Hormone healing post-pill

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So you're on hormonal birth control, and you want to support your hormones to make the transition easier when you come off! You might be wondering what your cycles will look like when you come off birth control, or you might be nervous or anxious to make this change. 

Choosing birth control is a personal decision, and coming off it is a similarly personal decision. Whether you're still on hormonal birth control, or it's been several months since you've come off, I wanted to outline some things to think about when it comes to your cycles and practical ways to support your hormones. 

When will my period come back?

If you're here, you probably know that hormonal birth control does impact your menstrual cycles. It seems to be different for every menstruator. In a study done in Germany in 2002, a group of 175 women who had come off the pill, compared to 284 women who had never been on hormonal birth control. For 57 % of the women who came off birth control, their cycles regulated after the first cycle. For the rest of the women, it took up to 9 months for their cycles to regulate.  

What accounts for this huge variation? My theory is that personal difference plays a part, as well as what your cycles were like before you went on hormonal birth control. This will be a big piece in how your cycles look when they come back. Think back to what your periods were like before you went on hormonal birth control. What was their average length? Where your periods heavy and painful? Did you ovulate every month? Did you have irregular cycles? If you had signs of hormone imbalance before you went on hormonal birth control, chances are that medication masked the issue, rather than treating the root cause. This means that when you come off the pill, those symptoms might come back similar or even more intense.

If your period doesn't return right away, be patient. It may take months for your cycles to regulate. If you're not getting your period, it means you are not ovulating. This is because your period is triggered by ovulation, not the other way around. Remember that your body was not ovulating for a period of time, and the hormones that are responsible for the events in your menstrual cycle were not active. Your body needs to remember the pathways for ovulation and menstruation to occur. 

Tracking your cycle with charting, either on paper or in an app, is a great way to measure how your cycles are healing following coming off hormonal birth control. Make sure to note bleeding length, quality and symptoms, cycle length and cervical mucous quality. 

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What about acne?

Depending on what type of hormonal contraceptive you were on, you might see a reduction or an increase in acne post-pill. The relationship between hormonal birth control and acne involves a couple factors. The main reason that your acne may go away while you're on the pill, is because the synthetic estrogen suppresses androgens, which reduce sebum production and acne. Depending on what type of hormonal contraceptive you were on, and the amount of progestin in the medication, will impact whether acne is exaccerbated or gets better after coming off. When you come off the pill, as your own natural hormones take over, is that your skin over produces sebum and your acne may get worse. It's important to note that acne may get worse before it gets better. Try to hang in there for several months as sebum production regulates and you should see a reduction in acne. Because research has shown that hormonal birth control impacts your gut microbiome, you can support reducing acne by learning about and nourishing of your gut microbiome. Eating diverse, organic foods, fermented foods and only using antibiotics if absolutely necessary are a couple ways to begin nourishing your gut microbiome. 

Vitamins & Minerals

One of the biggest concerns I have of the pill is the evidence that has shown significant nutrient deficiencies for women who are on oral contraceptives. If you are on hormonal birth control or you have recently come off, supplementing and getting these essential vitamins and minerals is really important. For healthy ovulation and menstruation, and healthy overall cycles, having sufficient vitamin and mineral levels is crucial.

  • Vitamin B2 - found in beef, salmon, mushrooms

  • Vitamin B6 - found in avacados, bananas, sweet potatoes

  • Vitamin B12 - found inliver, eggs, shellfish

  • Vitamin C - found inbell peppers, kiwi, citrus fruits, strawberries

  • Vitamin E - found in sunflower seeds, almonds, avocado, spinach

  • Zinc - found in oysters, lentils and hemp seeds

  • Selenium - found in brazil nuts, tuna, shitaake mushrooms

  • Magnesium - found in spinach, pumpkin & squash seeds, brown rice, almonds

Blood sugar balance

Another concern for women who are on hormonal contraceptives, is the effect of these medications on blood sugar stabilization  and insulin resistance. High insulin stimulates the ovaries to produce testosterone, impeding ovulation and regular cycles. Studies have shown a side effect of oral contraceptives is poor glycemic regulation. If you are on hormonal birth control or have recently come off, and you have signs of insulin resistance or absent periods, it might be something to look into. Exercising regularly, staying away from refined sugar and white flour, and eating regular meals that fill you up and keep you satisfied are ways to start balancing blood sugar.

Knowledge is power

I've said it before, and I'll say it again. I'm not anti - pill! There are certain situations and circumstances where hormonal birth control will improve quality of life as well as increase convenience. What I am against is misinformation and lack of awareness about the side-effects and impacts of a medication that women take every single day, many of them for their entire fertile life. In an ideal world, doctors would disclose the side effects of hormonal birth control, and not only the serious life-threatening side effects, but the more subtle and common side effects such as nutrient deficiency, long-term hormonal imbalance, acne, weight gain or mood changes. 

If you are reading this and you are on hormonal birth control, don't despair! The suggestions that I have made are not only for if you have come of hormonal birth control, but if you are currently on it. Making some changes with this knowledge in mind can decrease some of the side effects and make the transition easier if you do decide to come off. 

References: 

Palmery MI, Saraceno A, Vaiarelli A, Carlomango G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13.

Zimmerman Y, Eijkemans, MJC, Coelingh Bennink, HJT, Blankenstein MA, Fauser BCJM. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis.Human Reproduction Update. 2014 Jan; 20(1): 76–105.

Cycle characteristics after discontinuation of oral contraceptives.

Gnoth C, et al. Gynecol Endocrinol. 2002.

Khalili H. Risk of Inflammatory Bowel Disease with Oral Contraceptives and Menopausal Hormone Therapy: Current Evidence and Future Directions. Drug Saf. 2016;39(3):193-7. Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis - back to the future?. Gut Pathog. 2011;3(1):1. Published 2011 Jan 31. doi:10.1186/1757-4749-3-1 Cortés ME, Alfaro AA. The effects of hormonal contraceptives on glycemic regulation. Linacre Q. 2014;81(3):209-18.

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