You’re ready. You suspect hormonal birth control is no longer right for your body, and you have a sinking feeling it never was.
Of course, you have 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 peony. If you have no period by six months, 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.
The 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.