Coming Off The Pill and Hormonal Contraception
Coming off your pill? Put the right plan in place!
If you’ve been on the pill for years and you initially went on the pill to help support you with some imbalances in your cycle you want to have a read of this post. I’m going to outline:
# Some of the known side effects from being on hormonal contraception like the pill
# Some of the most common side effects women experience when they come off the pill
# How you can navigate coming off the pill so that your body comes back into balance as quickly as possible. Including a check list you want to cover before coming off.
Is it possible that the pill is causing my anxiety and depression?
A question I’ve been asked a fair bit. For good reason if you type into google side effects for any hormone based contraceptive you will see that many of them include on the list, changes in mood, sleep, libido, and fatigue.
Worth noting that this is not limited to just oral contraception but also extends to IUD’s (intrauterine devices) some of which also use hormones to make them effective at preventing pregnancy.
Not a bad idea to look into the side effects of any medications before you start taking them so that you can monitor your physical and mental state as well as any changes once you start the medication.
While the physical side effects of weight gain or acne are easily identified as a factor the psychological changes can easily be dismissed as something else all together.
So maybe you want off the hormonal contraceptives, you might be thinking of starting a family or feel it’s not the choice for your health, here are some things you might want to consider…
Coming off the Pill
There is often the expectation that you’ll stop taking the hormonal contraception and everything will return back to normal. Your cycles will be regular and there will be little to no impact on your over all health?
And for some women this may well be the case.
However many of my clients find that the journey off the pill is a little more complicated than the journey onto the hormonal contraception. With a whole host of unexpected challenges. So let’s jump right in!
Checklist before coming off the pill:
#1 Alternative contraception
If you wanna play safe after coming off the pill, consider taking an alternative contraception that is non-hormonal such as condoms, diaphragms and cervical caps or copper IUD’s. This post is not here to delve into the alternatives, but if you’re not planning on starting a family please have a plan as to what you’ll do to avoid a pregnancy.
#2 Pill bleeds are not periods
Your period is not necessarily a period during the pill. So, you must first understand that you are not ovulating during this period. Your cycle will likely take some time to return back to a normal rhythm after coming off the pill and this time frame will vary for each person.
Also worth noting here is that the pill can often mask existing reproductive issues. Once you come off the hormonal contraception the symptoms of any underlying condition may appear. It’s best to discuss your plans of coming off with your health practitioners, so that you have support in navigating any issues.
If you’re planning to fall pregnant please give yourself ample time to come off the pill before you expect to start trying.
#3 Testing before coming off
Having your general pathology testing and health screens done before coming off your hormonal birth control can be helpful, please discuss this with your health practitioners. Looking at things like, liver function, nutrient status like iron, B12 and others as well as inflammatory markers, could be a good idea as having this benchmark is helpful should you struggle when coming off.
Side effects when coming off the pill:
Okay so lets look at some of the most common complaints I hear when my ladies are coming off hormonal birth control…
#1 Hair Loss
Once you stop taking the pill, hormonal withdrawals can happen and this can cause hair to fall out or to start thinning. It takes about 3 to 6 months for it to stop. However, hair loss does not happen in many cases. There are herbal medicines that you can start taking months before coming off to help slow or prevent this from happening. Ask your naturopath if you’re a good candidate for them.
#2 Acne
Coming off the pill, your body is being called on to find it’s own hormonal balance in the absence of the synthetic hormones which have suppressed many of your natural hormones and this can lead to acne breakouts. It takes some time for the hormones to balance out and again this is where herbal medicine shines in helping to speed this process along.
#3 Fluctuations in Weight
After coming off the hormonal contraception, the fluctuations in hormones may lead to cravings and a tendency to eat more leading to gain weight. Water retention may also be an issue. There is also the potential for a PCOS picture which was somewhat masked by the synthetic hormones and being a metabolic syndrome you may find you’re eating the same amount but still gaining weight. Please seek out support with this one as it’s a complex picture that needs to be addressed with proper care.
#4 Period irregularities
Your period is greatly affected by the stop. You may find you skip your periods at times and may have irregular cycles, strange bleeds and spotting. The body has to adjust to the change and this takes time, there are several herbs and supplements which can help to speed this process along.
