Post-Birth Control Syndrome
support through your transition off hormonal birth control
coming off oral contraceptives?
Maybe you're considering coming off birth control, but are fearful of the side effects, or who you might be without it. Maybe you've made the move to a synthetic-hormone-free lifestyle already, and you're suffering some of the post hormone consequences . Regardless, I'm here to help.
Discontinuing hormone therapy can be difficult. The body grows accustomed to replacement hormones and therefore your own sex steroid hormone production becomes hindered. This is, in essence, how a birth control pill works. However, when the replacement hormones are discontinued, the body does not always properly restore its primary hormone production. This is where Naturopathic Medicine can really help.
First off, let's clarify a few things about life on the birth control pill ...
You don't ovulate while on the pill. By supplying exogenous hormones into your system, the negative feedback loop to the brain is told that you have enough supply, so the signalling from the brain to your ovaries shuts down. Therefore, your luteinizing hormone never spikes, and you never ovulate - hence an inability to conceive while on the pill.
Your period on the pill is not a real period. A true menstrual cycle involves ovulation, resulting in progesterone production. When conception fails for that cycle, progesterone drops, the lining sheds, and the cycle starts over. The bleed you experience on a birth control pill is entirely a result of you discontinuing the hormonal pills/starting your sugar pills for a week. This is called a withdrawal bleed.
It can take up to 6 months before normal hormone production is restored. If you've just come off the pill, or if you've been off for a few months and your period hasn't returned to normal, don't panic. It takes about 3 months for a primordial cell to ripen into a ready-to-ovulate oocyte, and remember that this process has just been suppressed for however many months/years you were taking the pill. While natural therapies can really help this process along, it is 'normal' for it to take up 6 months for this process to re-regulate.
what about an IUD?
An IUD, specifically hormonal based IUDs like the Mirena, differ from oral birth control pills in a few ways. First off, their route of administration is different. While the pill must first pass through the liver before it takes affect on peripheral tissue, the IUD has local absorption effects. The pros to this mean that dosing can be much lower (the IUD is on average a 1/5th of progestin compared to a pill) and local absorption in the IUD means no risk for blood clots (which the pill does). Secondary, the IUD only has one hormone - progestin, which is a synthetic form on progesterone, vs the pill which contains both estrogen and progestin.
However, some women also don't ovulate on the Mirena IUD, or ovulate very irregularly. Many of the same side effects experienced when discontinuing the oral birth control are also seen in women after removing their IUD.
post birth control support
Support for women discontinuing birth control therapy is targeted at a few primary goals:
Return to regular ovulation. Stopping the pill does not always = the return of healthy ovulation. Anovulatory cycles are one of the primary reasons women may experience hormone imbalances. This applies not only to women looking to get pregnant but also to those looking to return back to a healthy, symptom-free menstrual cycle. I also work with patients on how to use natural cycle tracking applications to function as a primary means of birth control (check out Natural Cycles for more info)
Support clearance of exogenous hormones. Birth control therapies are reported to deplete b vitamins, magnesium, and glutathione - all important nutrients for healthy liver detoxification. Furthermore, the body has been exposed to synthetic sources of hormones for a long time, so we ensure to include support for healthy liver detoxification in all our treatment plans.
Manage side effects from hormone withdrawal. Depression, anxiety, hair loss, acne, migraines, etc are all reported side effects of birth control use and/or birth control discontinuation. They are typically a result of imbalances created from replacement hormones, or secondary effects of synthetic hormones on neurotransmitter receptors in the body (ie estrogen and serotonin have a synergistic relationship). The goal is to understand the mechanism of why your symptoms are occurring (tracking, hormone testing, body temperature, ultrasound, ovulation strips) and utilize holistic therapies to return your hormones to a state of homeostasis.
Pregnancy preparation. Remember that it takes 3 months for a woman's egg to ripen, so preparation for pregnancy should always start at least 3 months prior to your desired conception date. Preparation includes support for healthy egg development, optimal ovulation, and proper fertilization/implantation. Also as equally important to a healthy pregnancy is optimal sperm quality, which takes about 75 days to prepare (remember that >30% of infertility comes from male factor issues).