What to expect when coming off the pill?
As a Naturopath I often see clients who want to get back to their natural hormones but are quite scared about what will happen to their body after coming off the pill.
To name a few common concerns; women are mostly scared about:
having painful and heavy periods
not getting their period back at all
acne breakouts
Before we get into that, I usually ask my patients what their periods and hormones were like BEFORE they went on the pill.
Now remember, I am not talking about the bleeds you had while taking the pill - they are not real periods. This may be hard to remember, many of you may have been on the pill for 10+ years or from such a young age that you can barely remember having a cycle for more than a couple of years when it is still maturing. Some things to think about are:
Were your periods regular?
Were your periods heavy and/or painful?
Did you have acne?
PSA: The pill just masks your period problems and they can commonly return once you stop the pill.
So let’s answer a few of the common questions I get asked by women who are wanting to come off the pill…
How fast will my period come back after stopping the pill?
It can be anywhere from 1 month up to 12 months later. The pill stops your ovulation and therefore you. need to ovulate to have a period. So if your body has trouble ovulating after stopping the pill this will cause your period to not come back right away.
Will my periods be regular?
If you had regular periods then there is chance oyou will return to having regular periods post pill. It is quite normal for your ovaries to take about 3 months to kick back into action. So be patient and persistent.
If you had irregular periods prior to starting the pill then you most likely went on the pill because of that reason. A lot of girls get prescribed the pill to “regulate their cycle” - although this is NOT what the pill does at all. So you need to go back to square one. Why were your periods irregular in the first place?? This first needs to be identified so you can treat the underlying cause- It could be due to a range of problems, such as PCOS.
Utilising herbal medicine BEFORE coming off the pill can prevent a faster transition to amazing menstrual cycles and unwanted side effects.
Will I get acne breakout after stopping the pill?
If you went on the pill for acne, it is quite likely that you will have a breakout after stopping the pill. Remember the pill is only masking the underlying issue, it does not ‘fix your acne’. You may have had no skin issues prior to the pill and only went on it ‘because all of your friends were on it’ - this is common for young girls. Now if that is your case, it is still possible that you too may have a skin breakout.
Why post pill acne??
Because the pill reduces the production of sex hormones. It also suppresses sebum (aka oils in the skin) back to the levels we had as a child. Naturally, our body bounces back after ceasing the pill and kicks back into gear to make these hormones as well as increases the production of sebum. Think of it kinda like a backlog of sebum after it has been suppressed for so long… you now have more sebum than ever before which causes breakouts.
It can also be due to a temporary surge in androgens (male sex hormones) as your ovaries begin to navigate producing hormones again. This can continue for months after you stop the pill and result in post-pill acne. Post-pill acne can persist regularly and for some can actually be at its peak at 3-6 months after ceasing the pill.
There are natural treatments to lessen the effects of post-pill acne. Read more here. Ideally, you would start treatment a couple of months prior to ceasing for best results. Each body is different, but there are avenues you can look into if you are concerned. SHBG (a protein that binds to sex hormones) and androgens (male sex hormones) can commonly cause acne and you may want to get these tested via a blood test.
Will my period pain return?
Remember the pill does not ‘fix’ your period pain, because the bleed on the pill is not a real period. So it is possible for your returned periods to be painful. First we need to find the root cause of your painful periods. Go back to the drawing board- you went on the pill because you had painful and/or heavy periods. We need to first identify if it could be something more serious like adenomyosis or endometriosis? There are natural treatments for these too read more here. If adenomyosis and endometriosis have been ruled out, then the heavy bleeding could be due to excess oestrogen. Read here how to support oestrogen metabolism.
Are there any other side effects from the pill?
The pill has been shown to deplete the body of key nutrients, including the B vitamins and the minerals selenium and zinc. Vitamin C and E are also affected (1). This is concerning, as many women cease the pill with the plan to try for a baby- these nutrients are fundamental for preconception and in the early stages of developing the baby.
The depleted nutrients are also important for thyroid function, liver detoxification and the production of neurotransmitters.
Imbalanced microbiota: There is evidence of alterations of vaginal microbiome imbalances as a result of the pill (2) which may extend to gut microbiome imbalances. These can lead to mood imbalances, thrush, bloating, diarrhoea, constipation.
Will my moods be disrupted?
It is possible that you may experience mood imbalances post-pill. The depleted nutrients are required for the production of serotonin, dopamine, GABA and melatonin. These are neurotransmitters that are responsible for making us feel good, happy, calm and relaxed. Low levels are linked to depression and anxiety. Additionally, your body is still trying to navigate balancing and producing your hormones naturally. Our female hormones oestrogen and progesterone, when in balance, are our happy and calming hormones.
Where do I start?
Ideally, you would start treatment at least 3 months before you stop taking the pill. This will minimise the effects and your body will be in a better place to be less reactive to the withdrawal of the medication.
