I often hear that millions of women take hormonal birth control without incident. That may indeed be the case but it certainly isn’t my experience in my practice. In fact, the most common question I get from women when they first find me is…
“How do I get off the birth control pill?”
I’m continually amazed by the sheer volume of women I encounter who are ready to part ways with their pill (or any hormonal birth control for that matter), either because their sex drive has plummeted or completely disappeared, they are finding that sex has become painful, they are experiencing other side effects like gut problems, chronic yeast or urinary tract infections, hair loss, irregular periods and maybe even amenorrhea (no periods).
All of these symptoms are very clear signals from your body that something is wrong. They might be statistically normal but I promise this is not the way your body was designed to function.
You may not be one of these women who experiences symptoms and instead you’re ready to come off because you want to get pregnant. That’s great too! I do recommend waiting at least six months after coming off the pill before trying to conceive because you want to make sure your body is in prime shape to nourish a baby. Additionally, there is evidence that women who conceive immediately after coming off the pill are more likely to have premature deliveries.
Here’s the first thing you need to know…
You can stop the pill at any time. Luckily, the pill is one of the few drugs that you can stop without having to wean off of it. Some women stop midway through their current pack while others prefer to finish it out. It’s completely up to you. When I was coming off the pill 10 years ago I finished the pack, but I’m a Virgo perfectionist who didn’t want to screw anything up! 🙂
Here are my recommendations before coming off the pill…
These suggestions will help to mitigate any of the negative side effects you might experience.
1. Start taking a great B Complex.
One of the key sets of nutrients depleted by oral contraceptives is the B Complex of vitamins, especially B2, B6, B9 and B12. I’ve written many times about how important these vitamins are for our overall AND reproductive health. You can read about that here, here and here. I recommend Thorne Research Basic B Complex, or at least a B Complex that has the Methylated B vitamins in it. This is a good place to start, although if you have an MTHFR gene mutation you might need to further explore what type of B vitamins are right for you.
2. Include these trace minerals in your diet and supplementation.
Zinc, magnesium and selenium can become very depleted while on the pill. Most women are already mineral deficient when they start the pill because of the standard western diet so it’s crucial to start building back up your stores of these minerals. When a woman stops BC and is deficient in these minerals she might develop a series of issues.
For instance, post-pill amenorrhea is fairly common. Or you may have a very irregular cycle, where the cycle length is alternating, you bleed for a very short of period of time, there’s a shortened luteal phase, there’s no ovulation, or ovulation is happening twice in one cycle. It can show up in many different ways.
For a zinc deficiency, try pumpkin seeds, red meat and shellfish. You can also supplement with zinc and I recommend Designs for Health Zinc. For magnesium, include lots of dark leafy greens, avocados, nuts and seeds.
I’ve also found supplementing with 300mg a day of magnesium glycinate can be very helpful too. I also LOVE Natural Calm magnesium in the evening – it helps you wind down and sleep well. Take either the glycinate or the Natural Calm for your magnesium needs. For selenium, try Brazil nuts (they have a very high amount of selenium), organ meats like liver and kidney along with oysters.
3. Start including probiotic-rich fermented foods in your diet.
Another problem I see with women who’ve been on birth control for awhile are gut problems and/or chronic vaginal infections. There is evidence that oral contraceptives alter gut function by messing with your gut flora. I dealt with it myself many years ago and I continually see it in my clients.
The problem is that altered gut flora will in turn affect hormone regulation so it’s extremely important to get your guts back on track. While the solution is nuanced, I recommend including probiotic-rich foods as a starting point – sauerkraut, kim-chi, other fermented vegetables and water kefir. If you’re not down with fermented veggies (it’s an acquired taste for some!) then try taking probiotics like Dr. Ohhira’s or Prescript Assist.
Healing your gut will depend on how long you’ve been on the pill and whether you had gut & digestive problems before going on it. I highly recommend my Fix Your Period program because I have a whole section dedicated to gut health along with a gut cleansing and healing protocol. (Please choose track 1 or 2 based on the symptoms you are experiencing).
4. Focus on lots of healthy fats and protein.
You need fat and protein to build hormones. Period. Without the right amounts you will continue to stay stuck in hormonal imbalance land. Make it your goal in life to get good quality fat and protein into each meal or as many meals as you can. I recommend a palm-sized portion of protein, a couple ounces of healthy fats (think avocado, fatty fish, nuts and seeds, coconut oil/coconut butter) and lots of raw and cooked veggies. Are you hungry yet? 🙂
Here are my recommendations for when you do come off the pill…
Obviously, numbers 1-4 above continue to apply but there are some more steps you can take.
1. Start tracking your cycle.
I recommend getting an app on your phone asap so you can begin to understand your own unique menstrual cycle. This process will be a lot less scary when you’re armed with the right knowledge. Remember, the pill has hijacked your hormonal function for as long as you’ve been on it so it’s important to develop a relationship with your hormones once they start to kick back in. This may take some time so a little love and patience with your body will go a long way 🙂
You’ll want to start by recording your first day of bleeding (your withdrawal bleed) which is also the first day of your cycle. You’ll also want to record any symptoms you experience throughout the month – emotional symptoms and physical ones too. If you’re feeling really motivated, I suggest taking your basal body temperature along with charting your cycle. This will help you pinpoint exactly when you actually ovulate again for the first time.
2. Liver detoxification.
The body eliminates toxins through your liver – it’s like your own personal garbage processing and disposal plant 🙂
Your liver also plays a massive role in helping your body rid itself of excess or harmful hormone metabolites so it’s crucial that you make sure it’s functioning at it’s best. Many women complain of horrible acne once they come off the pill and it’s likely due to poor phase 1 and/or phase 2 liver detoxification.
There are tons of ways you can detox but you want to make sure you’re doing it the right way. I suggest a food-based cleanse to start – it’s easy and gentle on the body. You can check out my Fix Your Period Cleanse 5-Day Reset as a place to start. It includes a shopping list, recipes, 5-day cleanse guide and a menu planner. I also include the different supplements to take to support yourself while cleansing.
One of those supplements is N-Acetyl Cysteine (NAC). It helps your body boost production of glutathione, a very powerful antioxidant and detoxifier. You might also want to try Di-Indole Methane (DIM) to help your liver break down harmful estrogens and produce more of the good estrogens.
3. Address your stress. For reals.
This is by far the most daunting of them all isn’t it? Many of us make commitments to address our stressful lifestyles but it’s a hard commitment to keep. It’s certainly something I continue to grapple with, especially as a business owner. While there isn’t any clinical evidence that oral contraceptives impact our adrenal health, there is lots of evidence showing that worn out adrenals are connected to hormonal imbalances.
You simply can’t fulfill your goals and live your purpose if you’re dealing with adrenal fatigue and feeling chronically exhausted. So, you have to make a decision – are you okay with the status quo or do you want to feel good enough to actually live and enjoy your life.
As you can see, there are a number of factors to consider when coming off the birth control pill. You’ve got to nail down the basics like diet, supplementation, detoxification and stress management in order to ease the transition. Hopefully this list is a good starting point for you.