Ditching hormonal birth control can feel liberating – it’s a chance to become more in tune with your body and your natural cycle and benefit from your body’s natural hormones– unless you start to experience symptoms such as heavy and/or painful periods, acne, mood swings, PMS, anxiety, or maybe even no periods at all. Those symptoms don't feel so liberating. These post-pill breakup symptoms have such an impact on women's lives they’ve been titled Post-Birth Control Syndrome (PBCS). These symptoms may not happen right away either – they can take up to four to six months to appear, so you may not even realize ditching your hormonal birth control (HBC) was the cause behind them.
There’s certainly a chance you may not experience any of these negative symptoms at all. Instead you may gain more energy, have a greater sex drive and develop a better mood. But if you happen to experience the negative side effects of ditching hormonal birth control, the best way to deal with them is to be prepared for them, and to know how to handle them when they show up. And know, with the right natural treatment you can experience the positive side effects of ditching hormonal birth control, too.
So what kind of symptoms can show up?
The following are some of the most common Post-Birth Control Syndrome symptoms:
- Loss of Periods (Amenorrhea)
- Heavy Periods
- Painful Periods
- Mood Swings
- Loss of Sex Drive
- Weight Gain and/or Difficulty Losing Weight
- Disgestive Issues
- Short Cycles
I want to break down a few of the most common ones in more detail.
If you went on hormonal birth control to clear your acne you can expect to have your acne return once stopping HBC. Post-Pill Acne is typically the worst 3 to 6 months after stopping the pill. Two things happen post-hormonal birth control that can cause acne to get worse. The synthetic estrogen in HBC, along with several types of progestin, suppress the production of sebum (skin oil). In return your body has to up-regulate the production of sebum, and the up-regulation will continue once you stop HBC. This can result in more sebum than you had prior to starting the pill, resulting in acne. The second thing that can happen is an increase in androgen production, as you come off of hormonal birth control and your ovaries start to produce androgens again. The upside here is your ovaries will start to produce estrogen and progesterone again, which are both beneficial for your skin.
Heavy, Painful Periods
If you had heavy and/or painful periods prior to starting the pill you can expect them to return. If you started hormonal birth control shortly after getting your period for the first time (within the first few years) this may just be your period regulating itself. As I’ll discuss more below, it can take up to 12 years for your period to regulate and mature. Make sure you are reducing inflammation in the body, clearing out excess estrogen and ovulating to produce progesterone.
If your period was regular prior to starting HBC you can expect your period to return within 3 months. If your period was irregular prior to HBC it can take up to 6 months for it to return.
So what causes these negative post-pill symptoms?
Real Period for the first time
You are experiencing a real period for the first time in a long time. (Pill bleeds are not periods.) Ask yourself what your periods were like before you started hormonal birth control. According to Dr. Jerrilynn Prior, a Canadian endocrinologist, it can take up to twelve years for your period to mature. Chances are you started hormonal birth control within the first twelve years of getting your period, and you’ve probably been on it for a while, which means it can take a bit of time for your period to regulate and become “normal” after stopping hormonal birth control.
Lack of ovulation
It may take months or in some cases even years for regular ovulation to occur again. Hormonal birth control suppresses ovulation, and therefore suppresses communication between your hypothalamus, pituitary gland and ovaries. Use the fertility awareness method to track your cycle and make sure you are ovulating (and producing progesterone!) each month.
Withdrawal from synthetic estrogen
Synthetic estrogen is strong, four times stronger than your own estradiol. Track your cycle post-hormonal birth control to make sure you are ovulating and producing natural estrogen and progesterone. Progesterone will help to balance the negative side-effects of estrogen.
Increase in androgen levels
Androgen levels will increase when stopping hormonal birth control. A small increase is beneficial – helping to improve mood and libido. A drastic increase can cause acne and hair loss. If you’ve been on hormonal birth control that has a progestin with a low androgen index you will have a rebound of androgens and an increase in androgen sensitivity, which may cause you to experience the negative symptoms of high androgen levels when you stop taking it.
