The Oral Contraceptive Pill and Nutrient Depletion: What Every Mum Should Know

The oral contraceptive pill (OCP) is one of the most widely used forms of contraception among women in Australia. In fact, data suggests that around one in four Australian women of reproductive age use the pill as their primary contraceptive method (Wright et al., 2020). For many mums, it’s a practical choice in the postpartum period: for its reliability, accessibility, and ease of use.

The OCP works by combining synthetic forms of estrogen and progestin, which suppress ovulation, alter cervical mucus to prevent sperm penetration, and affect the uterine lining to make implantation less likely. While highly effective, decades of research has shown that the pill doesn’t just influence hormones, it also has measurable effects on the body’s nutrient status.

Nutrients at risk of depletion with OCP use

Research spanning from the 1960s through to recent systematic reviews has highlighted that OCP use is associated with changes in key vitamins and minerals. These nutrients are critical not only for overall health, but especially for postpartum recovery, mood stability, and energy levels. Here’s what the science says:

Vitamin B6

B6 is involved in over 100 enzymatic reactions in the body, but is primarily known for its role in protein and energy metabolism, and in the synthesis of neurotransmitters, such as serotonin and dopamine which help to regulate mood (Palmery et al, 2013). B6 deficiency can lead to mood changes, fatigue, and increased risk of thrombosis (Palmery et al, 2013). Studies report reduced levels of B6 in OCP users, with one large study finding 75% of women on the pill without supplementation had suboptimal B6 levels (Palmery et al, 2013, Wakeman, 2019).

B6 can be found in salmon, tuna, organ meats, chickpeas, potatoes, leafy greens, nuts and cereals.

Vitamin B12

B12 is vital for red blood cell production, nerve health, and DNA synthesis (Palmery et al, 2013). Low B12 is linked to fatigue, brain fog, and increased risk of neural tube defects (NTDs) in pregnancy. OCP users consistently show lower blood B12 levels due to changes in the way it is utilised and transported in the body (Palmery et al, 2013; Wakeman, 2019). It is also important to consider B12 levels in vegetarian / vegan women despite OCP usage, as B12 can only be obtained from animal sources.

B12 can be found in organ meats, trout, salmon, sardines, dairy, and eggs. For vegetarians and vegans a supplement is usually recommended, alongside foods such as B12 fortified plant-based milks or nutritional yeast.

Folate (Vitamin B9)

Folate is essential for DNA synthesis, cell division, red blood cell formation, and energy production (Palmery et al, 2013). It is well studied that adequate folate levels play a role in healthy pregnancy outcomes via reducing the risk of NTDs. 

Research shows that oral contraceptive use can slightly alter how the body processes folate, though it is unclear if it can cause a clinical deficiency (Shere et al., 2015). Because many pregnancies occur soon after stopping contraception, maintaining optimal folate levels through supplementation or folate rich / fortified foods is important for reducing the risk of neural tube defects. Folate can be found in dark leafy greens, organ meats, broccoli, avocado, strawberries, beans, lentils, and fortified grains and bread flours.

Vitamin B2 (Riboflavin)

Riboflavin helps convert food into energy and supports nervous system health. OCP use has been shown to lower riboflavin activity, particularly in women with already poor diets (Palmery et al, 2013). Supplementing with B2 was also shown to reduce the duration, intensity and frequency of headaches, which is a common OCP side effect (Palmery et al., 2013).

Riboflavin can be found in dairy products, egg yolk, organ meats, pork, salmon, chicken, mushrooms, and avocados.

Magnesium

Magnesium plays a role in over 300 enzymatic reactions in the body. We like to call it a mothers best friend, for its role in supporting energy production, sleep, muscle recovery and hormones. OCP use is associated with lower magnesium levels, which may also shift the calcium-to-magnesium ratio and contribute to increased blood clotting risk of OCPs (Mohn et al, 2018; Palmery et al, 2013).

Magnesium supplementation should be considered alongside OCP use, and we recommend working with a health professional such as our Clinical Nutritionist or Naturopath to select the right dose and form for your needs. Magnesium can also be found in foods such as oats, spinach, nuts and seeds, quinoa, dark chocolate, cacao, black beans, and edamame.

