Ep. 605 "What Happens When You Stop the Pill in Midlife?" | Oral Contraceptives, Menopause, Perimenopause, Hormones

Welcome to the latest Midlife Minute.

Today, I’m taking a closer look at oral contraceptive use in perimenopause and menopause, exploring how oral contraceptives work, how they suppress or blunt perimenopausal and menopausal symptoms, alter hormone signaling and testing, what women may experience when they stop taking them, and why the gut microbiome is an essential part of the conversation.

IN THIS EPISODE, YOU WILL LEARN:

• How oral contraceptives suppress certain key signaling hormones, making it difficult to assess women’s menopausal status accurately

• What women may experience when transitioning off oral contraceptives

• How long-term oral contraceptive use can alter gut microbial function and inflammatory pathways

• The association between long-term oral contraceptive use and nutrient depletion

• Why the standard reproductive hormone markers used to assess menopause (especially FSH/LH) are unreliable while on the pill

• How the microbiome changes that occur as women age may compound the effects of previous oral contraceptive use

• Helpful dietary, microbiome, and lifestyle strategies to support women navigating the post-pill transition

Connect with Cynthia Thurlow  

• Follow on X, Instagram & LinkedIn

• Check out Cynthia’s website.

• Submit your questions to support@cynthiathurlow.com 

• Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. 

• Purchase Cynthia’s book, The Menopause Gut.

• Cynthia’s Intermittent Fasting Transformation Book

• The Midlife Pause Supplement Line

Resources: 

• Sitruk-Ware R, Nath A. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Practice and Research: Clinical Endocrinology and Metabolism. 2013;27(1):13–24. doi:10.1016/j.beem.2012.09.004

• Schaffir J, Worly BL, Gur TL. Combined hormonal contraception and its effects on mood: a critical review. European Journal of Contraception and Reproductive Health Care. 2016;21(5):347–355. doi:10.1080/13625187.2016.1217327

• Panzer C, Wise S, Fantini G, Kang D, Munarriz R, Guay A, Goldstein I. Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction. Journal of Sexual Medicine. 2006;3(1):104–113. doi:10.1111/j.1743-6109.2005.00198.x

• Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. European Review for Medical and Pharmacological Sciences. 2013;17(13):1804–1813. PMID:23852908

• Khalili H, Higuchi LM, Ananthakrishnan AN, Richter JM, Feskanich D, Fuchs CS, Chan AT. Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut. 2013;62(8):1153–1159. doi:10.1136/gutjnl-2012-302362

• Flores R, Shi J, Fuhrman B, Xu X, Veenstra TD, Gail MH, Gajer P, Ravel J, Goedert JJ. Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study. Journal of Translational Medicine. 2012;10:253. doi:10.1186/1479-5876-10-253

• Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: physiological and clinical implications. Maturitas. 2017;103:45–53. doi:10.1016/j.maturitas.2017.06.025

• Hua X, Cao Y, Morgan DM, Miller K, Chin SM, Bellavance D, Khalili H. Longitudinal analysis of the impact of oral contraceptive use on the gut microbiome. Journal of Medical Microbiology. 2022;71(4):001512. doi:10.1099/jmm.0.001512

• Mihajlovic J, Leutner M, Hausmann B, Kohl G, Schwarz J, et al. Combined hormonal contraceptives are associated with minor changes in composition and diversity in gut microbiota of healthy women. Environmental Microbiology. 2021;23(6):3037–3047. doi:10.1111/1462-2920.15461

• Seelig MS. Increased magnesium need with use of combined oestrogen and calcium supplementation. Magnesium Research. 1990;3(3):197–215. PMID:2133742

• Donders GGG, Bellen G, Mendling W. Management of recurrent vulvo-vaginal candidosis as a chronic illness. Gynecologic and Obstetric Investigation. 2010;70(4):306–321. doi:10.1159/000314022

• Krog MC, Hugerth LW, Fransson E, et al. The healthy female microbiome across body sites: effect of hormonal contraceptives and the menstrual cycle. Human Reproduction. 2022;37(7):1525–1543. doi:10.1093/humrep/deac094