Post-Pill Reset

Women go on birth control pills for a variety of reasons.  Perhaps you have been on and off them since you were 14 because you had unbearable cramps or extremely heavy bleeding.  Or maybe you were “irregular” or weren’t getting a period at all. Then of course many women go on them for strictly “recreational purposes.”  For as many reasons you might have gone on birth control there are so many reasons why you have decided stop.  This could be anything from terrible side effects, wanting to get pregnant or not wanting artificial hormones circulating in your body.  Some women will have no problems stopping birth control pills. Their periods normalize in a few months and they have no other issues.  Unfortunately, the rest of us are not so lucky and we experience post pill syndrome.  The good news with a good post-pill reset we can get a hold of our hormones and get our body back.

What is Post-Pill Syndrome?
Post-pill syndrome describes the variety of symptoms that start within the 4-6 month period of stopping birth control pills.  These symptoms include acne, irregular or absent periods, mood swings, digestive issues, short cycles, and extremely heavy painful periods.  There are three main reasons why women experience any of this symptoms after stopping.  The major reason is that some of many women started birth control to manage things like heavy painful periods, irregular cycles and acne.  The birth control suppressed these symptoms by altering hormone levels.  However this was just a temporary fix and once the birth control was removed, hormones went back to their original dysfuction.  The pill only covers up the problem and the underlying cause is never really addressed.

Another factor is that our hormones are constantly changing throughout our lifetime.  This is very apparent when a woman starts birth control her twenties and thirties and then decides to stop as enters perimenopause in her late forties or early fifties.  What she might be confronted with is a few months worth of heavy painful periods.  This is because progesterone is the first hormone to drop out during “the change.”  Low progesterone causes unopposed estrogen increasing the build up of our uterine lining making periods heavier longer and cycles shorter.

The last reason for post-pill syndrome, is that birth control can affect hormone production.  While on the pill, our body gets a steady supply of progesterone and estrogen so our bodies don’t have to put any effort into making them.  At the same time two other hormones, luteinizing hormone (LH) and follicle stimulating hormone (FSH) don’t surge to trigger ovulation.  Proper function of our menstrual cycle and fertility depend upon all four of these hormones interacting with each other.  Some women experience issues getting these healthy interactions started again after stopping birth control.  This is one reason why using birth control to normalize cycles or to get a period going may not be the best choice in the long run.

So what am I suppose to do?

Know your labs
At my naturopathic practice in New York City, I recommend that my post-pill syndrome patients follow up with their primary care doctor or gynecologist for hormone testing.  I prefer doing this prior to starting female specific herbs because it is important to see where the hormonal imbalances lie so we can develop the most effective naturopathic post-pill syndrome plan.  At a minimum, the labs should include estradiol, progesterone, testosterone, DHEA, prolactin, FSH, LH, sex-hormone binding globulin, ferritin and lipids.  The reason lipids are so important is that cholesterol is the building block for all our hormones. Thyroid labs including TSH, free T4 and free T3 as well as morning and evening cortisol can be useful as both thyroid function and stress play a role in hormone regulation.  In addition if I suscept or there is a past medical history of PCOS, I will want to look at glucose, insulin and HA1C.  If you are currently cycling, you will want to have your labs taken day 3 as this is the standard for assess fertility.

Healthy eating to reset
One of the most important elements to resetting the body after birth control pills is healthy eating.  I would even stress that you start a few months before you quit. The components of a healthy post-pill diet include liver optimizing foods, blood sugar balancing and organic clean foods free of toxins.  Why liver optimizing?  All of our hormones are processed through the liver so we want to make sure it is functioning well to handle the change in hormone levels that may occur after we stop birth control.  These foods include artichokes, beets, broccoli, cabbage, Brussels sprouts, cauliflower and onions.  Brassica vegetables like broccoli are particularily important because they contain indole-3-carcinol which does an amazing job at detoxing estrogen.  

Speaking of estrogen, as much as possible we want to avoid foods that have xenoestrogens, which are foreign substances that mimic estrogen.  These include pesticides, antibiotics, and BPA canned foods and beverages.  Animal dairy even if it is organic can be tricky because by its very nature is high in hormones as it is the sole food source for baby animals.  Dairy products in general slow down liver detoxification so they are best to be avoided.  Similarly eliminating or reducing alcohol can really help to enhance our liver clearance.

Now on to blood sugar.  Maintaining stable levels is important because insulin spikes lead to a decrease in SHBG which increases estrogen and testosterone levels.  Insulin also increases the production of testerosterone and is associated with polycystic ovarian syndrome (PCOS) and excess abdominal fat.  To keep blood sugars in balance,  make sure to have at least 10-15g of high quality lean protein, 3-5 g of fiber and a healthy fat at each meal.  You will also want to keep sugar and refined carbohydrates at a bare minimum. I wouldn’t go crazy on fruit either.  Stick with 1-2 servings per day of low glycemic fruits like blueberries, melon, and apples.  One of the best pieces of advice, I would give is the importance of a protein rich breakfast to establishing the basis for steady blood sugars throughout the day.  If your go-to is a pastry or bagel and a latte, making the switch to a two egg veggie scramble can make such a big difference. 

Final thoughts
A healthy eating plan can get you on the right path to resetting your hormones post-birth control.  If things still feel out of wack and your labs are all over the place, it might be time to start a comprehensive naturopathic plan including herbs and nutrients to balance your system.