Does going off the pill trigger the blues?

Q:

I’m 53 and had been on the pill for decades, but then my doctor wanted to see if I was in menopause so he suggested I stop taking it.

I did, and pretty much ever since, I’ve felt sad for no real reason. Is there a connection?

A:

Low moods can definitely be caused by going off of the pill. Research in the Journal of Clinical Endocrinology & Metabolism suggests that women who take estrogen-based birth control pills have 20% higher levels of vitamin D, a nutrient that helps boost feel-good serotonin. When the pill is discontinued, D levels can drop—especially in winter, when your body is deprived of the D it makes naturally when sunlight strikes skin.

You can replenish your stores by taking 2,000 IU of D-3 daily and eating foods that supply the vitamin, like salmon, eggs (with yolks), yogurt and cheese. If you don’t feel your mood lift within several weeks, your doctor can order a blood test to check your D levels and advise the ideal dose to correct your depletion. Most women with endometriosis (when the uterine lining migrates out of the organ, causing pain) are diagnosed in their 20s or 30s. But a mild case may not bring symptoms until your 40s, as amped-up hormonal fluctuations fuel the growth of misplaced tissue enough to trigger pain.

To steady hormones and ease discomfort, I advise supplementing with 60 mg. of Pycnogenol daily: In one study, this pine-bark extract relieved endometriosis pain for 77% of sufferers. Also smart: Eating fatty fish, nuts and leafy greens, all of which are high in anti-inflammatory compounds. And avoid soy, which can exacerbate endometrial tissue growth to worsen symptoms.

Thankfully, endometriosis typically fades in menopause, but if your pain spreads or worsens, see your doctor for more treatment options.

My menstrual cramps have gotten really bad,

and it turns out it’s because I have endometriosis. But I’m 46! What

gives?