I’m Off Birth Control: Now What?
Coming off birth control can be terrifying. For most of us we had the fear of god put into us at a young age about getting pregnant without the use of hormonal contraceptives. I know I did! In addition, because it can take up to 12 years for young girls and women to regulate their periods and hormones but we live in a society of quick fixes and a pill for an ill – many of us are put on hormonal contraceptives to “regulate our periods” in our young teens. I was only 15 when I went on the pill and I stayed on it for 7 years! And by the way, the pill does not regulate our periods, it’s main mechanism of action is to shut off the communication between brain and ovaries so you do not ovulate and therefore there is no way you can get pregnant.
As more research and resources become readily available to us, the more young women in their 20s and even 30s are considering transitioning off the pill – in fact I would say it’s the most common DM I get. By the way this article is not here to convince you to come off your medication. That decision should remain between you and your medical provider. Please don’t just come off a medication without talking to your doctor p.s. if you haven’t watched my Birth Control Workshop yet, I’d highly recommend it – it gives you all the PROS and CONS of all forms of birth control so you can speak directly with your provider about what the best options are for you!
Ok girl I got you – let’s get into some of the basics. If you are wanting more support – feel free to check out my new resource: “I’m off Birth Control Now What – A Woman’s Guide to Supporting Your Body After the Pill”
How do I know when I am fertile?
Great Question, boo! Let’s start with the basics – women can only become pregnant approximately 6 days out of the entire cycle! (say what!?) Yep – I bet you didn’t learn that in sex ed class – I sure didn’t. Let’s look at some science. Your body ovulates once in a cycle, right before that ovulation event your cervical mucus becomes the consistency of egg whites (you should be able to stretch it between your fingers). This is your fertile cervical mucus. If you have sex a few days before your ovulation event, your cervical mucus should help support that sperm in its mission to find its way to your eggs by keeping it alive and swimming upstream. Sperm can survive up to 5 days in healthy cervical mucus.
On ovulation day (approximately mid way through your cycle) one egg from one follicle releases – if that egg does not meet sperm with in the 24 hours of being released, it will disintegrate. Once you confirm your ovulation with Cervical Mucus and/or BBT, your cervix closes and fills with a thick mucus that stops sperm from passing through and your vagina becomes acid which kills sperm. Additionally after ovulation when you create progesterone this will continue to prevent ovulation for the remainder of your cycle. Hence, why you can only get pregnant approximately 6 days out of the entire cycle.
This is one reason why tracking your cycle is so important – whether it be for pregnancy or to avoid pregnancy. When used properly, various Natural Family Planning birth control options can be up to 99.4% effective when done properly — however, the range significantly based on the method that you use. However I would say if you really want to know how to do this properly, and increase your effective rate, you can consider working with a FAM practitioner. They are usually very affordable and will teach you the intricacies of YOUR cycle. We have a SHE Talks Health Podcast episode with Melissa Buchan all about this.
Another key way to track your fertile window is using basal body temperature tracking – this is where you stick a thermometer under your tongue every morning at the same time and record it on a piece of paper. When you see a consistent rise in temperature you know that your body has ovulated. This is because the hormone progesterone is a warming hormone and women post ovulation have a sustained temperature rise until their periods arrive. This can be tricky for some women who don’t have a regular bed time/wake time or who drink often (which can disturb your temp!( Your temp can also be thrown off by hypothyroidism or Hashimoto’s.
Finally, you can also track when ovulation is occurring through Ovulation Predictor Kits (OPKs) which measure Lutenizing Hormone (LH) the hormone the rises in order to help the egg release from the follicle at ovulation.
I personally recommend doing a combination of a few of these things and if you have the budget working with someone like Melissa, who can guide you through understanding your chart more efficiently.
What products should I consider now that I’m off of hormonal birth control?
1. Fem Tech/Tracking Devices
If the entire idea of tracking your cycle is overwhelming to you, you may want to consider a device to help you track. You can use a product like TempDrop or Daysy to track your Basal Body Temperature electronically in their app and charts. You can also look at urine test strips like that from the company PROOV (enter PROOV25 for 25% off) which tests your LH rise right before your ovulation event AND they also test your progesterone to see how successful that ovulation was.
Two words of caution on other period apps, they may allow you to record symptoms but an app CAN NOT tell you when you ovulated unless it specifically says so like in the cause of Daysy Fertility Monitor. Simply looking on an app calendar and seeing you are on Day 14 is NOT a sufficient way to track your cycle as your ovulation day can change month to month.