PCOS may also play a role in high androgen levels post HBC. If you had PCOS symptoms prior to starting birth control you may expect those to return. If you developed insulin resistance PCOS due to being on HBC this may cause excess androgen levels as well.
So how can you combat Post-Birth Control Syndrome?
The majority of the symptoms caused by Post-Birth Control Syndrome can be cured using the same methods, as the underlying causes are the same. (These methods will also help with PMS, even if it isn't caused by stopping hormonal birth control). For issues such as PCOS, more in-depth healing is probably needed.
Eating a diet that balances blood sugar plays a large role in hormonal health. Your liver is responsible for clearing excess hormones out of the body. It is also responsible for converting glycogen into glucose when your blood sugar levels are low. If your liver is spending too much time working to balance blood sugar levels it won't have enough energy left to clear excess hormones out of the body. Find a way to eat that stabilizes your energy levels throughout the day, instead of crashing after each meal or feeling hangry in between.
Diet also plays a large role in inflammation in the body. If you deal with digestive disorders, start to become extremely mindful of what you put into your body and how you feel after eating it. If you are sensitive or allergic to any foods (especially if you have an autoimmune disorder such as Celiac Disease) it is extremely important to eliminate those foods from your diet while you heal the lining of your small intestine. In order to clear excess hormones out of the body we have to be having regular bowel movements and what you put into your body plays a huge role in this. Our gut microbiome is also very important when it comes to hormonal health. The healthy bacteria living in our gut help to regulate the HPA axis, reduce inflammation, metabolize estrogen and activate thyroid hormone. If you have a lot of inflammation in the body or are frequently bloated, these are signs that you have dysbiosis, meaning an imbalance of good and bad bacteria living in the gut.
Lastly, focus on macronutrients and micronutrients. Protein, fat and carbohydrates, the macronutrients all play an important role in period health. Without enough of these macronutrients your hypothalamus won't send out the signals to your ovaries that its okay to make a baby (or have a period). A healthy period also requires micronutrients such as zinc, magnesium, Vitamin D and iodine, among others. While supplements may be necessary to obtain enough of these micronutrients, first you should aim to consume them via food.
Support Detox Pathways to Eliminate Excess Estrogen
Supporting your liver, digestive system and lymphatic system can help to clear out excess estrogen and excess metabolized hormones in the body. Your body has natural detox pathways that work on their own (read: you don't need a juice cleanse or to fast in order to detox). However, you can support your body's natural detox pathways by consuming less alcohol and processed foods and focusing on protein and micronutrients.
Support the Mind-Body Connection
Your hypothalamus will not send the message to your pituitary gland to release follicle-stimulating hormone (FSH) or luteinizing hormone (LH) if it perceives your body can not handle a pregnancy. You may not want a baby, but if your hypothalamus perceives you are under too much stress you won't ovulate, and no ovulation means no period. The two main questions to ask yourself here are "am I under a lot of stress?" and "Am I eating enough?".
You don't have to be underweight to lose your period. If you are not eating enough you will not be able to support a pregnancy, so you will stop ovulating. Make sure you are feeling nourished and satisfied each day. Another question to ask yourself is "Am I eating enough carbohydrates?". Not eating enough carbs, despite eating enough food overall can impair hypothalamic signaling.
Stress is inevitable, but unfortunately your body doesn't know the difference between being chased by a lion or a stressful deadline coming up at work. Find ways to offset stress daily.
What if you haven't stopped HBC yet?
If you are currently still on hormonal birth control and considering coming off of it, the best way to eliminate post-birth control syndrome is to put the above strategies into use before you are forced to. Focusing on your diet, supporting your detox pathways and eliminating stress can go a long way, especially if you begin months prior to stopping HBC.
For more personalized help with your post-birth control syndrome symptoms feel free to reach out to me at firstname.lastname@example.org