Have you been thinking about discontinuing your hormonal contraception/birth control method(s) soon? If so, you may be wondering how to go about it.
Stopping birth control is a decision that some women make when they’re ready, and it’s not always an easy decision. Each woman knows her body best, and using the synthetic hormones that are in contraceptive methods doesn’t always fit with long-term plans for better health. Even if you’ve been on birth control for years, there may come a time when you wonder whether the prescription is still right for you. Birth control, especially when started at a young age, can also mask underlying hormonal imbalances or reproductive health symptoms that you might now be ready to address and seek treatment for.
Common reasons women decide to discontinue hormonal birth control methods include:
- To find relief from side effects that are potentially related to synthetic hormones circulating in the body, such as: weight gain, mood changes including anxiety and depression, nausea, headaches, or acne to name a few
- A desire to practice NFA (Natural Fertility Awareness) methods which require tracking of a naturally occurring menstrual cycle and ovulation
- Trying to conceive
- Wanting a return to the body’s natural hormones and monthly cycle to support both physical and mental-emotional health.
Birth control that women typically use includes:
- Birth control pills — either a combination pill of synthetic estrogen and progestin, or a progesterone-only “mini pill”
- Hormonal IUDs — aka intrauterine devices, such as Mirena or Kyleena
- Nexplanon – or a different brand name for the hormone-releasing arm implant
Typical questions that come up for patients as they are thinking about stopping birth control include: What will happen to my body’s own production of hormones afterward? When will my period normalize? What types of symptoms may come up while my body detoxifies and comes off the synthetic hormones? Will monthly ovulation return on its own? Should I seek treatment to help balance my hormones, and if so – when?
Let’s talk a little bit about what happens in your body when you’re on birth control versus when you’re coming off it. Synthetic hormones in birth control prescriptions introduce changes to the body’s own natural production of hormones — suppressing them in many cases and driving them toward low levels. If there is bleeding that resembles a period while you’re on hormonal birth control, it’s not a true period or a natural cycle. It’s withdrawal bleeding that the prescription allows, for example on hormone-free days if you’re on the pill.
Endogenous hormones – in other words, the naturally occurring hormones that your body makes on its own — start to increase again after you stop birth control. Overall, that’s a positive change for your body’s health and monthly cycle. However, it may take time to establish hormone balance.
Some hormones may measure low at first, for example progesterone that is released during ovulation; others may show a rebound effect by increasing excessively such as testosterone and DHEA; and there may be imbalances between hormones such as estrogen and progesterone. Cortisol levels are also important to consider, as they are often affected by taking hormonal birth control (more on that later in the recommendations section). Cortisol is the important hormone that helps your body manage stress, mediates the immune system response, provides energy throughout the day, and balances mood.
The exact state hormones may be in after stopping hormonal birth control is hard to predict because each woman’s health and cycle is unique to her and contraception methods differ chemically by type. The body’s hormone levels also change the more time you spend off hormonal birth control.
For some women, monthly periods start up again within 2-3 months after discontinuing birth control, but for others it can take upward of 6 months or longer for periods to return. Monthly ovulation may also be inconsistent at first. Typical symptoms that can surface as your body adjusts hormonally include fatigue, acne, irregular periods, heavy and painful cycles, mood changes, nausea, and headaches.
If you’ve already made the decision to discontinue birth control pills or get an IUD or hormonal arm implant removed, you can prepare ahead of time for the upcoming hormonal shift. You can also get hormones tested 3 months after you’ve stopped using hormonal birth control.
Keep in mind, your body already has a natural ability to start balancing itself after you stop birth control. Simple natural therapies and lifestyle measures, however, can ease the ups and downs that hormones are likely to go through and lessen concerns around these shifts. Preparing ahead of time may also shorten how long it takes for hormones to find balance in the body and help prevent or reduce severity of symptoms related to hormone changes.
First, let’s talk about simple and affordable balancing steps you can take if you’re still a couple of months away from discontinuing hormonal contraception. These steps can help you feel confident in supporting your body through the transition.
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Fiber, Probiotics, and Water – Hormones, whether synthetic like those found in birth control or natural like those made by the body, are eventually detoxified from the body after they’ve already been processed and used. Your digestive system including the liver help perform this important function. Knowing that you’ll have synthetic hormones to cleanse from the body after stopping birth control means that supporting digestion and liver detoxification will come in handy. You can incorporate food-based fiber into your diet or take a gentle fiber supplement to help encourage regularity. In addition, it can be helpful to take a probiotic and make sure to drink plenty of water.
