My Journey Off Hormonal Birth Control (AKA “The Pill”), Part Two

July 2, 2018 | Post by Sam Presicci

My Journey Off Hormonal Birth Control (AKA “The Pill”), Part Two

If you’re reading this, you’ve probably read part one and had your interest piqued enough to give part two a shot. I didn’t anticipate all of messages I’d get from people excited about hearing more. The topic of hormonal birth control and the pill (along with periods and hormonal health in general) can sometimes feel like it’s a taboo conversation point. We’ve been taught to feel that periods are gross and that massive mood and hormonal fluctuations are totally normal. But none of that should be the status quo. I’m writing this today to help normalize periods and hormones, and talk about contraception. These things don’t have to be the elephant in the room.

Today, I want to talk about everything I did to prepare my body to come off the pill and everything I’ve done since then, too. Keep in mind that this is not meant to be a prescriptive blog post. These are things that worked for me, but as always, do your own research and decide what’s best for you and your body. I’m simply sharing my personal experience. Keep in mind that even if you’re on hormonal birth control with no plans to get off of it, you can still support your body with diet and lifestyle swaps.

Given that I was on the pill, that’s what my experience and my personal protocol was based on. If you’re using the IUD, patch or another hormonal method, you may want to tweak your approach accordingly.

What the pill depletes…

I want to start with the nutrients that hormonal birth control depletes as well as how it can affect your gut and microbiome. The pill can disrupt your normal gut flora and allow for overgrowth of things like yeast and harmful bacteria. Additionally, the pill increases something called Sex Hormone Binding Globulin (SHBG) which binds free hormones. Given this, the pill can cause low thyroid hormone or low testosterone, which can impact women in a multitude of ways (see this post by Dr. Jolene Brighten for more in-depth symptoms as well as other downsides of the pill).  The pill also depletes vital nutrients, including B vitamins, magnesium, selenium and zinc. This is not a completely comprehensive list, but it sets the stage for WHY it’s so important to prep for getting off the pill, rather than doing it without any planning.

Before getting off the pill…

For me, my preparation for getting off the pill began a few months before I actually stopped taking it. This is crucial for the easiest possible transition. I didn’t have to alter my lifestyle drastically, but I did begin supplementing to ensure I was giving my body adequate support. The more nutrition and lifestyle tweaks you can make in the 2-3 months before getting off the pill, the better. The reason for this is multifold, but it certainly has the benefit of reducing our body’s toxic burden, which means it’ll be better able to detox post pill.

Curious about what I did BEFORE I got off the pill to give myself the best chance for a smooth transition?

  • Food: anti-inflammatory, whole foods. This doesn’t mean a Whole30, but it means a basis of vegetables, fruits, high quality proteins, healthy fats, nuts and seeds. See my meal template post here for more info. It also means limiting refined sugar (and sugar in general), eliminating gluten altogether, and limiting grains.
  • Sleep: I aimed for 7-8 hours per night and worked to create an evening (and morning!) routine to further improve my sleep. Proper sleep hygiene is incredibly important when it comes to prioritizing quality sleep. I am working on a post of my own with simple ways you can improve your sleep, but here’s an article from Dr. Mark Hyman in the meantime.
  • Stress: Are you surprised to see this here? Working on mindset and stress management are crucial to reducing your body’s overall burden and improving your health.
  • Exercise: The short story is MOVE! I continued with my normal exercise practices during this time, including weight lifting, HIIT and daily walks with our dogs. I can’t remember if I was doing Crossfit at this time or not, but it really doesn’t matter! The important thing for this piece is to move in a way you enjoy on a regular basis (4-5 days/week).
  • Switch to more natural skin and home care. This was a big transition for me, and it happened gradually. But slathering our bodies in endocrine disruptors, spraying chemicals in our houses, and using all plastic containers (among other things) contribute to the toxic burden I mentioned earlier. Some of my favorite skincare products are listed under my ‘Shop’ page. You can also use the Environmental Working Group’s website or the ‘Think Dirty’ app to research the safety of your commonly used products.
  • Supplementation: I can’t stress enough that this is individual, so you may need something different than what worked for me. I began taking supplements aimed at repleting some of the nutrients that are depleted while taking the pill. I began taking an activated B complex, magnesium glycinate, zinc and digestive enzymes. I highly recommend taking professional grade supplements, which you can usually only purchase through a doctor, dietitian or other health practitioner.

