A Naturopathic guide to coming off the pill
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.
https://helloclue.com/articles/cycle-a-z/the-menstrual-cycle-more-than-just-the-period
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. Supplement with:
o Water soluble vitamins B2, B6, B9, and B12
o Vitamins C and E
o Minerals magnesium, selenium, and zinc
Micronutrients the pill depletes, foods they are contained in, and their Recommended Dietary Allowances (RDAs). Reference; https://pubmed.ncbi.nlm.nih.gov/23852908/
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:
o FSH, LH
o Testosterone, androstenedione, DHEAS, SHBG, FAI
o TSH, T3, T4, thyroid antibodies
o Fasting insulin and glucose
o 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:
o Less common; congenital adrenal hyperplasia, androgen secreting tumours, prolactinoma
- Consider:
o Gynaecologist
o Endocrinologist
o Bioidentical progesterone or progesterone cream
o Further investigations as needed
Common post-pill conditions and treatment:
- Post-pill acne
o Zinc, saw palmetto, berberine, Vitex, Peony/Licorice, DIM
o Consider the role of dairy
o High fibre diet
- Post-pill polycystic ovarian syndrome (PCOS)
o Inositol, cinnamon, zinc, folate, magnesium, saw palmetto, Peony/Licorice
o High fibre diet
- Post-pill hypothalamic amenorrhoea (HA)
o Increase food intake
o Increase carbohydrates
o Lower intensity exercise
o Stress management
o Omega 3, zinc, Withania, Rhodiola, Dong quai
- Post-pill irregular cycles
o Support ovulation – see below suggestions
o Vitex, Withania, zinc, magnesium, B6, iodine
o Check thyroid health
o Check fasting insulin and glucose levels
- Post-pill infertility
o Wrongfully labelled and often due to one of the above scenarios!
o Address accordingly
A selfie with the beautiful hormonal regulator Vitex/Chaste tree
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:
o Zinc, magnesium, B6, inositol, iodine, and omega 3 fatty acids
- Herbal modulators to support ovulation include:
o Vitex/Chaste tree, Dong quai, Peony, Black cohosh, Shatavari
- Adaptogens to support ovulation include:
o Withania, Rhodiola, Siberian ginseng, Schisandra
- Adrenal tonics to support ovulation include:
o 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 - completing)
References
https://pubmed.ncbi.nlm.nih.gov/23852908/