The list above is a short one of the most common complaints I receive at the natural health clinic, it can be a slow slog back to a balanced cycle for many women and it’s important that you try not to allow yourself to be disheartened. Please know that the body is amazing it will find balance we just need to help it along a little.
Some women first go on the pill to resolve an existing hormonal issue and find that when they come off the pill it’s still there. As prescribing the pill for endometriosis and PCOS is fairly common. Please note that it’s likely that the synthetic hormones are simply masking the symptoms and not resolving the imbalance in the first place. You may need to work with the original health condition once coming off the pill.
I’ve written an article on natural health care for PCOS here and for Endometriosis here.
How to Get My Period Back?
To make things clear, the period you get on birth control is not a real period. A real period involves ovulation wherein you can get pregnant. Coming off the pill every woman experience is different as so it may take time for your body to adjust and ovulate again. For some women it can take up to 12 months before you get your period back and regular. For others it can come back within 3 months of ceasing the hormones.
If you want a family please consider giving yourself the luxury of time and plan to come off sooner rather than later.
Ask yourself this… How long did you cycle for before you went on the pill? What were your natural cycles like?
#1 Normal periods
If you had normal periods before birth control…
If you don’t get you period after 3 months coming off the pill, consider getting a blood test for your FSH, LH, prolactin, androgens, thyroid, and insulin levels to check how your hormone levels are tracking. Why not check these right away you ask?
Generally it’s around that 3 month mark post pill withdrawal when you’ll get clearer readings on the hormones.
#2 Irregular periods
If you didn’t have a regular period before the going on the pill.
Prior to coming off the pill, test the following levels — Insulin, thyroid, prolactin, Vitamin D you can test these while still on the pill. Expect that periods might not return for a while.
There are several supplements such as magnesium, Zinc and Vitamin D that can be taken before coming off the pill to help balance the hormones. This should be assessed on a case by case basis.
#3 If you were acne prone
A fairly common reason for women going onto the pill is skin complaints.
Treat acne for 1-2 months before stopping birth control. Acne may return, but hopefully less than before, generally if you experience a flare up of acne it should peak around 6 months off birth control.
Cleaning up your diet prior to coming off is key for supporting with acne.
There are many nutrients and herbs that can help with balancing your skin see your naturopath for more guidance.
#4 Heavy bleeding or period pain before the pill
Before coming off the pill this time, consider seeing a doctor to investigate fibroids or endometriosis. Test your thyroid, insulin and iron levels as well. Expect that heavy and painful periods may return after coming off the pill. Consume foods rich in iron, turmeric, zinc and practice a dairy-free diet.
Overall, waiting for your period to come differs for each one of us. It largely depends on your history and lifestyle, and choice of contraception and length and well you get the picture, it’s complex.
Waiting for ovulation, remember the following…
It is possible to fall pregnant without ever seeing a period. This one has caught a few of my ladies off guard unfortunately so please just because you haven’t had a period doesn’t mean you can’t fall pregnant. First 3-6 months of coming off the pill please don’t rely solely on timing methods for contraception.
Herbal Medicines to Help Acne
Acne can be a complex picture with several contributing factors.
There may be hormonal imbalances contributing to the acne, as well as dietary factors.
Please address the following in your diet before coming off the pill, eat foods that have a low glycemic index.
Skin should be supported both externally and internally.
Some herbs help eliminate acne-causing bacteria and inflammation, and heal blemishes.
Herbal medicine that we commonly use in treating acne:
Tea tree
Witch Hazel
Aloe Vera
Neem
Manjistha
Lavender
Rosemary
An individualised approach to acne is key figuring out the type of acne which will then dictate the right approach and nutraceuticals.
Women’s Health Naturopath
As women we experience our cycles to keep us in tune with our environment, and learning to connect with these cycles is a part of the process of coming off the pill. Listening to your symptoms and responding to them with patients is key.
Taking time out to move your body through gentle yoga or breathing exercises can be helpful for reconnecting and also reducing stress. To find out more about how stress impacts your reproductive system check out this post.
Considering organising the support you need before you stop the hormonal birth control. Seek advice from your doctor and naturopath.
If you need some help putting together a plan to keep you as balanced as possible during your transition and beyond please fill out the form below and I’ll get back to you as soon as possible.
Alternatively you can find out more about the online natural health consultations here.