All About The Pill: Nutrient Depletions, Synthetic Hormones + How to Stay Healthy While On and Coming Off

Written and medically reviewed by Dr. Courtney Ranieri, ND, a licensed naturopathic doctor registered with the College of Naturopaths of Ontario (Reg. #3726). Last reviewed July 2026.

This is Part 1 of 'The Pill Series'.

For over 50 years, oral contraceptives, or 'The Pill', have been a standard prescription for women avoiding pregnancy, and for good reason: it's almost 99% effective with perfect use. The Pill is in no way 'evil', and has been instrumental in women's sexual health and liberation. It all comes down to being informed. Understanding how The Pill works, its benefits, and its short and long-term effects helps you make informed choices to protect your future health and fertility.

Background: natural hormonal cycles

Estrogen is naturally produced in the ovaries and increases during the first half (follicular phase) of your cycle, spiking around ovulation. Progesterone is produced by the matured follicle (corpus luteum) during the second half (luteal phase) and by the placenta in pregnancy.

How does the Pill work?

Most oral contraceptives today are combination pills containing synthetic estrogen and progestin, and most are monophasic (the same hormone dose each pill). While on the pill, estrogen stays consistent, which inhibits ovulation. Progestin also thickens cervical mucous and alters the uterine lining, making implantation difficult.

What's the deal with synthetic hormones?

Synthetic hormones are not identical to and do not act the same as their natural counterparts. Natural progesterone has a protective effect, while synthetic progestins can have testosterone-like actions that contribute to hair loss and acne. Oral contraceptive use has also been documented to increase the risk of cardiovascular events such as blood clots, heart attack and stroke; some studies find the risk of a clot is about twice as high.

'Periods' while on the Pill

Natural menstruation occurs when estrogen and progesterone drop after ovulation. On the Pill, the 'period' you have is actually a withdrawal bleed from stopping the pills on the week off, not a true menstrual cycle, since you're not ovulating.

The benefits of the Pill

The Pill is very effective at preventing pregnancy, and it can protect against endometrial cancer, help with endometriosis, ovarian cysts and acne, and regulate cycles. It's a reversible contraceptive.

Common nutrient depletions

• Vitamin B6: a cofactor for many reactions, required for serotonin and red blood cell synthesis.
• Vitamin B12: imperative for neurological health and healthy red blood cells; often lower in women on the Pill.
• Folate: required for healthy methylation and DNA synthesis.
• Zinc: important for over 100 reactions and immune function.
• Magnesium: needed for cellular energy; low levels can lead to migraines, muscle spasms and anxiety.
• Selenium: extremely important for thyroid function and hormone synthesis.

Coming off the Pill

Coming off the Pill is a reality for many women in their twenties and thirties. It can take some time for hormones to regulate. To make the transition smoother and reduce post-Pill acne, amenorrhea, hair loss and hormonal imbalance, working with a Naturopathic Doctor to replenish nutrients and support your hormones can help.

Book your appointment here.

About the author

Dr. Courtney Ranieri, ND is a board-licensed naturopathic doctor and the founder of Somewhere Health. She earned her Doctor of Naturopathic Medicine at the Canadian College of Naturopathic Medicine in Toronto and holds an Honours Bachelor of Science from the University of Western Ontario. Her clinical focus spans hormonal health, fertility, digestion, and women's health, with advanced training in pelvic floor therapy and integrative fertility care.

Book a visit with Dr. Courtney