The birth control pill has become a cure-all solution to menstruators’ problems. It’s prescribed for regulating irregular periods, managing PMS, treating pain and other symptoms from conditions like endometriosis and PCOS, and reasons outside of preventing pregnancy. But does it actually regulate or treat anything?
The answer is technically no, but before we get into it, I want to stress that this is not an anti-birth control article. I was on the pill for 14 years until recently. What you choose is your personal decision and I support it 100%. My goal with this piece is to help you make an informed decision in the context of hormone balance, not contraception.
The birth control pill does not regulate your period
It is a very common misconception that the birth control pill regulates your period. Most people I speak with tell me it was prescribed to them young and the purpose was not to actually control birth, but to make an irregular cycle more regular, or to deal with PMS. It’s prescribed to menstruators in their adolescence, before their cycle has had a chance to mature, and is taken well into their 20s, 30s, and 40s.
But your cyclical symptoms are a sign from your body telling you there’s an opportunity to heal. Also, if you’re in your teens, it’s normal for your cycle to be irregular when you’re young! Your body is getting used to the new hormones and it will take some time for a pattern in timing to happen. This is typically not a cause for concern in the teen years.
Dysmenorrhea (painful periods), however, should be looked into. Aligning with your cycle is a great practice to learn in the early years to help make this new part of life easier to manage.
The birth control pill does not treat symptoms
To treat is to heal or cure. The pill’s primary function is to suppress your natural cycle and prevent ovulation, thus preventing pregnancy (and subsequently, hormonal issues related to your natural cycle). It’s more of a band-aid to keep symptoms at bay, or a pause button. Whatever issues you had before going on the medication will likely arise again if or when you decide to stop.
Still, this can be an important and life-saving thing for many people who experience pain and other debilitating issues.
If you do experience those issues and decide to go on the pill, it’s well worth looking into what’s causing the symptoms while you’re using the pill to manage them. So after you get your Rx filled, you may want to work with a health practitioner on getting to the root of the problem.
How the pill can impact your period
If you aren’t familiar with what a natural menstrual cycle looks like, check out this post here. Below are a few things to consider about the pill in relation to your period:
A lighter flow
The pill works by keeping the lining of your uterus from building up, preventing ovulation, and suppressing the natural hormone fluctuations that come along with your cycle. Off the pill, you shed part of that uterine lining with your period.
When taking contraception, your period is called a withdrawal bleed, as it happens when hormone levels drop. You aren’t actually shedding anything.
Many people experience a lighter flow on the pill than their usual menstrual bleeding. Some people don’t bleed at all or only experience spotting, which may or may not frustrate you. This depends on the type of pill you’re on and its hormone levels. Spotting can also happen within the first few months of using a new prescription.
If you just started BCP and have missed your period, or if a missed period is new for you on the pill, take a pregnancy test to be sure!
Like I said, the birth control pill doesn’t “regulate” anything, but it does make things a lot more predictable. It gets you on a 28-day rhythm that’s easy to work with (if you remember to take the pill at the same time every day) because you know when your period is coming and can plan accordingly.
Also, no, you don’t have to take the placebo pills (the sugar pills in the last week of the pack). Double check with your doctor, but you should be able to skip right to the next pack, as the withdrawal bleed isn’t actually necessary.
Periods on birth control are by definition anovulatory (meaning you don’t ovulate). However, if you’re planning to come off the pill, know that it can take one to 18 months to start ovulating again. In that time, you may experience no bleeding, or heavy bleeding. If you are family planning, this is important to know!
To get a better idea of what’s happening in your body once you come off the pill, I highly recommend looking into the Fertility Awareness Method to learn more about how to determine if and when you’ve started ovulating again.
Potential nutrient deficiencies
What’s that have to do with your period? The food we eat isn’t just to give us energy, but its vitamins and minerals help our bodies do all of the things they need to for regular function.
The pill can prevent the proper absorption of certain nutrients, including those that are important for hormone health. Thus, this has the potential to deplete your body of vitamins and minerals, and deficiencies can alter hormone balance.
As we know, hormone imbalance can lead to the period problems you’re trying to correct, so this kind of defeats the purpose.
If you’ve been on the pill for a while, make a point to get tested at your next doctor’s appointment. Also, prioritizing foods in your diet that contain these extra nutrients can help keep things even-keeled (and are important if you are planning to transition off birth control as well).
Eating for your cycle while on the birth control pill
The potential nutrient depletion from the pill can play a part in PMS symptoms like mood swings, cramps, and low energy. Rather than supplementing (unless you’ve been tested and you’ve been advised on forms and dosages), you can target any potential issues gently through nutrition.
Consider keeping the following foods in regular rotation to prioritize these nutrients:
- Vitamin C: Limes, grapefruit, oranges, cherries, papaya, bell pepper, broccoli, brussels sprouts, strawberries
- Vitamin E: sunflower seeds, almonds, avocado, olive oil, swiss chard, whole grains, asparagus, berries, leafy greens
- B2: Eggs, mushrooms, almonds, nori, milk, poultry, wild rice
- B6: Cod, eggs, sunflower seeds, bananas, spinach, legumes, potatoes, walnuts, fish, poultry, beans, seaweed, lentils, lima beans
- B12: Beef, salmon, yogurt, eggs, tempeh, sea vegetables, bee pollen, nutritional yeast
- Folic acid: Lentils, black beans, spinach, collard greens, asparagus, cantaloupes
- Magnesium: Pumpkin seeds, sesame seeds, almond, spinach, swiss chard, cacao, salmon
- Zinc: Oysters, crab, lobster, almonds, pumpkin seeds, sesame seeds, beef, herring, eggs, peas
- Selenium: Brazil nuts, sunflower seeds, salmon, cod, mushrooms, onions, oats, poultry, eggs, spinach, beef
If you are planning to come off the pill at any point, definitely consider prioritizing these foods at least 2-3 months beforehand to help make the transition a little easier.
Here are a few recipes to get you started:
- Brussels Sprouts Salad
- Ginger-Glazed Chicken + Grilled Asparagus
- Lemony Chard + Chickpeas
- Savory Spinach-Artichoke Oatmeal
The birth control pill is feminist and necessary
I no longer take the pill (my primary concern was actually birth control and I am now using the Fertility Awareness Method mentioned above — this is NOT the rhythm method). Even so, that doesn’t mean I am against it. I do still believe it is necessary for so many reasons.
Menstruators should have full control of their bodies and should be able to decide for themselves if and when they get pregnant, especially with BIPOC women dying from pregnancy-related causes at 2-3x the rate of white women.
Not being forced into parenthood boosts our earning capacity too. A 2012 study from the University of Michigan showed that women who were able to access the pill increased their earnings 8% in their lifetime compared to those without access.
And again, putting your cycle on pause can be life-changing for those with painful conditions like endometriosis that interfere with daily life.
The options out there aren’t perfect, but it’s important to be educated about each one so we can best decide for ourselves what the right path will be.
I’m a nutritionist, not a doctor, so your decision to go on or off the pill is best discussed with a medical professional who knows your individual situation. I can, however, provide some information that you may want to discuss with them, and that’s how this article was intended.
For more info on side effects and long-term safety to bring to your discussion, check out this medically reviewed article on Healthline.