How to Come Off Hormonal Birth Control

how to come off birth controlYou’re ready. You suspect that hormonal birth control is no longer right for your body and you have a sinking feeling it never was.

You have a few questions about the process of coming off birth control. What will happen to your skin? Will you get your period? Which natural treatments can you use to make it all go as smoothly as possible?

I can’t offer you a one-size-fits-all list of recommendations for “coming off the pill”. But I can tell you what I would do if you were my patient.

I would first ask what your periods were like before you took birth control. I’m not talking about your pill bleeds—because they’re not periods.  I’m talking about your real periods—the ones you had ten years ago before you started the pill. For example, were your real periods regular? Were they heavy or painful? Did your skin break out? Because those problems have not gone away. They have merely been masked by the pill, and they are about to re-emerge.

Your plan is to address those pre-pill problems. Let’s look at four scenarios.

Plan A. You had normal periods before

Is this you? You had regular periods before you took birth control, and they returned the last time you had a break from birth control.

The plan: This is the simple plan. Just stop the pill (or ring or implant or injection), and see what happens. Chances are, you’re going to be fine. You might experience some mild acne or anxiety as you withdraw from synthetic estrogen, but it shouldn’t be too bad, and it shouldn’t last longer than three months.

Your goal is to ovulate regularly so you can make hormones and have a regular period. If you don’t ovulate after three months, then consider an ovulation-stimulating herb such as vitex. You might also want to talk to your doctor about blood tests for hormones such as FSH, LH, prolactin, and androgens. For details about testing, please see Chapter 7 of Period Repair Manual.

👉 Tip: When it comes to period health, it’s all about ovulation because ovulation is how you make your beneficial hormones estrogen and progesterone.

Plan B. You had irregular periods before

Is this you? You had irregular periods or no periods either before you took birth control or the last time you tried to stop.

The plan: Before you stop birth control this time, ask your doctor why you didn’t have periods before. Did you have PCOS and insulin resistance? Or were you possibly not eating enough? Or did you have a nutrient deficiency that prevented periods? A simple question for your doctor:

What was the problem with my periods back then?

Your doctor might say PCOS, but that’s not a complete diagnosis. Look deeper to find the real underlying cause. See The 4 types of PCOS.

Ask to see your old blood tests because they may reveal some clues. For example, was your thyroid tested? Was it optimal? Was your insulin tested? Then ask for new blood tests. You can’t test female hormones while you’re still on the Pill, but you can test for other things such as insulin, thyroid, vitamin D, and gluten sensitivity. (All those things affect periods.)

Identify a possible underlying problem, and then start treatment before you stop birth control. You’re removing obstacles to ovulation. You’re doing it now before you actually try to ovulate. For example, if you have insulin resistance, then work to reverse that driver. If you have a thyroid problem, then remove gluten from your diet. If you have been too restrictive with your diet, then eat more fat, protein, and starch. It’s hard to have a period without those foods.

Once you’ve made those changes, you’re ready to stop hormonal birth control. You might be pleasantly surprised at how well things go this time. Your body is different than it was before.

👉 Tip: Give yourself at least three months off hormonal birth control before you try an ovulation-stimulating herb such as Vitex or peonyIf no period by six months, then see your doctor.

Plan C. You had acne before

Is this you? Acne is why you went on the pill, and it’s why you’ve retreated back to it. Contraceptive drugs can clear skin, but that’s because they strongly suppress skin oils. The problem is your skin simply compensates by making more oil, so when you stop birth control, your skin will be even oilier than before you started.

The plan: Start natural acne treatment at least one month before you stop hormonal birth control. That way, the treatments have a chance to work before the peak of your post-pill acne about three months after stopping synthetic estrogen.

Best acne treatments are 1) a sugar-free, dairy-free diet, 2) zinc, and 3) the herbal medicine berberine. You can also consider diindolylmethane or DIM, which is a phytonutrient from broccoli extract. DIM works for acne—not because it detoxifies estrogen (it also does that)—but because it blocks androgen receptors. Read How to prevent and treat post-pill acne.

Plan D. You had heavy bleeding and/or period pain

Is this you? Your period was frightening when you weren’t on hormonal birth control. It was heavy and/or painful, and you are understandably a little reluctant to come off.

