Are your medications making your digestion worse? Your IBS and birth control may just be going hand-in-hand – ack!
Before we dive into this topic, we just want to mention that this blog post is not “anti-birth control.” Unfortunately, there is a limited understanding of potential digestive health issues related to birth control. We feel that having comprehensive information about the risks and benefits of taking hormonal birth control empowers women to be better informed and better advocates of the healthcare choices that best serve them.
In this article, we discuss what the potential consequences (related to digestion) are of taking hormonal birth control…we’re guessing that your prescribing physician didn’t warn you about these.
And we also know that these symptoms are not in your head. Too often women are not taken seriously when they bring up concerns to their doctors. In fact, my doctor was totally dismissive of how hormones were impacting my digestion. When you work with us, please know that we’ll listen to you and trust you.
Medical professionals are not discussing or acknowledging the powerful connections between your prescriptions and unintended consequences, like IBS! Let’s dive in so that you can make a more informed decision about what medications are a good fit for you.
Types of birth control
There are many different kinds of birth control, each with its own pros and cons to consider.
For this article, we are discussing the kinds of birth control that have hormones in them, such as “the pill”, hormonal IUD and the patch. These birth control options contain estrogen, progesterone, or both.
Non-hormonal birth control – such as condoms or a diaphragm, will not have connections to IBS and digestive health. They are not discussed here.
Quick review: what is IBS?
Women are more likely to have IBS – this may be due, in part, to differences in our hormones. And hormonal birth control may just make your digestive symptoms worse – ack(1)!
While symptoms of IBS can vary from person to person (and meal to meal), IBS might feel like:
- Belly pain
- Feeling full too soon during eating
- Gas and bloating
- Constipation, diarrhea (or, dreadfully, both)
There are many potential causes of IBS…and there can be more than one. For more in-depth information about IBS, click here.
In the meantime, let’s start to explore what is in your birth control as well as the potential link between IBS and birth control medication.
What is birth control, exactly?
Hormonal birth control contains the synthetic female hormones estrogen, progestin or both. They’ve been around for more than sixty years. Formulations vary on the amounts of the hormones and ratios of one to another, hoping to minimize side effects while maintaining effectiveness (2).
Examples of hormonal birth control include “the pill,” the ring, the patch, the IUD, implant or the birth control shot.
The elevated levels of estrogen and progesterone stop your body from releasing an egg during ovulation.
No egg released means no potential pregnancy.
Unfortunately, the effects of these elevated hormones might not end with the prevention of pregnancy. Birth control may increase IBS symptoms.
Can birth control cause digestive problems?
Short answer: yes. Your IBS and birth control might just be connected. Constipation, diarrhea and belly pain, to name a few.
Hormonal birth control can significantly increase your risk of Crohn’s disease (3). In addition, birth control can increase inflammation and increase intestinal permeability (aka leaky gut), two factors that are known to increase risk of IBS (4).
Birth control and constipation
One cause of IBS is changes in how fast or slow your muscles contract to move food and waste along your digestive tract. Estrogen may slow down digestion, causing constipation (5).
Some women experience constipation within their menstrual cycle. Additional estrogen may make constipation worse (6).
Birth control and diarrhea
On the flip side, lowering the levels of these hormones may cause diarrhea. Some women experience this without birth control medication, some women have worsening symptoms with birth control medications.
Some women find that their symptoms are more mild if they are on a form of birth control medication that has consistent levels of hormones (7).
Birth control: bloating and stomach pain
One common symptom of IBS is feeling more full and more pain while eating meals; your stomach muscles might be extra sensitive to the sensation of stretching as your belly fills up. The good news: higher levels of estrogen may make you more tolerant of belly pain (8).
The bad news? Progestins can increase salt retention, making you feel more bloated (9).
Can birth control make you gassy?
An increase in gas can be attributed to increased intestinal motility, diarrhea, changes in the bacteria living in your gut, what can be called the gut flora or your microbiome: same thing.
Birth control and gut flora
Birth control can change the microbiome: the community of bacteria and other microorganisms living in your gut. Changes in this community, what we call dysbiosis, is yet another potential cause of IBS. Not having enough diversity in your gut flora – which is common in those with IBS – can make your IBS worse (10).
What can I do to minimize IBS symptoms while on birth control?
Now that you know that your hormonal birth control medication and IBS symptoms may be linked, you may be wondering if you need to stop taking it.
Medications are one of many potential causes of IBS.
If you’re struggling with IBS symptoms, a few strategies you can prioritize include:
- Getting a good night’s sleep, as often as possible
- Having regular exercise that you enjoy
- Reducing stress
- Limiting caffeine and alcohol (sorry!)
- Drinking plenty of water
But if those strategies are not enough to quell your IBS symptoms, it may be time to ask for some help (hey, that’s us!).
IBS is a condition that will stick around unless you’re able to identify, and treat, the root cause. Easier said than done, but we’ve had lots of practice!
Can you take probiotics while on birth control?
Yes – just know that there are many kinds of probiotics.
Different species (sometimes called strains) of probiotics are like different animals at the zoo. Different strains of probiotics offer different benefits. And we feel best when we have a robust population of many different kinds of organisms in our gut, in the right place (11).
To get the most benefit of taking a probiotic, we recommend working with a knowledgeable healthcare practitioner that can match your symptoms, health goals and the right dose of the right probiotics.
Your IBS symptoms – diarrhea, constipation, bloating, gas and belly pain – might be linked to or worsened by your hormonal birth control.
It’s not in your head (it’s in your gut, ha!)
But in all seriousness, if you are not being heard by your healthcare provider, or not provided with the information to make a truly informed decision about your medications, it may be time to switch to a new doc.
Sara Kahn, MS, CNS, CDN is a board-certified nutritionist specializing in digestive health conditions like SIBO, IBS, acid reflux and more. She’s the founder of Belly Bliss Nutrition and the Solving SIBO Program.