How your choice of contraception could be driving you mad, sad and mentally foggy.

Kay Ali, Nutritional Therapist & specialist in hormones and mental health. Co Founder of You Need A Nutritional Therapist. Image taken by You Need A Nutritional Therapist Ltd ©.

Welcome back to part two of ‘The Ovary Act: Sex hormones, mental health and me.’ This week I’d like to discuss with you one of the most difficult areas I am faced with in clinic. Contraception. It’s quite possibly the most problematic topic to discuss in a partnership too. I’ve lost count of the number of women I’ve sat with troubled about how the responsibility of preventing a pregnancy falls on them and not their partner. Often, they don’t quite understand it. Yet, with decades of use most women develop a sixth sense that their choice of contraception is driving them over the edge. Deciding what to do about your method of contraception can feel like being stuck between a rock and a hard place. We don’t want to risk getting pregnant, yet we don’t feel good on it too. Sadly, it’s something that affects all women – younger, older, childless, mother, single or married.

So here’s the stereotype; mothers usually in their 40s are fed up with having to use contraception and feel that it’s time to pass the baton on to their husbands. “Vasectomy, my love? No, I didn’t think so.” As if dealing with the emotional instability that comes with a temperamental period every month for 20 years, 3 pregnancies, 3-6 years breastfeeding, work, mum and wife duties isn’t doing more than our fair share for the team, we then deal with the brunt of contraception in our partnerships. Whether it’s popping pills, sticking on patches, jabbing needles or wedging implants and coils it can make us feel grim and grey. And it has everything to do with how they disrupt the delicate dance of our hormones.

What choices are there?

Kay Ali, Nutritional Therapist & specialist in hormones and mental health. Co Founder of You Need A Nutritional Therapist. Image taken by You Need A Nutritional Therapist Ltd ©.

When discussing options with my clients I tend to organize contraception into two categories. Hormonal and non-hormonal. Let’s discuss the former option first. They include the combined and progesterone only pill, vaginal ring, patches, injections, implants and the intrauterine system (IUS). With the exception of the IUS, they all work by preventing ovulation. The story goes no egg, no fertilization. No fertilization, no baby. Now you might think this is good news, but it’s not. In fact, if mental health, sleep and productivity is your concern it’s bad news. Bad, bad news.

Here’s why. When we ovulate midcycle, the egg leaves a little blister that transforms itself into something we call the corpus luteum. This blister is responsible for secreting the lions share of progesterone that our bodies make. If we don’t ovulate, this progesterone production simply does not happen. Now imagine this is happening month upon month and year upon year with your choice of contraception. Progesterone levels drop and oestrogen becomes your dominant sex hormone. I guess, if it’s preventing pregnancies and keeping your uterine lining too thin for implantation, happy days right? Unfortunately not. In fact, on the contrary it can predispose you to depression, anxiety and insomnia (not to mention difficulty with weight loss, fertility and acne amongst other symptoms associated with oestrogen dominance).

Making the connection: progesterone and mental health

What most of us don’t realise is that progesterone is essential for our mental health. We tend to associate it with maintaining pregnancies and that glorious pregnancy glow. However, it does way more than that. In both men and women progesterone keeps us feeling happy and well rested. It’s found in brain cells at levels 20 times higher than what circulates in our blood. In fact, progesterone is a key component of the myelin sheath, the protective layer that insulates each nerve fibre and ensures quick communication from neuron to neuron. In other words, progesterone keeps our brains sharp and productivity high. So if we become deficient in it, you can imagine how mentally unstable we might become.

Kay Ali, Nutritional Therapist & specialist in hormones and mental health. Co Founder of You Need A Nutritional Therapist. Image taken by You Need A Nutritional Therapist Ltd ©.

But that’s not all. Progesterone may help us feel good too. Research has shown that it activates GABA receptors in the brain resulting in calming effects. GABA is a neurotransmitter responsible for controlling fear, anxiety and over stimulation of our brain cells. When it binds to GABA receptors located across our nervous system it calms everything down. The logic follows that anything that is capable of binding to GABA receptors can induce the same effect. This is exactly how prescriptive medications for anxiety and insomnia work. Benzodiazepines like Valium slow down the central nervous system by activating GABA receptors. And guess what? Progesterone does exactly the same thing. Minus the nasty side effects and addiction, of course. So if we want to feel good, manage stress better and sleep well naturally, we should be supporting our progesterone balance.