Exercise – There’s no discussion about health that doesn’t involve exercise, it seems. And for good reason. Exercise naturally helps support metabolism, detoxification, and hormone balancing. It keeps the body feeling strong and resilient, helps prevent digestion from getting sluggish, and improves mood. It encourages us to keep the body hydrated, improves circulation, and reduces stress. It also helps boost the immune system, as long as it’s not overdone. All the benefits of exercise will help offset how much you experience hormone shifts from coming off birth control, and they will also support your body’s balancing act as its own hormone production kicks in. If you don’t have a current routine, you can start out with 20-30 minutes of exercise 2-3 times per week at minimum. Or you can shoot for 10 minutes every day or on most days (at minimum). Incorporate cardio and light weights, stretch, and hydrate. Your monthly cycle will thank you as it returns to its own rhythm!
Moderation with sugar, alcohol, caffeine – If you think about it, your body’s detoxification organs will have plenty to deal with as they start to clear out synthetic hormones from birth control. During that time — and if you have the opportunity, a couple months beforehand — it’s not a bad idea to practice moderation with sugar, caffeine, and alcohol intake. There’s no need to have a cold turkey moment in any of these departments (unless you’ve been wanting to change extreme habits for a while and prefer complete avoidance). Oftentimes moderation and having a limit is enough to help clear the way for your body to focus on detoxing synthetic hormones. Try to avoid yo-yo diets, overly restrictive eating habits, or starting up a huge “return to health” regimen around this time. Your body will have enough on its plate coming off birth control that new and extreme measures may feel like too much to handle physically. Gradually introducing new lifestyle habits into your routine works better for consistency and long-term health.
Phytoestrogens – Flax seeds and edamame are just a couple of foods that contain phytoestrogens, which are estrogen-like compounds that come from plants. Incorporating these foods into your diet 1-2 months before discontinuing birth control can help balance out the synthetic estrogen found in many contraceptive methods. Once you’ve stopped birth control, phytoestrogens may help reduce or alleviate potential symptoms that can arise such as headaches, heavy and painful periods, and PMS.
Zinc, Magnesium, and Vitamin D – These basic nutrients support ovarian health and the immune system, and they may be helpful not only before the transition off birth control, but also afterward. They can be found as part of a multivitamin or taken separately at daily recommended doses.
Adrenal Support – Because hormonal birth control can take a toll on adrenal health and cortisol production (a hormone which helps your body deal with and manage stress), adding a supplement that contains an adaptogenic herb such as Ashwagandha may help prevent potential symptoms related to cortisol imbalance. Adaptogens strengthen and heal the adrenal glands to support stress management and overall recovery. Adrenal supplements are widely available for purchase, or you may choose to start up this treatment with the support of a naturopathic or functional medicine doctor after getting cortisol levels measured first.
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In conclusion, these 5 measures will not only help you prepare for the transition off birth control, but will also help you get reconnected with your health and body in general. Birth control serves its purpose as contraception, and sometimes women may turn to it for the only successful treatment they can find for symptoms such as severe acne and painful, heavy, or irregular periods. But birth control can also create a disconnect from physical and mental-emotional health. For those women who determine that hormonal birth control is not a good fit health-wise, discontinuing the prescription can get them reconnected to their bodies again.
Getting back in touch with your health prior to stopping hormonal birth control can help you embrace and welcome your own hormones back as they start to return.
Once you’ve stopped using hormonal contraception, it can be helpful to schedule an appointment with a naturopathic/functional medicine doctor to get more specific therapeutic recommendations based on your specific symptoms. You and your provider can also get a plan in place for hormone testing 3 months after you’ve stopped hormonal contraception. Within that time, your doctor can help you work on tracking cycles accurately for more information about your monthly cycle, period, and ovulation.
If you’re ready to stop birth control immediately or have already done so (in other words, you don’t have a 2- or 3-month timeframe to prepare, or even 1-month), don’t worry! You can start these measures up now and they’ll still be helpful. And you can now start the 3-month countdown to getting your hormones measured with the help of a practitioner.
Please call or email us with any questions about how naturopathic medicine can help with the transition off birth control, or to schedule an appointment. We offer free 10-minute phone consultations if you’d like to learn more.