You’re right to be worried. If you had difficult periods before the pill, then you will probably have them again when you stop. Remember, pill bleeds are not periods, so you can’t count those. If you had heavy periods as a teenager, then you might have outgrown that problem.

The Plan: If you haven’t already done so, please see your doctor to identify an underlying condition such as fibroids or endometriosis. If you do have an underlying gynecological condition, you may still be able to come off the pill, but it will be a little more complicated.

If you don’t have an underlying gynecological condition, then your heavy bleeding is from estrogen excess. You can promote healthy estrogen metabolism by reducing alcohol, maintaining healthy intestinal bacteria, and taking nutritional supplements such as DIM, calcium d-glucarate, and iodine.

Reduce inflammation by avoiding inflammatory foods such as dairy and taking anti-inflammatory supplements such as turmeric. The combination of a dairy-free diet and turmeric works wonders for heavy periods and period pain.

And iron supplements lighten periods.

For more information, please see my book Period Repair Manual.

Better birth control

Alternative methods of avoiding pregnancy include the Daysy fertility tracking device, fertility awareness-based methods, copper IUD, condoms, and the cervical cap.

84 thoughts on “How to Come Off Hormonal Birth Control”

  1. Hi Lara,

    I came off birth control three weeks ago because A) my hair has definitely lost it’s curl and it’s thinner, and B) it’s not good for your body. My question is this: if I’ve already started ovulating, will that help keep away telogen effluvium due to stopping the pill? My hair is already so thin, so I’m worried that telogen effluvium would make it absolutely awful.

    Thanks for your advice!

  2. I am so pleased to find your blog! I’m trying to find the right treatments/supplements to control heavy bleeding. I’m keen to avoid a hysterectomy which doctors recommend. Before having a levongesterol releasing IUD I had heavy but regular bleeding, and a medium-sized fibroid. On the IUD the bleeding was worse – unpredictable, flooding, clots sometimes the size of a tennis ball – and after six months I had it removed. Fibroid is now very large. Now, free of artificial hormones for six weeks, I have had ten days of extremely heavy bleeding (as distinct from the immediate withdrawal bleed), noticeably worse than my pre-artificial hormone periods. I hope this is simply my body trying to find its own rhythm again. Is it possible to know how many months it might take to normalize? And in the process would agnus castus (vitex) help, as well as the estrogen-inhibitors you list? Very many thanks in advance for your response.

    • Honestly, I don’t think vitex will help. The estrogen inhibitors might help a little but you need some serious treatment. Don’t let it get too bad. Please see my Heavy Period post and Chapter 9 of my book.

      • Very many thanks for taking the trouble to reply. As I indicated, pre artificial hormone my cycles had inconvenient moments but I could live with it. It’s only since the IUD that life became really very difficult. I’d hate to think that I need a hysterectomy purely because of an IUD and the mess it’s made! I have read your Heavy Period post, and will buy your book. I’m not sure what you mean by serious treatment, can you say? – I’m certainly prepared to give anything a go that isn’t surgery. Thank you again.

        • I mean dairy-free diet, turmeric, and maybe high dose natural progesterone capsules. Also, figure out if you’re insulin resistant or not, because that can worsen heavy periods.

          • Thanks again for your reply! I know I am not insulin resistant (having had recent bloods because of anaemia), and I will begin dairy-free and look into natural progesterone. Turmeric I’ve been taking for three weeks already. I will also pile on DIM, iodine, magnesium – assuming that all this can be taken together. The IUD was there for six months, and my aim is to be back to where I started in fewer months than that! Having found your tremendous blog I am much more confident that I will get there.

          • You’ll also probably need iron.

            Please be careful. Don’t let it get too bad because heavy bleeding can be quite serious.

          • I have had iron pills prescribed for four months now, to make sure my anaemia doesn’t return. Thanks so much for your comments – I will certainly recommend your blog to my perimenopausal friends here in London!

