How to transition off hormonal birth control (especially the pill)

Have you made the decision to come off hormonal birth control? Maybe you are a bit nervous, because you originally went on birth control for your acne, and are worried that it will come back with a vengeance? 

Well, there’s good news and bad news. The bad news is, that post pill acne usually gets worse before it gets better, and can actually be at its worst 6 months after stopping the OCP. This is because several birth control pills suppress androgens, which suppresses sebum production in our skin, helping to reduce acne. When we stop the pill, because they have been suppressed for so long, our androgen and sebum production go into overdrive, often resulting in acne.

It is also common to have PMS, PCOS, anxiety, amenorrhea and painful, irregular and/or heavy periods develop or return after ceasing hormonal birth control. Depending on what your periods were doing before you started hormonal birth control will also affect how quickly it takes to ovulate again - it could take months and unfortunately in some cases even years. 

The good news is, there are things we can do to support our bodies and reduce these acne flares and establish a healthy regular cycle. The following is not an extensive list, but helpful to start at least one month prior to coming off hormonal birth control.

  • Take a good quality zinc supplement daily with food and increase dietary intake. Not all forms are created equal, so work with a practitioner to guide you. Zinc works by:

    • Reducing inflammation by modulating inflammatory cytokines 

    • Inhibiting 5-alpha-reductase activity (implicated in acne)

    • Reducing androgens binding to receptors and reducing sebum levels 

    • Inhibiting prolactin secretion

    • Increasing progesterone levels 

    • Nourishing ovarian follicles 

  • Support liver function: did you know that synthetic oestradiol in the OCP  is around *4 times stronger* than endogenous oestrogen? It is important to support the liver to clear these synthetic hormones so we can encourage endogenous production and ovulation. We can do this by supporting liver clearance of hormones using:

    • Certain herbs and nutrients

    • Cruciferous vegetables, especially broccoli and broccoli sprouts: these help with metabolizing oestrogen, reducing aromatase enzyme and blocking androgen receptors. 

  • If you suffer with endometriosis or PCOS, start treating these conditions at least one month prior to stopping the OCP.

  • Ensure you are eating enough nutritious foods to support ovulation. If your periods are slow to return, it is worth having your nutrient and hormonal status assessed via pathology testing. 

As always, see a qualified naturopath or practitioner (like me!) before implementing the above strategies to make sure they are right for you.

Hayley Brass