regular cycle” (a pill period is just a breakthrough bleed, not a true period), once the pill is stopped, those hormone issues are still present, and symptoms typically return.
Some OCPs also have androgenic effects, meaning they increase androgen hormones including testosterone, which cause skin breakouts/acne, excess hair growth, thinning of the hair and insulin resistance (the same symptoms of PCOS). However newer OCPs typically minimise these effects.
Where this can impact fertility is when you come off the pill, androgens can stay elevated for some time. Androgen hormones stop ovulation, which needs to occur in order to fall pregnant. We can however use nutrition, supplements and lifestyle to lower androgens and restore hormone balance.
Nutrient deficiencies caused by the pill:
- Folate – required for DNA growth, healthy formation of the neural tube, and reducing chromosomal mutations
- Magnesium – cofactor for over 300 enzyme reactions in the body including essential for hormone production
- Zinc – reduces oxidative stress (for egg quality), essential for growth & development and immune function, reduces androgens that impact ovulation
- Selenium – protects against chromosomal damage, DNA repair, essential for thyroid hormones (which impact ovulation and menstrual cycle regularity), required for foetuses immune and nervous system development
- Vitamin C – essential for progesterone production (hormone produced after ovulation and maintains pregnancy), and collagen synthesis (skin health)
- Vitamin E – required for synthesis of sex hormones, for egg quality and immune modulation (this is important for implantation to fall pregnant)
- Vitamin B12 – deficiency can interfere with ovulation, egg development, and implantation
- Vitamin B6 – essential nutrient during pregnancy for nervous system development
- Vitamin B2 – essential for growth and development of foetus
Preconception care ideally needs to start at least 4 months prior to trying to conceive.
That’s because it takes 3 months for eggs to mature and 4 months for sperm to mature. Your nutrition and lifestyle today is effecting the quality of eggs released in 3 months time that you could potentially fall pregnant with. And egg quality is a key predictor of fertility outcomes, and having a healthy pregnancy and baby.
If you’ve been considering coming off the pill, whether that be to start a family or for other reasons, I would love to help support your body during this process. We can tailor a plan to replenish these nutrients, restore hormone balance and ovulation, and optimise your fertility.
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