  3. Hi Lara,
    I just turned 24 and I’ve been taking the pill for 6 years. After 3 years my cycles got irregular, bleading 2 or 3 times a month and none in the next one. So my doctor recommended a 3 months pause. After another 3 years, the same thing happened and I decided to stop the pill for good.
    It’s been 2 months know, and I’ trying to make this transition as healthy and easy as possible. I just bought your book to help me get through it.
    But I’m uncertain about how to evaluate my periods before the pill, since I was still a teenager and know I’m an adult. Should I consider they will be just about the same?
    I keep thinking my body and hormones will not be the same since I’m not a teen anymore. For example, I used to have strong PMS, and so far I didn’t feel any. But I’m not sure I already ovulated, as I am also trying symptothermal control and my temperatures are not keeping higher during my luteal phase.
    You think I should consider my teenage periods characteristics to plan better ways to make my transition easier?

    Thanks for all the information you bring!

  4. Hi Dr. Briden,
    I have been on the birth control, Mononessa for almost a year now. I originally went on it to control my acne, but I have also lost a lot weight on the pill. I went from around 115-120 to now 105 pounds. I am very scared I will gain the weight back or more, as well as the acne. Do you know how I can maintain this weight loss? Or why the birth control caused me to lose this weight?
    Thanks for sharing your knowledge

  5. Hi Lara,

    I removed my IUD over 1.5 years ago and have been having irregular bleeding ever since. I have read your book which I found so informative. My hormone levels were checked and are all normal and no polyps but I was diagnosed with cervical erosion. The treatment they are offering me is a cervical freeze but I have been wanting to get pregnant ever since and would not want to lower my chance to succeed with this procedure. Do you have any natural ways to treat cervical erosion?

  6. Dear Lara,

    Thanks for your blog. I really appreciate the chance to get the kinds of information about my body which gynaecologists can’t seem to provide.

    I have PCOS and recently decided I would come off the pill. While still taking the pill over the last month, I followed your advice to start taking magnesium supplements, as well as zinc, fish oil capsules and a probiotic. I got these from Dr Marilyn Glenville’s Naturopathic Practice in the UK – they were much more expensive than the varieties available in shops. Now I’m having the pill withdrawal bleed but the bleeding is much, much heavier than the light spotting I would get before I took the supplements. I’m very curious – can you explain whether is a connection between the two?

    Thanks again,

    • Hi Lisa,
      Was there anything else different this month such as antibiotics? The state of intestinal bacteria can change rate at which the Pill’s synthetic estrogen is cleared, therefore causing more estrogen exposure and heavier bleed. In theory, a probiotic could do something similar, but I’ve never seen it with my patients.
      Bear in mind that your coming periods will be very different from your pill bleed anyway.

      • Hi Lara, no antibiotics, but I did have a bout of gastroenteritis about a month ago (before the previous pill bleed). Afterwards I felt really low, both physically and emotionally. I hoped that the magnesium supplements etc would help to bring me back into balance, and thought that coming off the pill at that point might be too drastic.

  7. Dear Lara,
    I have been diagnosed with pcos recently and since then I have been trying to understand and learn as much as I can about it and I found your website to be very helpful so thank you very much!

    I honestly have still a lot of questions though with regard to what my options are… and in particular I am very dubious about what type of pcos I have.

    I would really appreciate some advise on that if you could! To give you some infos I have always had very regular periods (some of them very painful). I never thought I had any type of problem with my ovulation till last summer when I went to see a doctor because I was losing a lot of hair and I had some acne, so after that I found out I have some cysts in my ovaries and of course some of my values were not right (my FSH and my LH were very low (1,9 and 5,2 mU/ml), the delta4 -androstenedione was high, and my fibrinogeno was low). Since I was leaving for a pretty long time abroad my gyno just prescribed me yaz and I have been taking it from last summer (and I gained weight).
    I am overweight so I kinda thought I would fall in the first category but my values for insulin, cholesterol and everything else is perfect (just low iron) so I really am not sure what I should do. Of course I am trying to lose some weight by avoiding sugar and limiting carbs and doing some exercise, I also switched from normal milk to coconut milk and I have recently started avoiding all gluten products thinking that may be one of the causes.

    I don’t like taking the pill (I was feeling way better before starting it, both physically and emotionally) and I am trying to find some healthier alternatives. I would really appreciate any advise you may have and thanks again for your website, I have understood myself a lot better since I discovered it.


    • Hi Valeria, High androstenedione usually indicates the Type 3 inflammatory type of PCOS, but I would query in your case whether that is the whole story. It sounds like hair loss was your first and main symptom (and also acne). Your really should have had a thyroid test. Was that done?

