Women opt to stop taking birth control for many reasons, whether they are trying to conceive, tired of taking a pill every day, balancing hormones, or for other personal reasons. Whatever the reason, we want to support you with all the evidence-based information so you know exactly what to expect.  

This article will discuss changes and symptoms you may experience after the pill, beneficial lab testing to monitor hormones, and how you can support your body as hormones balance out.

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Things to Know When Stopping Birth Control

The main thing to note is that after discontinuing birth control, the hypothalamic-pituitary-ovarian (HPO) axis, which was once inhibited by hormonal contraceptives, is now able to start sending proper signals. As your hormones are trying to balance out, you may begin experiencing symptoms in your cycle, hormones, and mood.

Cycle Length

The majority of women report having a period within 30 days of stopping birth control. In some cases, it could take up to 3-months for your cycle to re-establish a regular pattern. This also depends on your body's normal rate and rhythm before birth control.

There are two main reasons for delayed or absent periods, which are delayed ovulation and imbalance of hormones. Delayed ovulation can occur after the use of combined estrogen-progestin oral contraceptives (COCs), which suppresses ovulation by inhibiting gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), and follicle-stimulating hormone (FH). As these pathways are no longer inhibited, normal production and communication between the hormonal signaling could take time to regain function. The imbalance of hormones is often due to the withdrawal of oral contraceptive hormones.

Estrogen and Progesterone balance are the key players in re-establishing pathway function. Removing birth control may result in your body needing extra time to return to a baseline flow.

Your Periods Could Become Heavier and More Painful

Heavy periods affect one-third of women. After discontinuing birth control, some women will revert to old cycle patterns, including menorrhagia, due to the imbalance between estrogen and progesterone, which can take a few months to self-regulate.  

Your Libido May Increase

Women may be surprised by their newfound sex drive. While taking birth control, you may have experienced discomfort during sexual activities, which leads to less interest in intimacy. Eliminating birth control can resolve discomforts such as vaginal dryness and improve low libido. Birth control pills can also alter your sex drive by decreasing testosterone levels. Testosterone is responsible for sexual desire, which means you could see a spike in libido once this hormone begins to re-emerge.

Your Mood May Change

Mood changes such as depression, anxiety, and irritability are all potential side effects of discontinuing birth control. Women who experienced mood swings while on birth control or before are more likely to experience this unwanted side effect.

A prospective cohort study in Denmark looked at one million women ages 15 to 34 over 14 years and assessed the relationship between hormonal birth control and subsequent depression diagnosis or antidepressant use. The study results suggest that depression is a potential adverse effect of hormonal birth control.

*Note: If you suffer from depression while taking birth control, it is best to consult with your doctor to address this before discontinuing contraceptives.

You Can Get Pregnant Rather Quickly

Increased libido combined with uninhibited ovulation is a recipe for…pregnancy! If getting pregnant is your goal, then great, you are on the right track. One study found that at 12 months post oral contraceptive use, women had a quick return to fertility. Another study following 21 women of childbearing age showed that 18 of the 21 women were pregnant within 13 months of cessation of birth control.

Functional Medicine Labs to Consider Post Birth Control

Although it is not required to have labs when discontinuing birth control, it could be a proactive way to optimize your health. Assessing hormones, nutrient status, and liver function are beneficial tests to monitor patients suffering from hormone imbalance symptoms, painful periods, absent periods, altered libido, or PMS.

Hormone Testing

There are three methods of testing sex hormones- urine, blood, and salivary. Blood testing, such as the Female Hormone Panel by Precision Point, is a great option to get a snapshot of the sex hormones. It's a good baseline test for women who have been off birth control for three months and their cycles are becoming regular. If symptoms arise after stopping birth control, this test can be used as a screening to see if more extensive hormone testing is indicated.

The Comprehensive Hormone Profile by Doctor's Data is a salivary test that provides information on active and bioavailable sex hormones and cortisol patterns throughout the day.

The DUTCH Complete urine test by Precision Analytical (DUTCH) is the gold standard for testing sex hormones and their metabolites. If your cycles do not self-regulate after getting off birth control, or you have a previous diagnosis such as PCOS, this would be a test that gives helpful insight into case management!

Nutrient Testing

Obtaining a CBC is always helpful to ensure no pre-existing anemia or other nutrient deficiencies are present. The Micronutrient Test by SpectraCell Laboratories can also be a valuable tool, as hormonal birth control is notoriously known to deplete Vitamins and Minerals, particularly B2, B12, B6, Folate, Zinc, Magnesium, and Selenium.

