For some of the 62 percent of women who are currently using birth control, coming off contraception will be easy. But for others, it can pose a real challenge. Many women experience unwanted symptoms like acne, hair loss, and irregular periods that can last months or even years.
What is hormone birth control and how does it really work?
There are more than 10 different types of birth control, but according to former Parsley clinician Elizabeth Milbank, MD, MPH, the most common two are the hormonal IUD and the pill. The pill works by essentially “tricking your body into thinking you’re already pregnant,” says Dr. Milbank, who is board certified in both lifestyle and preventive medicine. More specifically, oral contraceptives contain hormones that “prevent the brain from telling the ovaries to ovulate, keep the endometrium very thin to prevent embryo implantation, and thicken the cervical mucus so sperm can’t pass through,” she explains.
In contrast, while hormonal IUDs can partially suppress ovulation their primary function is to thicken cervical mucus and block the sperm from getting to the egg. They do still contain hormones—but at much lower levels than the pill. For these reasons, “When we’re talking about negative symptoms of coming off birth control, we tend to be talking about the pill,” says Dr. Milbank.
What are common symptoms of going off the pill?
“The most common symptom is irregular periods,” says Dr. Milbank. Depending on the woman and how long she has been on the pill, it can take a while to re-establish a normal monthly cycle. “For some women, it may be the case that their period comes back right away, but for others it can easily take four or five months,” she says.
Other common symptoms of going off the pill include acne, headaches, hair loss, difficulty sleeping, mood swings, cramping, and heavy periods. Oftentimes women start experiencing the same symptoms they had when they were younger. In fact, according to Dr. Milbank, “they often experience the symptoms that made them go on the pill in the first place.”
That list of symptoms is enough to make any woman pause and wonder: Is there anything to look forward to about going off birth control? According to Dr. Milbank, yes. In fact, “the great side effects are usually what I hear about,” she says. Oftentimes, her patients report that they lost those five pounds they just couldn’t get rid of. And even better, libido can come “raging back.” Low libido and vaginal dryness—which aren’t discussed nearly enough—are really problematic side effects of being on birth control; side effects that often resolve themselves right away when the pill is discontinued. “I’ve heard women say coming off birth control made them feel alive again,” says Dr. Milbank.
What is post-birth control syndrome?
When the negative symptoms of going off birth control are persistent, functional medicine doctors often refer to them as “post-birth control syndrome.” The term is not recognized in all medical circles, but it describes the range of very real symptoms many women experience during this time. And according to Dr. Milbank, despite the fact that many conventional doctors brush it off, experiencing some degree of hormone imbalance after getting off birth control is very common.
“What I don’t think most doctors do well enough is prepare their patients for the length of time it can take their hormones to regulate,” she says. “When you take away the estrogen and progesterone from the pill, your body has to remember how to work again. It might not happen right away,” she continues.
How can you prevent post-birth control syndrome?
If you’re thinking about going off birth control, there are steps you can take to promote general hormone balance and hopefully reduce any negative side effects.
Choose a gentler form of birth control
According to Dr. Milbank, this can even start with the type of birth control you choose in the first place if you’re not trying to get pregnant. “The good thing about IUDs is that there aren’t nearly as many symptoms when you take them out. That makes them a good option to avoid post-birth control syndrome completely,” she says.
Hone in on your diet
Coming off the pill is a good time to focus on maintaining a healthy, satiating diet, says Dr. Milbank. “Your body needs healthy fats, carbs, and calories to make hormones, so this is no time for a low-calorie, low-carb or low-fat diet,” she says. Instead, she recommends eating plenty of nutrient-dense foods like avocado, nut butter, olives, and whole grains.
Make stressing less a priority
Stress is also an important factor in hormone health. “When cortisol [our body’s main stress hormone] is high it can affect the production of female hormones,” says Dr. Milbank. So whether it’s yoga, acupuncture, meditation or reading, finding ways to unwind while you’re coming off the pill is key.
When should you see a doctor for post-birth control syndrome?
Sometimes the body just needs a little time to adjust after coming off birth control, but symptoms don’t always resolve themselves with time—and that could be a hint that there’s an underlying condition that needs to be addressed. “I would say that if it’s been a year, go see a physician,” says Dr. Milbank.
There are a few exceptions to this, such as irregular bleeding, which could be caused by a fibroid, cyst, or other abnormality that needs treatment. “If you’re bleeding frequently it can also put you at risk for an iron deficiency,” says Dr. Milbank, so make an appointment with your doctor if you’re experiencing that symptom specifically.
Trying to conceive is another reason to seek care sooner rather than later, especially if you’re noticing classic symptoms of hormone imbalance. “If you’re trying to get pregnant, go sooner—maybe after 6 months,” says Dr. Milbank, who also recommends that her patients come off the pill a little earlier, instead of right when they want to start trying for a baby. “A delay infertility happens and it’s normal,” she explains. Giving your body a little extra time can be helpful so you don’t feel stressed or like you’re under the wire.
How do you know your cycle is functioning normally?
If you’re managing stress, eating the rainbow, and getting plenty of sleep, chances are your hormones will regulate in six months or so. “The best sign of fertility—and that your hormones have reached a healthy place—is the return to a regular, consistent cycle,” says Dr. Milbank. As she explains, it doesn’t matter if your cycle is 24 or 34 days long as long as it’s around the same length each month. “That’s a very good sign that you’re ovulating and there’s no reason for concern,” she says. You can track your cycle using an app or the calendar on your phone.
Finally, many women have been on the pill for so long, they forget that it’s normal to experience some changes in mood and energy levels throughout the month. “But these are generally normal for someone not on birth control,” says Dr. Millbank. It’s important to remember that it’s temporary—and that a little patience and self-care will go a long way.