      • Thank you for your answer!
        Yes, I also have some acne and some unwanted hairs and my periods at times were very painful but my biggest concern at the time was about my hair.
        Except for those symptoms and some overweight I have always been perfectly healthy… and I have not really done that many analysis in my life honestly. I do not think I ever tested my thyroid so I will do that as soon as I can 🙂

        • Dear Lara,
          I was able to test my thyroid and my insulin properly only a couple days ago and well… it looks like I am perfectly fine. All my values are perfect.
          Also, I stayed away from gluten and milk for about 3 weeks and noticed absolutely nothing different so i am now back at the starting point. 🙁

          Any tip would be very appreciated! thanks

          • Hi Valeria, do you mean that your hair loss didn’t improve after 3 weeks on the diet changes? It will take much longer than that. Did your doctor test “thyroid antibodies”?

          • I have been tested for the TSH and that was ok.

            I will try again with the change with gluten for a longer time and see if there is any change but since I started the pill my hair/acne situation got a bit better already…
            Thanks Lara

  8. Hi Lara – I’m going to the Ancestral Health Symposium in Queenstown in October, so I look forward to meeting you!

    I went off the pill in April 2014 after being on it for 10 solid years with no breaks, and started menstruating basically as soon as I did that and had a copper IUD inserted. About 6 months after that, I had all of my sex hormones tested for a baseline (none done prior to this). My estrogen came back high (this was a salivary test), and FSH low (bloods were taken around day 22/23 of my cycle). Since going off the pill, my periods have been getting progressively more painful and heavy, despite my largely ancestrally-aligned diet (although I do still have dairy as it’s such good quality in NZ).

    My skin has also started behaving like I’m 16 again – though this issue never resolved with the pill, but did go away for a while in my early 20s). My question is, what gives?! Is there something obvious I am missing?

    Thanks for your input!


    • Hi Jenna,

      Thanks for your comment.

      With heavy and painful periods, I always think about dairy (if you haven’t already, please see my What Dairy Does to Periods post). If dairy (A1 casein) is inflammatory for you, then it doesn’t matter that it’s “good quality” or organic.

      I look forward to meeting you in October!

  9. PS: I did not mention the fact that I have very regular cycles (26 days), I ovulate, I do not have PCOs, and I had my thyroid checked a couple of times (blood tests) and I do not have any problems apparently. A dermatologist told me that I had slight femal baldness pattern but explained at the same time that it was a very natural process due to aging (uh?). Anyway, no one can tell me what is wrong with hair and yet it all started when coming off the pill (Diane 35).

  10. Hi Lara,
    I am 33 and I stopped the pill in January 2013. I had all sorts of terrible symptoms such as cystic acne (never had acne before taking the pill), hair loss, night sweats, mood swings, etc.
    After quite some time, the acne nearly disappeared. I still break out from time to time but it is nothing comparable to what I had after coming off the pill. What really helped was yarrow and more recently yarrow combined with vitex.
    The only problem is that although my skin is ok now I am still loosing a lot of hair. I thought things were getting better but it recently starting falling again. I am desperate. I used to have long beautiful curly hair that everyone complimented. Now it is so brittle, dry and so thin. You can even see through it! It looks like I have menopause (which I don’t given my age).

    I have been taking all sorts of things to help it grow back: vitamins, cystine B6, iron, brewer yeast etc but nothing seems to help on the long run.

    According to you, why would my skin be ok now but not my hair? Those problems were connected to the same cause (coming off the pill). Progesterone-like plants obviously help my skin but could they be have a bad effect on my hair?

    Thanks you!

  11. Hi Lara! I’ve recently discovered your blog, and I love it! It seems like you are talking about everything affecting me right now! I have a couple questions about berberine, which I want to take for its purported benefits for “sealing” the gut, lowering insulin sensitivity, lowering androgens, and acne. First: Is berberine extract more effective than an herb containing it, such as goldenseal? I ask because goldenseal is less expensive and more widely available. Second: Should one be taking probiotics while taking berberine/goldenseal? Especially if you have leaky gut? I have read that while it kills bad bacteria, it may also be killing the good? Thanks in advance for your response and for your wonderfully informative and concise blog!

    • It should be as effective to use goldenseal as berberine extract (typically from Phellodendron), but take care you the buy a sustainably sourced product, as goldenseal is an endangered herb in some parts of the world.

