Long-Term Use of Birth Control Pills: Impact on Digestion and Health

Long-term use of pre-exposure prophylaxis (PrEP)?

Hello, doctor.
I have been taking the oral contraceptive pill Diane regularly for over six years without interruption.
I have had poor digestion since childhood, often experiencing bloating, and I developed a bad habit of skipping meals during my growth years.
Earlier this year, I found my digestive issues to be quite bothersome, with persistent bloating, gastroesophageal reflux, and poor appetite.
I scheduled an appointment with a gastroenterologist for an endoscopy, which revealed bile reflux.
While discussing my digestive condition with friends, one suggested that my long-term use of oral contraceptives might be slowing down my digestion, so I wanted to ask for your professional opinion on whether there could be a connection.
Additionally, I discovered earlier this year that I have slightly elevated blood sugar levels.
My fasting blood sugar was 91 mg/dL from a blood draw and 103 mg/dL from a fingertip test, with an HbA1c of 5.6%.
The doctor said it was not a concern, so I did not continue to monitor it.
Recently, I have been feeling unwell, often measuring an ear temperature between 37.5-38°C, and I suspect I might be experiencing chronic inflammation.
I decided to check my blood sugar again, and this morning, after fasting for 11 hours, my fingertip blood sugar was 114 mg/dL.
I am unsure if these health issues are related, so I am providing this information for your reference.
Thank you.

Serendipity, 20~29 year old female. Ask Date: 2023/08/09

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it should not be related to taking contraceptive pills.
Wishing you good health.

Reply Date: 2023/08/09

More Info

Long-term use of birth control pills, such as the one you mentioned (Diane), can have various effects on the body, including potential impacts on digestion and overall health. It’s important to understand that while hormonal contraceptives are generally safe for most women, they can lead to side effects that may affect different systems in the body, including the gastrointestinal (GI) tract.

Firstly, hormonal contraceptives can influence the digestive system in several ways. Some women report experiencing gastrointestinal symptoms such as nausea, bloating, and changes in appetite while on the pill. These symptoms can be exacerbated by pre-existing digestive issues, such as the ones you described, including bloating and gastroesophageal reflux disease (GERD). The hormones in birth control pills can affect the motility of the gastrointestinal tract, potentially leading to slower digestion or altered gut flora, which might contribute to symptoms like bloating and discomfort.

Regarding your specific situation, the diagnosis of bile reflux (bile flowing back into the stomach) could be a significant factor in your digestive issues. Bile reflux can cause symptoms similar to acid reflux, including heartburn and nausea, and may be aggravated by hormonal changes. While there is no direct evidence linking long-term use of birth control pills to bile reflux, hormonal fluctuations can influence the function of the digestive system, which might exacerbate underlying conditions.

Additionally, your concerns about blood sugar levels and the feeling of chronic inflammation are valid. Hormonal contraceptives can also impact insulin sensitivity and glucose metabolism. Some studies suggest that certain types of hormonal birth control may lead to changes in glucose tolerance, which could be a concern given your recent blood sugar readings. The slight elevation in your fasting blood sugar and the HbA1c level of 5.6% indicates that you may be on the borderline of prediabetes, which warrants monitoring and lifestyle adjustments.

It's also worth noting that chronic inflammation can be influenced by various factors, including diet, stress, and hormonal changes. If you are experiencing persistent low-grade fever (as indicated by your ear temperature readings), it may be worthwhile to consult with a healthcare provider to rule out any underlying infections or inflammatory conditions.

In summary, while there may not be a direct causal relationship between long-term use of birth control pills and your digestive issues, the hormonal changes they induce can certainly play a role in exacerbating pre-existing conditions. It’s essential to discuss your symptoms and concerns with your healthcare provider, who may recommend further evaluation or adjustments to your current medication regimen. Lifestyle changes, such as dietary modifications, stress management, and regular monitoring of your blood sugar levels, can also be beneficial in managing your overall health.

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