Did you know that the Oral Contraceptive Pill can be a major contributor to anxiety? This is due to the way it suppresses hormones, affects neurotransmitter production, alters the gut microbiome and depletes nutrients.
 
Hormone Suppression
The OCP is a form of contraception that in basic terms ‘switches off’ your hormones that stimulate a menstrual cycle. One major hormone that it shuts down is Progesterone. Progesterone is a neuroprotective hormone and a GABA-A receptor agonist. This means that when progesterone levels increase, so do GABA levels. GABA (Gamma-amino-butyric-acid) is an inhibitory neurotransmitter that plays a role in promoting calmness, good mood and sleep. Low levels of GABA have been associated with anxiety and an inability to relax and calm down a racing mind.
The OCP also switches off your Oestrogen production, which is a hormone that helps to calm a fear response, regulates serotonin production and stimulates beneficial mood changes in the brain. It makes you feel energetic, outgoing and confident, and without optimal levels can leave you feeling depressed and anxious.
 
Gut Microbiome Altering
From as little as 6 months of use, the OCP alters both the intestinal and vaginal microbiome, which can lead to candida overgrowth (thrush in both the gut and vagina). Studies have also shown that the OCP changes expression of tight gap junctions in your gut which can lead to dysbiosis and leaky gut syndrome. Along with bloating, fatigue, diarrhoea and headaches, both candida and leaky gut are associated with anxiety and mood changes.
Your gut health and mental health are intrinsically connected as they send messages to each other via the gut-brain axis. If you have been experiencing both gut and mental health issues, the pill could actually be the problem.
 
Nutrient Depletion
The OCP depletes many vital nutrients in the body, including a very important one, Vitamin B6. B6 is required for the production of serotonin and GABA (your anti-anxiety neurotransmitters). Even with supplementing B6 daily, your body will still be depleted of the amounts required for optimal production. The OCP also depletes zinc, selenium and magnesium, which are micronutrients your nervous system uses to regulate your HPA-axis (the network of communication between your hypothalamus, pituitary gland and adrenals), which control the body’s response to stress.
 

There is a lot to take into consideration when coming off the pill due to the hormonal changes that may cause acne, sleep problems, mood changes and physical symptoms that occur when your sex organs wake up and start producing hormones you may not have produces for several years. This is why it is so important to work with a qualified Naturopath when deciding to make the change to ditch the OCP so that they can have a pre and post pill plan to make your transition symptom free.
 
If you are ready to make this change, I would love to work with you!
 
References:
 
Ehlen, J. C., Hummer, D. L., Paul, K. N., & Albers, H. E. (2010). GABA involvement in the circadian regulation of sleep. In GABA and Sleep(pp. 303-321). Springer Basel

Hall KS, Steinberg JR, Cwiak CA, Allen RH, Marcus SM. Contraception and mental health: a commentary on the evidence and principles for practice. Am J Obstet Gynecol. 2015;212(6):740–746. doi:10.1016/j.ajog.2014.12.010

Khalili H, Granath F, Smedby KE, et al. Association Between Long-term Oral Contraceptive Use and Risk of Crohn's Disease Complications in a Nationwide Study. Gastroenterology. 2016;150(7):1561–1567.e1. doi:10.1053/j.gastro.2016.02.041
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Longone, P., di Michele, F., D’Agati, E., Romeo, E., Pasini, A., & Rupprecht, R. (2011). Neurosteroids as neuromodulators in the treatment of anxiety disorders. Frontiers in endocrinology, 2.

Making sure you are getting the right amount of ZZZ per night affects more than your energy levels! Moderate sleep deprivation (less than 8 hours per night) can cause weight gain, thyroid hormone disruption, reduced immune function, inflammation and cognitive and memory decline. During sleep is when our body’s repair tissues and detox baddies out of our system. We have a neuro glymphatic fluid system in our brain that expands by 60% during sleep to allow waste products from the brain to be cleared. In particular, the system helps remove a toxic protein called beta amyloid from brain tissue, which has been found to accumulate in the brain of people who develop Alzheimer’s disease. This system only activates and flows effectively during sleep, so if you want to protect your brain, you need to get the right amount of pillow time every single night. 

Below are some tips to help you have a heavier, healthier sleep. 

1.    Limit exposure to blue light before bed 
Blue light is emitted off computer screens, TVs and smart phones. This light activates the Suprachiasmatic Nucleus (SCN), which is located in the hypothalamus of the brain. This SCN is responsible for controlling your sleep and wake hormones. When it is activated by light it sends a message to your pineal gland to inhibit production of melatonin (your sleep hormone). Restricting blue light exposure at least 1 hour before bed ensures that you are getting enough production of your sleep hormone to put you into deep sleep. Having orange or red lights on in the evening, like warm coloured lamps or candles instead of fluorescent lights will result in a deeper sleep as well. 