      Yes, I am cautious about the potential for berberine to damage good bacteria. That’s why I recommend regular breaks from the herb, and yes, I often do combine or intersperse with probiotics. (Don’t take at exactly the same time, but different times of day should be ok)

      • Thank you so much for your answer, very helpful! Please keep blogging and informing everyone 🙂

  12. Hey Lara! I bought your book right when it came out off amazon & loved it!! I wanted to share my story in case someone out there is struggling like I was 🙂

    I got off birth control pills 1.5years ago & its been quite the journey to get my cycles back!

    I was “diagnosed” with PCOS after not having a cycle the first 6 months off the pill (I’m 5’2, I weigh 105, have no excess body or facial hair, and have no insulin resistance) this was determined only by ultrasound, not by lab work!

    Months and months went by with worsening ovary pain from the cysts & I was beginning to believe I really might have PCOS…
    Fast forward to a year after getting off the pill & I was still not able to have my own cycles.
    I turned to a local naturopath that changed everything!

    After only 4 months of clean(ish) eating, supplementing on two weeks and off two weeks with progesterone cream, adding in fermented cod liver oil/butter oil blend daily, and taking Intact Digest before bed, my cycles have returned! (And with them my ovarian cysts pain has stopped entirely)

    I had my first REAL cycle last month & was over the moon to have a second one again this month!
    You were so correct in saying PCOS is a term thrown around loosely! My naturopath told me all my body was lacking was remembering how to make enough progesterone to get the cycles going…and sure enough she was correct. Even the slight acne I had appear as little bumps on my forehead have disappeared.

    I’m 25 & am getting married in just a few months. I’m so so thankful that I got off birth control pills when I did! We both want kids right away & im so thankful that this might actually be a possibility now. Thankyou so much for writing the period repair manual and giving me so much hope and encouragement that my cycles WOULD return! I hope this story gives others hope too 🙂

    • Hi Laura,
      thanks so much for sharing your story, and for your warm words about my book. I really appreciate the feedback.

  13. Hi Lara! Love your blog! I hope you can help. I stopped Nuvaring 2 years ago after many years to try to start a family. I thankfully continued with regular 28 day cycles, but horrible cystic acne set in. Was diagnosed with Insulin resistance and hypothyroidism, now on metformin and synthroid. Lost 20 lbs. In two years we’ve only conceived twice and both ended at 5 and 6 weeks. Tons of tests done, HSG, hysterscopy, etc. all clear. Just consulted with our second reproductive endocrinologist, and told we’re not infertile and to take progesterone starting CD 18 each month and just keep trying. Also found I had high prolactin, tested again, it went down but still on the high side. I’m going to be 35 this year and desperate for answers. I feel like it must be hormonal because of my IR and hypo. Will we ever conceive? Thank you!

    • hi Maggie, there are so many factors for achieving a healthy pregnancy. Sounds like you’re doing a lot of the right things. You want your thyroid function and insulin sensitivity to be as good as possible.

      Don’t forget about the male side of things. Even if your partner has been told normal sperm count or motility, you should also double check the semen analysis report for morphology or DNA fragmentation. Those are markers of genetic quality of sperm, and low or low-normal sperm morphology can lead to an early miscarriage like you describe. Fortunately, sperm quality responds very well to nutritional supplements. There are a number of male prenatal supplements on the market, and I think they are essential.

  14. Hi Lara!

    On your acne post, you recommend take berberine for 8 months with a month brake and then repeat the 8 week course.
    However, on a post for “The Love Vitamin”, you recommend “taking it six days per week (one day break), and stopping it for one month after three month’s use”.
    I wonder which of the two approaches is the best.
    Thanks in advance.

  15. Lara, are you anti or pro vaccine? Would vaccines actually be helpful if they didn’t carry harmful poisons such as mercury or fluoride? Or could we actually live through/fight off (even with the help of medicine) these diseases today throwing out the need for vaccines all together? Please help us understand. Thank you very much.

