How to Transition off Hormonal Birth Control

Birth Control is indeed a prescription written by a doctor, so before you make any decisions, please consult with your doctor!

If you’ve spoken with your doctor, here are some of the basic things you may want to consider BEFORE / DURING you come off hormonal BC (information paraphrased from “Period Repair Manual” and “Hormone Cure”):

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 just quit right when I finished the pack…

Here are my recommendations before coming off the pill…

These suggestions should be reviewed with your doctor, but are meant to help 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. We 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 varying, you bleed for a very short of period of time, there’s a shortened luteal phase, or there’s no ovulation. 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. We recommend this supplement as well – Pure Encapsulations Zinc 30mg.

=>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. Support your Gut health

Here is one of the best gut health supplements on the market: RESTORE. It helps bind pesticides, gluten, and other inflammatory molecules so that they do not wreck havoc on your gut lining. The less inflammation to your gut lining, the less dysbiosis of gut bacteria, and the less risk of autoimmunity and food sensitivities.

4. 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 the pill alters gut function by messing with your gut flora.

The problem is that altered gut flora will in turn affect hormone regulation and neuro-chemistry so it’s extremely important to get your guts back on track. While the solution can vary, we recommend probiotic-rich foods as a starting point – sauerkraut, kimchi, other fermented vegetables, kombucha, and kefir. You can also try taking probiotics like Hyperbiotics PRO-15.

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.

5. Get your Sun

The best way to get vitamin D is through sun exposure. You should expose your face, hands and arms to the sun, three or more times a week, for 10-20 minutes, depending on your skin, the season, and the distance from the Equator. The best time of day for this is between 10am-2pm. Most importantly, this exposure to the sun should be without sunscreen, as sunscreen interferes with the production of Vitamin D.

In addition, you can supplement. You should work with a skilled practitioner who can test and retest you three months after you begin supplementing. You may also want to follow the Vitamin D Council’s recommendation: If you are deficient, then they recommend 1000IU per 25lbs of body weight daily. If you weigh 125lbs, you’ll take 5000IU a day.

Make sure if you buy supplements that they contain vitamin D3 and not D2 which actually does not raise blood levels of vitamin D. In addition, vitamin K2 is needed to prevent vitamin D toxicity, so your supplement should contain K2 or you should eat fermented foods that are rich in K2. Think sauerkraut.

If you choose to supplement, we recommend Vitamin D3 + K2 5,000 IU.

6. Focus on lots of healthy fats and protein.

You need fat and protein to build hormones. Period.  Make it your goal in life to get good quality fat and protein into each meal or as many meals as you can. We 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 at each meal.

7. Start tracking your cycle.

We 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. I use the GLOW app.

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 fertility signs (check out this article to learn how). This will help you pinpoint exactly when you actually ovulate again for the first time.

Then depending on what happens the next 3-4 months, we can personalize your recovery plan. We typically see 2 cluster of symptoms after coming off hormonal BC (if you don’t fall ito any particular category, let us know and would be happy to help you).

A. Super heavy/crampy period/excessive water weight gain:

Typically could mean excess estrogen / low progesterone:

Obviously, numbers 1-7 above continue to apply but there are some more steps you can take.

1. 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.

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. And finally, Milk Thistle which enhances the liver’s ability to remove excess estrogen from the liver.

DIM (promotes conjugation and detoxification of estrogen) – this product contains a lot more of the liver detoxifying herbs and amino acids as well!
Tumeric (reduces inflammation and reduces estrogen by blocking an enzyme called aromatase)
Progesterone oil (reduces thickness of uterine lining)

2. Address your stress.

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.

3. Bio-identical Progesterone.

Progesterone is important for your overall sense of equilibrium or well being. It raises body temperature (making it thermogenic and a boost to metabolism) and helps your thyroid perform efficiently. It is a natural diuretic, which means it helps you release excess fluid in your body. Progesterone also stimulates something called GABA receptors (GABA has sedative qualities) so you feel relaxed and calm. Progesterone is made from pregnenolone, the main prehormone. Progesterone is thus a pre-hormone of cortisol. And as you know, you are stressed, your adrenal glands make a whole lot of cortisol. So what ends up happening is that your body will steal from your supply of progesterone by shunting pregnenalone so that it can make more cortisol. Cortisol also blocks progesterone receptors causing your mood to worsen, excess fluid retention, increases anxiousness, and breast tenderness, particularly before you period.

If reducing stress still hasn’t resulted in an increase in progesterone, you can try bio-identical progesterone on Day 14-28 to stimulate the production of progesterone.



B. Really light/normal period with acne/oily skin:

Typically could mean high androgen/testosterone and PCOS

1. Get Your Blood Tested
You may have PCOS – if so, we reccomend you order a DUTCH test along with a sex hormone and blood chemistry panel which will show at least one of the following:

-High androgens (testosterone, androstenedione or DHEA)
-Low Sex Hormone Binding Globulin (SHBG)
-High Luteinizing Hormone (LH)

2. You May be Insulin Resistant

The most common reason for PCOS is an underlying problem with insulin and leptin. Together the two hormones regulate blood sugar and appetite. They also can effect your female hormones. In the case of PCOS, you are NOT sensitive to insulin and leptin. You are RESISTANT to them, which means that you cannot respond to them properly. Insulin cannot tell our cells to take up glucose for energy (so it converts glucose to fat instead) and leptin cannot tell your hypothalamus to suppress appetite so you feel hungry all the time.

A blood test will show high insulin if you have insulin resistance and high leptin if you have leptin resistance. The biggest causes of these resistances are sugar, smoking, trans fat, birth control pill, stress, sleep deprivation, magnesium deficiency, and environmental toxins. Too much insulin impairs ovulation and causes your ovaries to make androgens instead of estradiol. It also stimulates the ovaries to make too much LH (which further stimulates androgens). And finally, too much insulin reduces SHBG thereby liberating too much free testosterone.

First thing to do is eliminate the sugar! No more desserts, snacks, fruit juices, pop, etc.

Along with all the supplements listed in Steps 1-7 above,

Alpha-lipoic acid -300-600 mg / day
Inositol -300-600 mg twice / day
NAC 1200 mg / day

3. Your testosterone is extra androgenic

Testosterone increases sebum production and therefore worsens acne. The enzyme 5α-reductase catalyzes the formation of DHT from testosterone in certain tissues. Relative to testosterone, DHT is considerably more potent as an agonist of the androgen receptor (AR). In order to inhibit this formation, the following supplement can be used to relieve symptoms of excess hair growth, cystic acne, and male pattern baldness (to name a few):

Saw Palmetto / Stinging Nettle / Pumpkin Seed

We hope you learned a little about what happens to the body post birth control and hot to go about easing symptoms and bringing your body back to balance. Let us know if you have any questions!

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