2.    Breathe 
The 4-7-8 breathing exercise has been shown to reduce time taken to fall asleep. Breathe in through your nose for 4 seconds, hold for 7 seconds and breathe out quickly through your mouth for 8 seconds. Repeat this at least 4 times. 
There are two different streams of the nervous system, the Sympathetic Nervous System (SNS), often called fight or flight, and the Parasympathetic Nervous System (PSNS), known as rest and digest.  In normal life, we encounter lots of stressors, and this means we are often going to bed in a heightened SNS state. However, to be able to have a restful, restorative sleep our bodies need to be in a PSNS state, and deep, mindful breathing activates this. 
 
3.    Reduce high histamine foods in the afternoon and evening
Histamine is an excitatory neurotransmitter that promotes wakefulness (that’s why antihistamine drugs often make you drowsy). Reducing the amount of histamine containing foods that you consume in the afternoon and evening can help to reduce the feeling of wakefulness and insomnia at night. High histamine foods include alcohol, pickled or canned foods, matured cheeses, smoked meats like salami, shellfish, beans and pulses like chickpeas and lentils, nuts and chocolate. If you are particularly sensitive to histamine and suffer from insomnia, you may need to completely remove these foods from your diet to ensure you get a good night sleep. 

4.    Increase foods that improve melatonin production
Melatonin is your sleep hormone and is produced from the amino acid tryptophan. Incorporating more foods into your diet throughout the day that are high in tryptophan will help improve natural melatonin production at night. These foods include, salmon, chicken, turkey, eggs, spinach, bananas, pumpkin seeds and yoghurt. 

5.    Lower your body temperature
Sleep occurs when our core body temperature drops, which signals the brain to start producing melatonin. A way that you can encourage a drop in core body temperature is having a hot shower about 1.5 hours before bed. The hot water heats up your skin so when you get out of the shower, the air rapidly cools your body down as it evaporates water from your skin.  This rapid cool down signals your brain that it is time to sleep. It is also important to have a cool bedroom temperature and wear light, breathable clothes to bed (or nothing at all). 

6.    Avoid caffeine after 10am
Caffeine has a stimulating affect on your nervous system that lasts for around 8 hours after consuming. Depending on how accustomed to caffeine you are, some people can still fall asleep after a late night coffee. However, studies have shown us that caffeine use in the afternoon and evening greatly reduces the time spent in REM and deep restorative sleep. This is the stage where your memory formation is occurring, hormones are regulating and tissues are repairing. 
Closing your eyes for 8 hours a night does not always equate to restorative, healthy sleep. If you wake up tired then you have not had enough time in deep sleep and could benefit from reducing caffeine intake. You may be extra tired for a few days whilst your body is adjusting, but your brain and body will thank you in the long run. 

7.    Journal your thoughts
​A common cause of insomnia is racing thoughts, overthinking, analysing past events or mentally planning for the next day. Writing out what you are thinking before you go to bed will help clear your mind. Write out your list of to dos for the next day, or things you can’t forget, so your brain can let go of the information as it knows now that if won’t be forgotten. If you are overthinking a situation, write it all out. Seeing it on paper usually makes it seem like a lot less of a big deal than it does in your head. Getting your words and thoughts in order can also help you to come up with solutions easier so your mind can switch out. 

8.    Supplement if required. 
There are certain nutrients like magnesium, zinc and B vitamins that are vital for putting your body into a PSNS and allowing for restorative sleep. When we are under significant stress our body doesn’t absorb nutrients from whole foods properly, so supplementing with nutrients and herbal medicines that are easily absorbed is vital to avoid deficiencies. Supplements help to physiologically reduce stress hormones and inflammation, so that your body is able to have a good nights sleep. As good sleep is required for stress management and stress management is required for good sleep. So having a helping hand through using supplements for a while can help to get you to a place where you are able to manage your stress and sleep through diet and lifestyle practises. 

*Always consult your healthcare professional before taking supplements. 

REFERENCES:

Sleep drives metabolite clearance from the adult brain. Science. 2013 Oct 18;342(6156):373-7. doi: 10.1126/science.1241224. 

Self-Regulation of Breathing as an Adjunctive Treatment of Insomnia
Ravinder Jerath, Connor Beveridge, Vernon A. Barnes
Front Psychiatry. 2018; 9: 780. Published online 2019 Jan 29. doi: 10.3389/fpsyt.2018.00780