Coming Off The Pill? Here’s What You Need to Know

30.09.18

One of the best things about getting older is the relationship we start to form with our bodies, right? We figure out what makes it feel good, what we need to avoid, what rules and rituals to abide by, and what to steer clear of entirely.

 Our reproductive health falls under this umbrella of bodily functions we get to know better with age. Or at least, that’s what I keep reading. But how much can we really know about our inner workings when the majority of us have been on a birth control pill since we were 13?

Unlike the bleed we have when we’re ovulating, a Pill bleed is simply a withdrawal from the pharmaceutical steroids in the Pill. These steroids look similar to our wonderful hormones estradiol and progesterone but they’re not the same. And when we don’t experience the full expression of our endocrine system, we miss out on all the benefits estradiol and progesterone have on our bones, muscles, metabolism and mood.

This is why an increasing number of millennial women are saying goodbye to the BCP. They’re choosing to forego it’s potential risks and side effects in favour of a more holistic alternative, three of which are mentioned in this article. You might find that none of these options are right for you, and that is okay. The constant shame around birth control methods needs to stop – no matter what end of the spectrum you fall. The BCP is not the devil, it’s popular because it works. And if you suffer from debilitating conditions like endometriosis or extremely heavy periods, BCP can be life-changing and should be celebrated. But as Dr. Lara Briden (author of The Period Repair Manual) puts it, “What I don’t celebrate is the distorted message that hormonal birth control is the only birth control.”

Naturopath and holistic healthcare practitioner, Twyla Watson, agrees that there is a lack in education around the way the BCP works and how it interacts with our hormones. In particular, Twyla said she was shocked at the misconception that just because you still bleed when taking the Pill you therefore have a “period”, “The truth is that you don’t experience a menstrual cycle on the BCP, and you certainly don’t experience a period. In this sense, the Pill doesn’t regulate your hormones – it annihilates them. It is this loss of our natural hormones – which do so many wonderful things for our body each month – that cause those unwanted side effects like weight gain or a loss in libido.” The loss in libido is particularly problematic for young women who have been put on the Pill to manage acne or painful periods but haven’t had the chance to come into the full expression of their sexuality yet. Twyla said, “I see young women who think something is wrong with them because their libido is gone and it has become a major strain within their relationships, but almost none of these women are aware that this is a common side effect of the BCP.” 

Okay so you’ve made the decision to come off the BCP. What should you expect and what are your options?

Twyla said that your symptoms, if any, when coming off the Pill will largely be determined by what was going on before you went on it, “As I said, this is because the Pill doesn’t actually regulate your cycle, it simply puts whatever was happening “on hold” for a while.” A good example is acne. The BCP works really well for acne because it suppresses sebum levels (skin oil) to those of our childhood, but this only works while you’re on the Pill. A lot of patients experience acne when coming off the Pill because your body starts up-regulating sebum levels for anywhere between one and six months post-Pill. Dr. Briden recommends avoiding cow’s dairy and sugar in the months following the Pill, which both spike a hormone called IGF-1 and causes acne. The BCP also depletes key micronutrients that will need to be restored, especially zinc, magnesium, selenium, vitamins B2, B6, B12, Vitamin E, Vitamin C and folate. Twyla recommends working with a naturopath/functional medicine practitioner to restore these to normal levels. And don’t forget about your diet, “You want to make sure you’re eating hormone-nourishing foods that will support your hormones when everything comes back online! This means fats like avocado and extra virgin olive oil, gentle carbs like sweet potato, rice and buckwheat, and adequate protein.”

The options for birth control are not only limited to the Pill. Far from it. But there are pros and cons to each option that need to be weighed up. Three of the most common non-hormonal options are the copper IUD, diaphragms, and fertility awareness methods like Daysy. Barrier methods like diaphragms can be used in conjunction with spermicide to boost their efficacy (according to Planned Parenthood they have a 6% failure rate which is a lot higher than the 0.3% failure rate of the Pill).  The diaphragm is a silicone cup inserted into the vagina before sex that blocks sperm from reaching the uterus. It involves no synthetic hormones which is a good thing, however forward-planning is key because it must be inserted prior to the act (so spontaneous sex is less possible). The copper IUD is a small T-shaped device that is professionally inserted. Costs vary from country to country but the copper IUD is fully funded in New Zealand. It’s a “set it and forget it” birth control option. As in, can be left for up to 10 years (!!). Like literally, set it and forget it. The copper IUD doesn’t suppress ovulation and it doesn’t alter your hormones, it simply produces an inflammatory reaction that prevents pregnancy because it is toxic to sperm and eggs. And lastly (are you still with me?), according to Dr. Briden, the fertility awareness method (FAM) works because, as a woman, you are only fertile for six days per cycle. So to avoid pregnancy, you must simply determine which days you are fertile and then either not have sex on those days or use a barrier method like a diaphragm or condom. The simplest type of fertility awareness method is the Daysy fertility monitor, which is a certified medical device that measures your basal body temperature and then does all the calculations for you.

I hope this hasn’t felt like information overload. But rather, education overload. I don’t have all the answers but I do know some smart people who have a lot of them, and I will always do my best to provide you with those answers whenever I possibly can.

I promise.


Always consult your doctor or healthcare professional before starting something new.
Header image by Holly Burgess for The Twenties Club