Stopping the pill or any kind of hormonal contraception can be a daunting time. Most women start using hormonal contraception, not for contraceptive purposes but to treat menstrual issues like acne, period pain and heavy bleeding. But they don’t ‘fix’ these issues, they just mask them. So, as long as you take the hormonal contraception your symptoms are gone, but as soon as you stop they will return. The uncertainty of “what will my hormones be like? When will my period return?” can often make the transition a little uneasy. But coming off hormonal contraception, whether it is to make babies or just to give your body a break from the artificial hormones, can be a relatively smooth transition. It just requires a little pre-planning.
The first step in coming off hormonal contraception, if you are using it for contraception, is to make sure you have an alternative contraception available to you. There are many options available and the old ones are making a comeback. Think condoms, diaphragms, symptothermal charting and even the withdrawal method – these are all non-hormonal options you can consider.
To make the transition super smooth, the biggest question you need to ask yourself is “what were my periods like before I went on these hormones?” This will give you a good idea of what they will be like when you stop. Don’t fear, below is a step-by-step plan on what to do to ensure that when you come off hormonal contraception, your transition is not only smooth but with will result in minimal symptoms.
What were your real periods like?
- Normal periods
- Heavy Periods
- Period Pain
Normal, Regular Periods
Ok, so you’re the lucky one who had a regular period with no acne or period pain and more than likely went on the pill for contraceptive purposes. The focus of your transition is to ensure you return your gut and nutritional stores back to normal levels to support healthy hormone balance. Did you know that the pill has a negative effect on your gut health? This results in higher levels of bad bacteria than good bacteria and your nutritional stores can also take a beating if you are deficient in zinc, vitamin C, folate and magnesium.
Probiotic – Take a broad-spectrum multi strain probiotic that contains both lactobacillus and Bifidobacterium in order to recolonize the gut with healthy bacteria. This should be started 2 months before stopping hormonal contraceptive and continued for 3 months once you have stopped the hormonal contraceptive to ensure good colonisation. You can also include fermented foods into your diet like miso, kefir, good quality yoghurt, etc.
Multivitamin and Mineral Complex – I recommend all women on hormonal contraceptives take a multivitamin and mineral supplement every day because the artificial hormones increase your body’s need for nutrients. If you aren’t already taking a multivitamin and mineral then I suggest you start. This will help restore your nutrient levels and help with hormone balance, energy and general wellbeing.
St Mary’s Thistle – This is also known as milk thistle and is an herb that supports liver detoxification. Taking St Mary’s thistle once you have stopped the hormonal contraceptive and continuing it for 3 months will help clear your body of the artificial hormones and restore your natural hormone balance. You can take St Mary’s thistle as a tea, tablet or as a liquid.
Broccoli – Broccoli contains a nutrient known as indole – 3 – carbinol, a compound found in cruciferous vegetables like broccoli, Brussel sprouts and cabbage that helps detoxify excess oestrogens out of the body, like those found in the hormonal contraception. Eat a serving (about 1 cup) of cruciferous vegetables every other day to help clear excess oestrogen.
Going onto hormonal contraception for acne is very common particularly for girls who started taking the pill in their late teenage years. The thought of stopping is like a scene out of a horror movie! The distant memory of a face full of acne, red with pus-filled sores is enough to keep you taking hormonal contraception. But with the right preparation, coming off should be as painless as possible. Post-pill acne peaks 6 months after stopping the pill but the following recommendations can help ensure that this transition is as bump free as possible.
Two months before stopping the pill:
Dairy free diet – Dairy acts as inflammatory to the body. It also creates mucous (think whiteheads and pus-filled pimples). Many people don’t tolerate dairy very well and it causes gut inflammation and weakens the immune system. It is often said that the skin is a reflection of the gut, so a compromised gut isn’t going to result in glowing skin. Going dairy free means avoiding all cow’s milk and products including yoghurt, cheese, ice cream and milk. Instead of cow’s milk, try goat’s or sheep’s dairy products.
Sugar free diet – We all know how bad sugar is for our bodies. But, did you know it’s extremely inflammatory and reduces collagen production in your skin? Sugar can result in inflamed breakouts and scarring (no thank you!). Going sugar free is crucial in the fight against acne.
Zinc – The pill contributes to a lot of nutritional deficiencies, particularly zinc. Chances are, your zinc levels will be pretty low. Zinc is vital for collagen production, prevents scarring, kills the bacteria that causes acne, and reduces inflammation. This is your acne must have! I recommend getting your zinc levels tested with an oral zinc taste test and if they are low take 25mg of zinc daily for three months before retesting.
Fish oil – Fish oil is like zinc, an acne must have! There are a lot of studies supporting the use of fish oil in the treatment of acne. It not only helps prevent scarring but also reduces inflammation, making the pimple less red and painful. Aim for 3g of fish oil per day. If you don’t eat a lot of salmon and oily fish, you may need to take a fish oil supplement.
Once you stop the hormonal contraception the focus shifts to restoring gut health and supporting liver detoxification as it is the hormones causing the acne. Continue with the above suggestions and then add in:
Berberine – Berberine is a compound found in certain herbs like goldenseal. It helps reduce acne by reducing testosterone levels in women and is an anti-inflammatory that also helps restore good gut health. Gut health is usually compromised by the pill, supporting bad bacterial overgrowth. I recommend taking berberine for 4 weeks. Do not take berberine if you are pregnant or breast feeding and speak to your pharmacist or doctor if you are on medication.
Probiotic – Once you finish taking the berberine, then it’s time to recolonize the gut with a broad spectrum multi strain probiotic that contains both Lactobacillus and Bifidobacterium. Take the probiotic for at least 3 months to really get that gut in a good shape. You can also include fermented foods in your diet like miso, kefir, good quality yoghurt, etc.
Indole-3-carbinol – This is a compound found in cruciferous vegetables like broccoli, Brussels sprouts and cabbage. Indole-3-carbinol helps detoxify excess oestrogens out of the body, like those found in the pill. It can be taken as a supplement or you can increase your consumption of cruciferous vegetables.
How long will it take?
It can take up to 3 to 6 months but you should notice that the acne is much improved from the start if you follow the above treatment. If after 3 months you aren’t getting the results you are after, I would suggest testing your oestrogen, testosterone and sex hormone binding globulin (SHBG) as you may require a tailored herbal treatment to help balance your hormones. If you get acne just before your period it is likely from too much oestrogen, if the acne occurs all cycle long it is usually from too much testosterone.
In part two of this two-part article series on how to safely come off the pill, we discuss heavy periods, painful periods and how to come off hormonal contraception if you want to make babies… stay tuned!
(Read more here on How to Come off the Pill Without Breaking Out)