  16. Hi Lara. I came off the contraceptive pill after 10 years….Gasp. Got told I had cysts, blood tests came back practically within range. Changed my diet and lifestyle drastically, terrible acne and hair loss. I didn’t have a period for 10 months but with the help of peony/liquorice combo it came back. Over the last 7 months I have had 60 day cycles and recently had a monthly bleed….so about 4-5 periods all up. Can you tell me how I will know if I am ovulating or not? I recently started on a natural progesterone cream is this a good idea?

    • Now that you’re having monthly bleeds, you are probably ovulating. The simplest way to confirm ovulation is to track your basal body temperatures. It should be about 97.7°F (36.5°C) in the days before ovulation and then about 98.6°F (37°C) in the days after (all the way to your period). That rise takes place over a couple of days just after ovulation. I explain this and other physical signs of ovulation in my book.

  17. Hi doctor Lara! I ve just bought your book and it is fantastic. I would like to know your opinion about primrose oil since I take 1200 mg a day and I find it helpful with my pms symtoms. Thank you!

    • Thanks Jacqueline. It’s fine to combine evening primrose oil (EPO) with the other treatments I discuss in Chapter 8.

  18. Hi! I did well on a Paleo diet (no sugar, dairy or grains) while I was on hormonal birth control. I went off and gained a lot of weight back (15 kilo or so) although I have not changed my diet. I don’t get my period at all, like I did before I started with the pills 3 years earlier. Before that I would just take progesterone to bring on a bleed. I have PCOS as well as insulin resistance. I have taken Vitex for 3 months now and no difference. My acne is bad, I have constant wetness like ovulation causes but no period/ovulation. I also have psoriasis that is getting worse. It sounds liek I would benefit from magnesium but I have the oil you massage into your skin to absorb as I have malsorption issues after having gastric bypass 10 years ago. That also could be why Vitex didn’t affect me. I am not sure how much of it I am absorbing. I would appreciate any help. I am seeing a naturopath near me but she is also stumped. Thanks!

    • Did anything else happen around the time you stopped birth control? such as stress or antibiotics or other medication?
      Your priority is to restore insulin sensitivity. That will enable you to lose weight, and should also improve PCOS symptoms. Yes, magnesium is a good option, but also look at inositol and maybe intermittent fasting. Double check that you’re not having any hidden sugars, or “natural” sugars such as dates, fruit sweeteners etc. Vitex is not a good choice for PCOS (see my Vitex post).

      • Thanks for the response! This does make a lot of sense now. I am not super strict Paleo and after the first 4 months of rapid weight loss, I started to allow myself raw honey, dates and other dried fruit, as well as occasional coconut sugar or maple. That is probably the culprit although it is super difficult to be so strict for so long!

        I did have many issues shortly before going off birth control – I had mono and CMV which knocked out my exercise for quite a while. I had non stop infections, 8 months of constant low grade fever and I did take some antibiotics when I had strep throat. A LOT of stress in general. I went to top immunologists because we thought I might have an immune disease like lupus but it wasn’t that. Constant joint/muscle pain that jumped from body part to body part. It has been 3 years since the start of this. The only thing that helped me was a great reflexologist who took away the fever and aches.

        Just recovered now from a bout of sciatica and plantar faciitis and I can finally walk normally after a whole year. I am worried because I haven’t had a period for around 10 months now and if this treatment takes 6-9 more months to work, how dangerous is it for me to be without a period. I had a breast cancer scare earlier that turned out to be nothing after my reflexologist worked on me but I really worry. thanks so much!

        • Hi Elena, stress + sugar + antibiotics is the perfect recipe for weight gain. That’s definitely what happened.
          As I mentioned, your focus has to be to normalise insulin. That means no sugar (no honey, dates, honey etc). I know it’s hard, but it’s really the only way for insulin resistance.
          If you can do that, you may get a period more quickly than 6 months.

          • Just an update Lara – I did a strict diet cleanse for my liver with a local naturopath and my psoraisis has improved a lot and my period came back along with ovulation. My weight still is the same but my acne has improved. I would like to start some supplements like the inositol, magnesium and berberine. How much of each? Is the magnesium oil that I use daily enough or do I need a supplement as well?
            My blood sugar goes a little funny sometimes even when i am not eating anything with sugars in them. Then, to get my numbers back up and me feeling better, I eat a few dates. It is very hard to regulate. I am hoping berberine can help with that. I get a lot of stomach distress usch as diahrrea. Which probiotic should i take? I read a lot of good things about saccharomyces boulardii.Is that the best one? Thanks!