You will also not be safe from pregnancy using Fertility Based Awareness methods until at least 3 months post pill since it will take some time for your brain to start communicating with your ovaries again. Please be careful and use extra precautions if pregnancy is not your goal
2. Menstrual Products
The most important part is you find products that make you feel great. There is no one size fits all when it comes to menstrual products. You can support your body with a menstrual cup which you insert into your vagina to collect blood, you can use organic cotton tampons, pads or even period underwear! My only warning is that you have a few options to try incase you don’t know how the cup will work, or whether your bleeding will be too heavy for period underwear.
I personally use a combination of tampons & Period Underwear. Another consideration would be looking into brands that properly source their materials – looking out for “organic cotton” and making sure nothing has been sprayed with chemicals or synthetic fragrances. These can be inflammatory for you – which is the last thing you need. In fact, I’ve had clients who’ve switch to organic tampons and that alone has made their pain reduce.
What types of things are normal & what should I be concerned about?
If you are anything like I was you are probably under the impression that cramps, pimples, PMS and migraines just come with the territory of being a woman. That couldn’t be further from the truth. Just because you bleed every month, doesn’t mean you have to suffer. In fact, if handled correctly, your hormones can become your greatest superpower (there’s more on this inside my new self pace course “I’m Off Birth Control, Now What?”) So let’s chat about common symptoms clusters that pop up post birth control and what you can consider to do about it. (remember we go into depth about each of these in the new self paced program)
PMS/Irritability/Anger/Crying all the time + Brain Fog and Weight Gain
These symptoms are most commonly associated with post pill estrogen dominance or estrogen excess – this is very common post pill as your liver has been burdened by the medication for years, which makes it challenging to clear estrogen the way it is supposed to. Add on the fact that birth control can cause intestinal imbalances which is the final place that estrogen in detoxed out of the body and you’ve for a recipe for estrogen dominance. As you work on cleaning up the liver burden and maybe even adding in liver supportive foods or supplements, this can start to shift. Think about things like alcohol consumption and xenoestrogens in the form of plastics and BPA’s. You may also need some gut support here, mama. Fermented foods, Probiotics, Prebiotics and maybe even a GI MAPS or similar stool test to see if you have a bacterial imbalance, yeast overgrowth or parasitic infection (you can do that with me here).
Trouble Sleeping Combined with Anxiety, losing your hair and/or feeling swollen or puffy?
This could be low progesterone which often co-insides with estrogen excess as a culprit of complete hormonal chaos post pill. The most important thing with low progesterone is going to be to get you ovulation regularly again – in the interim Dialing down stress is extremely important. Stress and progesterone just DON’T work together. You can also talk to your provider about the uses of Vitex, B6, Vitamin C and bio-identical progesterone for this hormonal imbalance. Remember – it is essential that you test – DON’T guess. and you speak with your provider about whats best for your specific body. (I would personally recommend a DUTCH Complete after 90 days post pill to see what your hormones are doing now that they are off medication. You can do that with me here).
Acne, hair growth on your chin, chest, abdomen, hair loss on your head?
These symptoms could indicate high androgens or male sex hormones like testosterone. This is extremely common after transitioning off birth control – it’s called Post Pill Androgen Rebound. This is when you stop the pill you are also stopping the suppression of testosterone. Then when your hormones aren’t being blocked anymore, wabam – say hello to that testosterone. This one is really important because many women are diagnosed with PCOS when in fact they are having PCOS like symptoms without actually having PCOS. The most frustrating part of this is that many women go to their doctor and the only thing they are presented with is going back on birth control which they may not want to do!
This is definitely one of those places where we also, test DON’T Guess because herbs, supplements and medications could do more harm than good or you could just be wasting valuable time and money. You may find the following tests helpful to consider: insulin, SHBG, Testosterone, FSH, LH, HsCRP this is so you can identify why these symptoms are happening, are they happening because of brain signaling issue, an insulin resistance problem or inflammation? Once you find out what is the cause of high testosterone, you may find the following supplements helpful: saw palmetto, zinc, vitamin D and nettle (all help with excess testosterone), Green Tea can help with SHBG. If you actually find you have a blood sugar imbalance chromium, cinnamon, magnesium and inositol can be very helpful along with balanced meals. Turmeric and Omega’s help lower inflammation which makes your hormones cooperate and signal well to each other.
As you can see this can get confusing quickly which is why I do believe it’s best to work with a practitioner who knows your case and can create you a customized protocol that will help you get answers!
Ook but Sophie, what do I do?!
This is honestly just the tip of the iceberg when it comes to all you have to know about transitioning of birth control but I do hope it’s been helpful for you to start thinking about what you can do to support your body. As always my door is open, if you have questions shoot me a DM on instagram (@shetalkshealth) or you can listen to the podcast episode on this very topic. Finally, if you are ready to learn more you can purchase the new do – it – yourself course “I’m off Birth Control Now What: A Woman’s Guide Supporting Your Body After the Pill.”