The oral contraceptive pill (OCP) has been in use for over 50 years. Approximately 50–80% of Australian women have used ‘the pill’ at some stage during their reproductive lives. Australia was the second country in the world to have access to it.
The OCP has uses in addition to contraception, such as reducing or ceasing menstruation, decreasing menstrual symptoms, managing dysmenorrhoea, endometriosis, acne vulgaris (common acne) and hirsutism.
There have been adjustments to the doses of active ingredients (progestins and oestrogen derivatives) to try and balance potential adverse side effects with continued efficacy. While this is a whole topic in itself, our article here focuses more on the depletion of certain nutrients when the pill is taken.
Nutrient deficiencies, such as B vitamins, vitamin C, and various minerals, have been observed during use.
Reduced riboflavin (vitamin B2)
Vitamin B2 is necessary for energy production, normal cell function and growth and is critical for proper functioning of the nervous, endocrine, cardiovascular, and immune systems.
Signs and symptoms of vitamin B2 deficiency include degenerative changes in the nervous system, dysfunction of the endocrine system, skin disorders, and anaemia.
Vitamin B6 (pyridoxine)
Vitamin B6 is involved in the metabolism of homocysteine, neurological development, immune function, and formation of haemoglobin. A deficiency of vitamin B6 has been associated with inflammation, anaemia, impaired glucose intolerance, depression and confusion. It plays an important role in metabolism of neurotransmitters, such as dopamine, serotonin, glutamate, and gamma-aminobutyric acid (GABA).
Low plasma levels of vitamin B6 are associated with increased risk of arterial and venous thrombosis.
Reduced folate/folic acid levels
A deficiency of folate results in reduced DNA synthesis and cell division, peripheral neuropathy, and macrocytic anaemia. A deficiency of folate during preconception and during early pregnancy can lead to neural tube defects.