It goes without saying that if you suspect that progesterone deficiency is your problem you should get your levels tested using a 24 hour urine test. It’s important you get this done between days 19-22 of your cycle for an accurate picture of your progesterone secretion. But what do you do if it’s low? Well, it seems pretty obvious to me. You should start by assessing your contraception.

IUS and non- hormonal contraception

At this point you’re probably thinking that the choices left are obvious – opt for IUS or a “fit and forget” non- hormonal contraception like the IUD a.k.a copper coil. If only it were that simple! While the IUS doesn’t prevent ovulation, it has been known to disrupt ovulation for some women. What’s more is there seems to be an obvious issue that so many of us are missing. It’s made of plastic. Granted it’s pharmaceutically graded, but I personally don’t trust it. While campaigns across the country are raising awareness of plastic toxicity in our environment, it seems absurd to me that we’re inserting plastic within us. I mean, it’s plastic that sits in our uterus for a minimum of 3 years. Surely, some level of toxic man-made chemical is being secreted into our system? The research on plastic toxicity and its disruption of our endocrine system deserves an entire article to itself. So for me, the IUS is just not something I feel comfortable recommending. Which leaves us with the intrauterine device.

Kay Ali, Nutritional Therapist & specialist in hormones and mental health. Co Founder of You Need A Nutritional Therapist. Image taken by You Need A Nutritional Therapist Ltd ©.

Whenever I discuss the side effects of hormonal contraception on our mental wellbeing, I’m almost always interrupted by someone who will say “but I’m not on the hormonal one, I’m on the copper coil”. If only it was the answer to our problems. While the IUD does not secret synthetic hormones preventing ovulation, it does expose us to copper toxicity. The IUD works by releasing copper which creates a hostile environment for sperm to survive. In turn this reduces risk of fertilization. Simultaneously, it increases risk to copper excess. Why does this even matter?

Scanning through the scientific database there is a sufficient body of evidence linking copper excess with zinc deficiency and various body dysfunctions. It has the ability to profoundly affect every system in the body especially the reproductive, nervous, and glandular systems. But more than any other, it has a devastating effect on our mental health. This explains why common, yet undisclosed side-effects of the copper IUD include severe anxiety, panic attacks, depression, increased anger, brain fog, spaciness, paranoia, insomnia, racing thoughts and dizziness.

It’s no wonder I’ve had clients describe themselves “like a mad woman possessed” while on the copper IUD. Similarly, it’s very common for women to notice an improvement of their mental health after it’s removed.

It’s all about understanding your natural cycle and working with it

So what now? If condoms and diaphragms are not for you, the only option left is to adopt fertility awareness methods. This can be quite risky for the first 4 months while you compile enough data to understand your unique physiological symptoms that are pegged to your monthly cycle. However, it’s the most natural method that won’t screw with your hormones nor your mind. There are 3 main fertility indicators that you should log:

  1. Daily body temperature

  2. Cervical secretions

  3. Length of your cycle

Understanding the patterns of these indicators helps you to identify your most fertile days. In turn you should know when is best to abstain from intercourse or use condoms or diaphragms. I personally recommend to help log your body temperature and cervical secretions. However, I always emphasise to my clients that it’s important that they are extra cautious for the first 4 months to prevent slip ups from occurring. The more data you have the more accurate your fertility predictions can be. If adhered to perfectly, it’s estimated that fertility awareness can be 94% effective.

The truth is only you can know what the best form of contraception is for you. It may well be the IUD with routine blood checks on your copper levels to help manage copper toxicity. For others the lower effective rate of fertility awareness is a smaller price to pay than the risks associated with hormonal contraception and mental wellbeing. Whatever you decide, it’s important to gain an understanding of your current hormonal balance so that you can make the most informed decision for you.

Until next week’s post,

Kay Ali x

Nutritional Therapist & Co Founder of You Need A Nutritional Therapist Ltd.

Kay Ali, Nutritional Therapist & specialist in hormones and mental health. Co Founder of You Need A Nutritional Therapist. Image taken by You Need A Nutritional Therapist Ltd ©.

If you’d like to work with Kay on balancing your hormones and supporting mental wellbeing please get in touch via

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