          • If you are eating the right foods (meat, fat, and starchy vegetables), then you should not need dates to regulate your blood sugar. From the sounds of it, I would say that quitting sugar (including dates, agave etc) is your number one priority. Magnesium is the best supplement for reducing sugar cravings, and it should be taken orally. I discuss magnesium dosing in my book.

  19. Hi Lara,
    I have recently come off the pill 4 months ago. I am suffering from a lot of break through bleeding. Do you have any solutions for this??

        • Is it just light spotting with ovulation? Ovulation spotting is common and normal and nothing to worry about, especially when in your first few cycles off the Pill (it’s the first time you’ve ovulated since before the pill). If the spotting is later in your cycle, then it is premenstrual spotting and could indicate progesterone deficiency.

          • No not just with ovulation. I recently saw my gyno with no obvious answer, i had an u/s which was normal. She did blood tests which showed low free androgens and an elevated SHBG level. Is there anything I can do for this? Still having the issues with break through bleeding. She thought these things were not related and offered my more contraception options which i don’t want!

          • So, not just with ovulation or premenstrual. Do you mean that you see a light spotting or show on most days?

  20. Hi Lara,

    At what dose does Magnesium begin to sensitize Insulin Receptors when you are Insulin Resistant?

      • Should we also use Calcium when we use Magnesium? I have read that you should, but I have also read that Calcium supplements aren’t healthy and cause build ups and we should get all of our Calcium from our diet…What do you think? To supplement Calcium or to not?

        • The reason that calcium supplements increase the risk for kidney stones and heart disease is that they deplete the body of magnesium. Generally, I don’t prescribe calcium supplements except during pregnancy and for osteoporosis (even then, calcium is not the main treatment for osteoporosis). But I always give together with magnesium.

          • Thank you very much, that is very helpful. I have one last question. I recall seeing on your site some place that it is almost impossible to get a period without eating meat. Why is this?

  21. Any thoughts on d chiro inositol/myo inositol for dealing with post pill acne? i went off in july and have had no period and severe acne…I tried saw palmetto, licorice/peony, and none of it has helped. thinking i’ll try inositol next. your blog has been very informative so thank you!

  22. Lara, with so much evidence/science in favor of the Vegan diet, why do you promote/believe in eating meat? If excessive protein is damaging to health, meat produces a free radical called AGES which causes Diabetes and Metabolic Syndrome/Diabetes is caused by Fat Toxicity/Overload then can you convince me that meat is beneficial to me and my health? The only vitamins unavailable in Fruits and Veggies are B12 which is produced in the soil and which is produced by the sun. What is right? What is true?

    • Thanks for your comment Ella. After 20 years with patients, I’m convinced that it’s easier to be healthy when we have a small amount of meat for satiety, fat, and zinc content. Dairy, however, can be a big problem because it is highly inflammatory for some people. Vegetables should be the bulk of what we eat.

  23. Hi Lara,

    I have read your book and was indeed very resourceful. You touch on how the pill causes cellulite and weight gain on the hips that eventually goes away. And weight loss that should happen unless the pill has done permanent damage.

    My question is in your experience how long does this typically take and are there ways/supplements that can help with this?

    • Progesterone helps to reduce estrogen-hip weight, so as long as you’re ovulating (making progesterone), then hip weight should reduce over six months or so.

  24. Hi Lara,

    I bought your book and really enjoyed reading it.

    I stopped the pill in September with no period since. I had regular periods before I went on the pill, I went on yaz for acne at 18 (I’m 25 now) I got blood tests done and an ultrasound, and it only shows my free testosterone was elevated. I was prescribed spiro but am apprehensive about taking it. What do you recommend my course of action is?

    It’s odd because my periods were fine before I went on the pill and now that I went off my body is going haywire (acne, increased hair, etc)

    • Hi Brianna, post-pill PCOS is such a common experience (you’ll see that I discuss it in Chapter 7). I strongly feel that Spiro is not the answer. You want to re-establish healthy ovulations so your testosterone will reduce normally (see Chapter 7).

  25. Hi Lara, Do you have to take a ‘liver support’ when taking a DIM supplement? I have read about DIM (Estroblock) on the Love Vitamin and she has said if you take DIM without one your skin can get a lot worse?