Liver Function Evaluation

Long-term use of birth control can affect liver enzymes and cholesterol markers. Obtaining a Comprehensive Metabolic Panel and Lipid Panel can give insight into how well your liver is functioning and if there is any concern. A 100-participant study evaluated the lipid profiles of women ages 21 to 40. The results revealed that total cholesterol, HDL-C, LDL-C, and triglycerides were significantly higher among women taking oral contraceptives compared to the group that was not.

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6 Natural Ways to Balance Hormones Post Birth Control

Below are the top 6 natural ways to balance hormones after birth control:

1. Nutrition

Maintaining a whole foods diet- high in fresh produce, macronutrients, and fiber is necessary for hormone production, stress response, and the return of ovulation.

Protein, carbohydrates, and fats are all necessary for hormone production and regulating ovulation. Healthy options include wild-caught fish, legumes, sweet potatoes, and oils such as avocado, coconut oil, or olive oil.

Eating foods such as flaxseed, broccoli and cashews can help balance hormones after birth control. Flaxseed has estrogenic and antiestrogenic properties that can help regulate ovulatory processes by regulating sex hormone action. Phytoestrogens are also important, as they are antioxidants that help support the natural function of estrogen.

2. Herbs

‍Vitex Agnus (Chaste tree berry) adjusts hormones by a "proposed mechanism of action in that Vitex Agnus causes a decrease in prolactin, which leads to a reversal of LH suppression, allowing full development of the corpus luteum, increasing progesterone levels and reducing symptoms of PMS." (19) One randomized-controlled double-blind placebo study found that Vitex effectively relieves mild to moderate symptoms of PMS. If you are someone who got on birth control to help balance hormones, Vitex may be a good option if the hormone imbalance is in question post-birth control.

Jia-Wei-Xiao-Yao-San (JWXYS) is a commonly prescribed traditional Chinese herbal formula for PMS and probably one of the most studied Chinese herbal formulas for stress relief. Studies have shown that JWXYS plays an antidepressant role by regulating a comprehensive network of neurotransmitters, neurotrophins, hypothalamic-pituitary-adrenal axis, amino acids, and lipids.

The adaptogen, Ashwagandha, is a widely used botanical used in traditional medicine to help manage stress. This plant regulates cortisol levels as your body responds to stress, thus making it easier to adapt to internal changes.

3. Supplements

A 2003 cross-sectional study looked at the status of homocysteine, folate, vitamin B6, and vitamin B12 in 219 healthy women. Results stated that those who routinely took oral contraceptives had significantly lower levels of vitamins B6 and B12. Other deficient nutrients are Magnesium and Zinc. Taking a high-quality Vitamin B complex, along with Magnesium and Zinc, would support nutrient restoration and symptom reduction.

Essential fatty acids are beneficial in cellular communication, and Omega-3 Fatty acids supplementation provides anti-inflammatory benefits that combat pro-inflammatory Omega-6, decreasing painful periods.

4. Stress Reduction

Managing your stress by implementing relaxation techniques, prioritizing and organizing your life, and taking time to enjoy hobbies is crucial for cortisol regulation. The stress hormone cortisol interacts with sex hormones. If this is chronically elevated, it can lead to further imbalances and symptoms. Finding a sweet spot between work and play is great for hormone health!

5. Sleep

Our bodies follow a circadian rhythm. This means that the daily cycle of 24 hours affects how our body cycles. Aiming for 7-9 hours of restorative sleep per night is the recommended duration for optimal health. There are some women whose sleep is disturbed by hormonal shifts, and in those cases, it would be best to see your doctor for guidance.

6. Exercise

A meta-analysis on physical activity and sex hormones revealed that movement reduced testosterone levels. Regularly moving your body, in the form of walking, weight training, yoga, or HITT, has all shown a positive correlation in regulating hormones. The best advice is to find a routine that works for your life and is something you could see yourself doing at least three times a week.

*Note: Always consult with a doctor before stopping hormonal birth control. They can recommend how to do it safely and describe what to expect.

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Summary

Although hormone imbalance after birth control impacts many women, there are tools to help you navigate this process. Getting off birth control can happen with ease when you have the right plan in place. Creating a plan that considers what your body will need in the form of nutrition, supplements, and lifestyle modifications will put you in the best position as you leave the pill behind.

While some women will be able to bounce back quickly, others may benefit from consulting a functional medicine practitioner. Obtaining labs and an individualized understanding of what is happening inside your body may be the best path to balanced hormone health!