Vitamin C & Vitamin E

Vitamin C and vitamin E are antioxidants that protect tissues, boost immunity, and aid skin healing, which is important during postpartum recovery. Studies show reduced vitamin C and E levels in OCP users, along with increased oxidative stress, which can increase risk of cardiovascular disease (Mohn et al, 2018; Palmery et al, 2013).

Vitamin C can be found in capsicum, broccoli, kiwi fruit, strawberries, and citrus fruits. Vitamin E can be found in nuts and seeds, avocado, spinach, and broccoli.

Zinc & Selenium

Zinc supports immune function, wound healing, and hormone balance. Selenium is essential for thyroid function and antioxidant protection. Both are also critical nutrients for reproductive health. OCP use has been linked to lower serum zinc and selenium, so maintaining a good dietary intake of these minerals is important (Palmery et al, 2013; Wakeman, 2019). 

Zinc can be found in oysters, crab, lobster, nuts, seeds, legumes, beef, and lamb. While the selenium content of our food is directly linked to selenium content of our soil, it is becoming harder to obtain sufficient intakes of this mineral. Best food sources include Brazil nuts, mushrooms, spinach, legumes, chicken, and eggs.

So, what can you do about it?

If you’re taking the pill, it doesn’t mean you’re destined for nutrient depletion. But it does mean being proactive. Here’s how you can protect your health:

1. Check your diet: Focus on eating a range of fresh, whole foods and don’t skip meals as this can leave huge gaps in vital nutrient intake across the day.

2. Consider supplementation: Evidence supports that targeted supplementation can restore optimal nutrient status in pill users, particularly B vitamins, folate, magnesium, zinc, and antioxidants. However, not all supplements are created equal. We recommend working with a practitioner who can tailor a plan for you (and avoid spending hundreds of dollars on things that don’t work / or you don’t need).

3. Work with a practitioner: Every mum’s body is different. Our team of Naturopaths and Clinical Nutritionists can assess your unique nutrient needs, look at any symptoms you may be experiencing, and create a safe, tailored plan to restore balance.

   
   

The OCP remains one of the most effective and accessible contraceptive options for women. But like all medications, it comes with effects on the body beyond its intended use. By understanding the nutrients most at risk, you can take steps to safeguard your health and energy, ensuring you’re not just “getting by” in motherhood, but thriving.

👉 Book a check-in with our team to make sure your nutrient status is supporting you, not holding you back.

Book a consult today

Disclaimer: This advice is general in nature and not intended to be personalised medical advice. If you have concerns about your health, any medication you are taking, or questions around supplement use, we recommend speaking to your GP or other health professional.

References:

Mohn, E.S., Kern, H.J., Saltzman, E., Mitmesser, S.H., McKay, D.L. (2018). Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update. Pharmaceutics,10(1):36. https://doi.org/10.3390/pharmaceutics10010036 

Palmery, M., Saraceno, A., Vaiarelli, A., Carlomagno, G. (2013). Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 17(13):1804-13. https://pubmed.ncbi.nlm.nih.gov/23852908/ 

Shere, M., Bapat, P., Nickel, C., Kapur, B., Koren, G. (2015). Association Between Use of Oral Contraceptives and Folate Status: A Systematic Review and Meta-Analysis. J Obstet Gynaecol Can. 37(5):430-438. https://doi.org/10.1016/s1701-2163(15)30258-9 

Wakeman, P. (2019). A Review of the Effects of Oral Contraceptives on Nutrient Status, With Especial Consideration to Folate in UK. Journal of Advances in Medicine and Medical Research; 30 (2):1–17. https://doi.org/10.9734/jammr/2019/v30i230168 

Wright, S. M., McGeechan, K., & Bateson, D. (2020). Family Planning NSW: Assessing  prevalence and trends in contraceptive use of Australian women using a market research dataset.        https://www.fpnsw.org.au/sites/default/files/assets/ANZJPH_Contraception-Paper_20210202