After getting off the pill…

Once I stopped taking the pill, I began a gut healing protocol. I removed most of the commonly inflammatory foods for 30+ days (it was very similar to a Whole30) and concurrently worked on bolstering my good bacteria and healing my gut. I consumed bone broth regularly, focused on pre and probiotic rich foods, and used a powder called GI Revive that’s designed to help heal the intestinal lining.

Since the pill does disrupt your normal gut microbiota and can contribute to leaky gut, a reset like this is recommended post-pill.

I ended up having a pretty “easy” transition off the pill. I had one final withdrawal bleed a few weeks after stopping the pill, and I ovulated about 2 weeks-1 month after that and got my period. For others, it’s not nearly that simple. They may suffer from Post Birth Control Syndrome, which can crop up as long as 6-12 months after stopping the pill. Additionally, if you had irregular periods or acne before starting the pill, those issues will almost certainly come back. To work to improve them, consider some of the lifestyle and diet modifications mentioned above and, if needed, consult with a functional medicine provider for help.

Something that I didn’t do until much later, but that I’d recommend within the first 3-6 months post pill would be to run a DUTCH Complete or DUTCH Complete Plus panel. This testing is the gold standard when it comes to hormone and cortisol testing, and I think the results are invaluable. You can only run a DUTCH test through a provider (like me!). I did end up ordering a DUTCH panel for myself a few months ago, given some symptoms I was having (feeling run down, tired upon waking, etc). The results showed that there are probably still some lingering effects from the pill (a dysrupted cortisol curve and low testosterone, to name a few). With these results, I’m able to target my lifestyle and supplement choices to get these markers where I’d like them to be.

Alternatives to hormonal contraception…

If you’re contemplating getting off of hormonal contraception, the next question becomes what to use instead. It’s so ingrained in us that the pill is one of the only safe methods of contraception. Because of that, it can feel really overwhelming (and almost impossible) to come off of it.

Did you know that you’re really only fertile for about six days per cycle? SIX DAYS! This usually includes the five days leading up to ovulation and ovulation day itself. And did you also know that most hormonal contraceptives give you a monthly withdrawal bleed that is meant to help you feel more comfortable and feel like you’ve gotten your period, when in reality you haven’t? Seriously…the pill gives you a fake period. Learning this was truly a revelation for me.

After doing some research, I landed on a method called Fertility Awareness Method (FAM). You can certainly do this method with just a thermometer and paper charting, but it takes some practice. I personally opted to purchase a Daysy Fertility Monitor. Daysy does the work for me, so that all I need to do is take my temperature in the morning. You can use Daysy whether you’re trying to prevent pregnancy or trying to conceive. She gives red, yellow and green lights each day, depending on where you are in your cycle. Oh, and this is so far from an advertisement. I just love this easy method.

Photo credit: https://usa.daysy.me/

For the first few months post-pill, Daysy will give you all yellows as she tries to figure out your cycle. Once you’ve been using Daysy for about three months and had a true period post pill, she’ll begin to learn your cycle.

When I first got off the pill, I waited for my withdrawal bleed (my last “fake” pill period) and then peed on Luteinizing Hormone (LH) Ovulation test strips every single day until one showed ovulation. You definitely don’t have to do this, but I wanted to be sure. I’m sure there are mixed reviews on these, but they’ve always been spot on for me. Since my cycle is regular, I don’t use them much anymore, but they were incredibly helpful in the beginning.

When Daysy flashes yellow or red, it’s important to use some other method of protection. Some options include condoms, a diaphragm (with non-toxic spermicide), or abstaining altogether.

Daysy is not the only one of it’s kind and there are certainly other options out there. I don’t have experience with them, so I didn’t want to mention them here. I recommend against simply using a period tracking app, since these apps don’t have any idea of your temperatures or whether you’re actually ovulating or not. Pinpointing ovulation is the key to preventing pregnancy.

This post is really just skimming the surface. If you’re interested in hearing or reading more, I HIGHLY recommend checking out the resources that I’ve linked below. There’s a whole lot of background on the female body and menstrual cycle that I didn’t want to get into here, but that’ll help you understand all of this a lot better.

Resources…

I cannot recommend Dr. Lara Briden (Period Repair Manual) or Dr. Jolene Brighten enough. Check out their resources! If you’re planning on using FAM as your birth control method of choice, I highly recommend Taking Charge of Your Fertility. Another book that I’ve heard great things about is called WomanCode.

If you are thinking about transitioning off the pill (or you already have) and you want the help and expertise of a dietitian and coach to troubleshoot your eating, run functional labs and create lasting lifestyle changes, check out my coaching package options!

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