    • Interesting. I don’t routinely prescribe with ‘liver support’, but then I always give as part of plan that also removes inflammatory foods, which is very healthy for the liver.

  26. Hi Lara,
    I have been off the pill for 18 months now. The hair loss after stopping the pill was horrendous. It has started to improve slightly, however seems to go in cycles, I have underlying androgenetic alopecia. My doctor has put me on a bio similar progesterone & DHEA , as I am entering menopause, and no longer ovulating, and these levels were very low. I am also on iodine, Mg, vit D and iron supplements. As I am no longer able to ovulate myself, do you have any further suggestions, as its seems like once you enter menopause with AA it is a double whammy!

    • Hi Melanie, If your periods have actually stopped, then you might want to talk to your doctor about small dose of bioidentical estradiol (great for hair!).
      Also, be careful with both progesterone and DHEA because at high dose they are androgenic (testosterone-like). At low dose, progesterone is good for hair.
      finally, what do you mean by “bio-similar”? They should be bio-identical.

      • Hello Lara ,

        I hope i don’t upset you with my question . My name is Claudia , i am a transexual girl , and although it might seem a little off-topic , i would like to ask you about the progesterone behaving in an androgenic way . Basically i am like a woman after hysterectomy and i am using bio-identical estrogen and progesterone . Could you please give me an idea at what levels the progesterone would be androgenic ? Beside health and well being , we are focusing on developing common female features , so that’s another reason to avoid androgenic substances .
        I am 25 now , and started progesterone cream , about 100 mg a day , seven months ago . I feel ok , but i felt like my breast and hips development stopped .

        Thanks in advance ,

        • Hi Claudia, Synthetic progestins can be androgenic, but natural progesterone is not (at any dose). At least not directly. However, progesterone at high dose can convert to testosterone. (As well as being a hormone in its own right, progesterone is also the precursor to other steroids such as estrogen, testosterone and cortisol). 100 mg progesterone is likely to convert to something. I suggest that you do a 24 hour urine test to measure all hormonal metabolites including estrogens and androgens, and see what your body is doing with the progesterone.

  27. Hi Lara, I am still unsure of my root issue even after reading all of your posts. I stopped taking the pill a little over 4 months ago. I did not have a period at all until birth control (which is why I started, because they told me I had to- to keep myself healthy (ha), I was also diagnosed with PCOS due to blood tests- elevated FSH and LH- and “cysts”). However, I did have a period a month after I quit the pill. Is it possible that I am bleeding and not ovulating? (My periods are 2 days long, which has been a consistent length for me on and off the pill- is that healthy? Side note- on the pill, I never had periods regularly- it was usually twice a month or a skipped month) I also still suffer from acne. I am probably not insulin-resistant (I have never been overweight). I do have some gluten sensitivity symptoms so I have considered the inflammatory option…

    Thank you for your posts!!

    • Hi Keri, if you never had a period until birth control, then you’ve never had a period (pill-bleeds are not periods). That one bleed that you had a month after the pill was probably not an ovulatory cycle (meaning you didn’t ovulate), so from the sounds of it, you have never ovulated, which is a worry.

      When you say “elevated FSH”, how elevated? How old are you?

      • Did I mention the wrong hormone? But I am not sure; the doctors did not tell me how elevated. I am 23 years old.

      • hi Lara,
        I would like to know why ovulation are so important except for the fact they are the reason for pregnancy. Also, if a woman is not ovulating for a long time, does that affect the egg quality. As recently i read about every women born with fixed egg reserve. Your insight in this matter will be very much appreciated.

        • Ovulation is important because that is how we make our essential hormones estradiol and progesterone. I explain this in several places on this blog and in my book.
          Having not ovulated should not affect egg quality.
          Finally, there is growing evidence that women are not born with a fixed egg quality. I discuss this in my book. See: The Game-Changing Discovery of Ovarian Stem Cells

  28. Hi Lara, I am curious to know what you think about using saw palmetto to lower testosterone levels for women with for pcos…

    • Saw palmetto should theoretically be helpful because it inhibits the activity of 5-alpha reductase (thereby reducing conversion of testosterone to DHT). But I haven’t seen any evidence that it promotes ovulation (the way peony and licorice does), so I don’t prescribe it.

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