Over the years there has been debate as to whether oral contraceptive use in women leads to depletion of certain nutrients in the body.  There is some evidence that oral contraceptives may reduce levels of Vitamin B1, B2, B6, folate, vitamin C, vitamin E, zinc, magnesium and calcium.  However, many of these studies were small [...]]]>

Over the years there has been debate as to whether oral contraceptive use in women leads to depletion of certain nutrients in the body.  There is some evidence that oral contraceptives may reduce levels of Vitamin B1, B2, B6, folate, vitamin C, vitamin E, zinc, magnesium and calcium.  However, many of these studies were small and carried out over 20 years ago with very little follow up since.  During this time the contraceptive pill has changed dramatically and now contains lower doses of hormones.  Women who are eating a healthy, nutrient-rich diet probably gain enough vitamins and minerals to counteract any deficit but many women in the UK are not reaching the minimum 5 portions per day of vegetables and fruits and many also do not gain enough magnesium and other minerals through their diets. 
 

The early studies do warrant attention and I was interested to find two more recent papers (1,2) which point to the importance of being nutrient-aware when taking oral contraceptives.  These two studies look at how oral contraceptives may have an effect on the antioxidant levels in the body.  

I have written about dietary antioxidants in many previous blog posts.  Antioxidant intakes and bodily status has been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as carotenoids, vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body by mopping-up destructive unstable oxygen molecules known as ‘free radicals’, these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

It has been thought for some time that oral contraceptive use may lead to increased oxidative stress in women.  One study (1) which took place in 2007 included 209 healthy women aged 40-48 years.  The oxidative stress status of the women was studied, this included an analysis of antioxidant levels, trace minerals and three markers of oxidative damage to fats (lipids).  Among the 209 women 23% used oral contraception, 57% did not use contraception and 20% used hormonal and copper intrauterine devices (IUD). 

Results showed(1) that women using oral contraception had significantly higher oxidative damage to lipids (lipid peroxidation) compared to the other 2 groups of women.  Lipid peroxidation has been linked to heart disease.  Oral contraceptive users also had significantly lower blood plasma levels of several antioxidants such as beta-carotene and gamma-tocopherol (a form of vitamin E).  The study scientists checked their data and confirm that modifications in plasma beta-carotene levels could not be attributed to dietary differences between the three groups.  The beta-carotene levels were 39-50% lower in the oral contraceptive users compared to the other groups of women.  The authors conclude that these lowered levels of antioxidants and increased signs of bodily oxidative stress could represent a potential cardiovascular risk factor for these women.

Another study (2) looked to examine the influence of oral contraceptive use on blood serum levels of antioxidants.  The study was a very small, preliminary trial in pre-menopausal women.  The researchers found that oral contraceptive use significantly decreased coenzyme Q10 (an antioxidant) and alpha-tocopherol (vitamin E) levels.  The authors conclude that further studies are needed to investigate the potential role of oral contraceptives on oxidative stress in women.

Coenzyme Q10 is naturally produced by the body and was first isolated in 1957, it is essential for energy production in all bodily cells and also acts as an antioxidant in the body.  Coenzyme Q10 itself is found in many foods but is particularly concentrated in nuts and oils.  The body does produce this nutrient naturally and does not rely on external sources.  In order to produce CoQ10 we require various essential cofactors.  These include a variety of vitamins especially of the B group (Folic Acid, Vitamin B2, The Niacinamide form of Vitamin B3, Vitamin B5,Vitamin B6, Vitamin B12) and Vitamin C .  Hence a healthy diet rich in fruits, vegetables, wholegrain cereals and lean proteins will aid the natural production of this coenzyme and help to keep our circulating levels high.

The results of these studies need backing up by further larger clinical trials but could indicate the consideration of antioxidant supplementation for women taking oral contraceptives. 

Eating a healthy diet low in processed and refined foods and rich in vegetables, fruits, nuts/seeds, beans and pulses, lean meats, fish (especially oily varieties), wholegrains and healthy fats is the best way to ensure that your body gets plenty of vitamins, minerals and antioxidants.  If you feel that your diet is regularly falling short then you could consider taking a broad spectrum multivitamin and mineral supplement – but remember that a supplement cannot be considered as an alternative for a healthy diet.

1.Chapelle JP et al.  2007.  Effect of different contraceptive methods on the oxidative stress status in women aged 40 48 years from the ELAN study in the province of Liege, Belgium.  Hum Reprod.  22:2335-2343
2. Palan PR et al.  2006.  Effects of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants.  Am J Obstet Gynecol.  194:e35-38

Written by Ani Kowal

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