The Journal

A Naturopathic guide to coming off the pill

June 28, 2021

The oral contraceptive pill (OCP) is the primary method of contraception in Australia, reported to be used by over 40% of contraceptive users. Following this, the next most commonly used contraceptive is the humble condom, at 18%. I have seen the trend towards LARCS (long acting reversible contraception) rise over the last few years. LARCs include hormonal implants, IUDs (Mirena, Kyleena, the ParaGard copper IUD), and contraceptive injections (such as DMPA). However these numbers are still quite low compared to the number of women currently on the pill.

With these statistics, is no surprise that women are seeking support for coming off the pill, to assist with making the transition as smooth as possible, to support a regularly, ovulatory, natural cycle, and very commonly for assistance with adverse symptoms related to pill use.

Hormonal fluctuations in a natural, ovulatory menstrual cycle

Whilst using the pill, key nutrient depletions of concern include vitamins B2, B6, B9, B12, vitamin C and E, and the minerals magnesium, selenium and zinc. Post-pill, common symptoms and concerns of clients I see include hormonal acne, irregular cycles, lack of a cycle returning, spotting, and mood swings. In this blog I will provide my suggestions for coming off the pill, unwanted symptoms associated, as well as recommendations for specific pill-related concerns.

It is important to note that I am not a doctor, and therefore cannot prescribe medication nor advice on when to take it or when to cease taking it. If you want to come off a medication, it is always recommended that this be done under the guidance of your GP.

Phase 1; Before Coming Off the Pill

3 months before coming off the pill, replete nutrients if not already being addressed. Review and consider supplementation with:
- Vitamins B2, B6, B9, and B12
- Vitamins C and E
- Minerals magnesium, selenium, and zinc

Micronutrients the pill depletes, foods they are contained in, and their Recommended Dietary Allowances (RDAs)

Phase 2; First 3 Months

Once you have ceased using the pill, I suggest gentle liver support to work on clearing any excess synthetic oestrogen and progesterone left in the body
Continue to supplement with nutrients mentioned in phase 1

Phase 3; 3 – 6 Months

If cycle has not returned, identify cause of hormonal irregularities (see below)
Pathology suggestions include:
- FSH, LH
- Testosterone, androstenedione, DHEAS, SHBG, FAI
- TSH, T3, T4, thyroid antibodies
- Fasting insulin and HbA1c
- Prolactin
Individualised nutritional and herbal treatment would follow once results have been analysed
Consider acupuncture

Phase 4; 6 months+

Test for hormonal irregularities
Address underlying condition/s if relevant:
- Less common; congenital adrenal hyperplasia, androgen secreting tumours, prolactinoma
Consider:
- Gynaecologist
- Endocrinologist
- Bioidentical progesterone or progesterone cream
- Further investigations as needed

Common post-pill conditions and treatment:

Post-pill acne

Zinc, saw palmetto, berberine, Vitex, Peony/Licorice, DIM
Consider the role of dairy
High fibre diet
Read this blog

Post-pill polycystic ovarian syndrome (PCOS)

Inositol, cinnamon, zinc, folate, magnesium, saw palmetto, Peony/Licorice
High fibre diet
Read this blog

Post-pill hypothalamic amenorrhoea (HA)

Increase food intake
Increase carbohydrates
Lower intensity exercise
Stress management
Omega 3, zinc, Withania, Rhodiola, Dong quai

Post-pill irregular cycles

Support ovulation – see below suggestions
Vitex, Withania, zinc, magnesium, B6, iodine
Check thyroid health
Check fasting insulin and HbA1c

Post-pill infertility

Wrongfully labelled and often due to one of the above scenarios!
Address accordingly

Lifestyle tips to support ovulation:

Prioritise self-care - enjoy 30 minutes of ‘me time’ daily
Manage your stress - say no to anything that does not serve you
Enjoy gentle movement 4 - 5 days a week (no high intensity exercise)
Aim for at least 2 rest days weekly
Aim for 7- 9hrs restful sleep per night
Eat approx. 150-200 grams of carbohydrates daily (this will not apply if you are insulin resistant or have blood sugar dysregulation issues)
Include healthy fats at every meal

Supplementation to support ovulation:

Nutrients to support ovulation include:
- Zinc, magnesium, B6, inositol, iodine, and omega 3 fatty acids
Herbal modulators to support ovulation include:
- Vitex/Chaste tree, Dong quai, Peony, Black cohosh, Shatavari
Adaptogens to support ovulation include:
- Withania, Rhodiola, Siberian ginseng, Schisandra
Adrenal tonics to support ovulation include:
- Licorice and Rehmannia

If you are looking for individualised support for coming off the pill please get in touch by booking in a session here.

Jaclyn is a qualified Naturopath with a focus on hormonal complaints, cycle health, reproductive and fertility care, skin issues, and adrenal health.

Author

Jaclyn Cave
BHSc (Nat), BComm (Soc)
Masters Womens Health Med (UNSW)

References:

https://pubmed.ncbi.nlm.nih.gov/23852908/
https://pubmed.ncbi.nlm.nih.gov/760421/
https://www.abs.gov.au/AUSSTATS/abs@.nsf/2f762f95845417aeca25706c00834efa/e50a5b60e048fc07ca2570ec001909fb!OpenDocument