Updated: Sep 2
I have had many women come to my practice because they have irregular periods, or were put on birth control to manage their symptoms and now they want to stop birth control. Whether you are currently on birth control for irregular periods, or are no longer taking birth control; this article has applicable and helpful information for you!
Listen to my webinar on understanding your cycle and balancing hormones. Find the video here
Your Period on Birth Control, aka. Withdrawal Bleeding
To start off, let’s talk about the difference between natural periods and periods when on birth control. If you are on birth control, the periods you have each month are not true periods but actually what is called withdrawal bleeding.
In a natural period your body increases production of progesterone in the second half of your cycle, to thicken the uterine lining for a potential pregnancy. When the egg is not fertilized/implanted during ovulation, the body sheds this uterine lining and excretes it through period bleeding.
Note: The hormone fluctuation in a natural period provides a boost in progesterone during the second half of your cycle. Progesterone helps the body relax. It also is known to improve mood, sleep, and anxiety. Unfortunately you do not experience this same benefit when taking birth control.
When taking birth control, you experience withdrawal bleeds every month or every few months, depending on what type of birth control you are on. Withdrawal bleeding is triggered by a drop in synthetic hormone levels in the body, which cause the lining of your uterus to shed (same as a natural period).
Synthetic hormones in birth control turn off the normal communication between the brain and ovaries that are in charge of hormone fluctuations during your cycle. This is why women on birth control tend to have lighter and shorter periods. (1) It is also why it is a common go-to for doctors to prescribe birth control when women have irregular or heavy periods.
The primary role of birth control is to stop the ovaries from ovulating and/or keeping the uterine lining thin so that implantation of an egg cannot occur. This is why birth control is effective in preventing pregnancy.
Are there side effects of long-term birth control use?
There's a good chance if you are reading this article, you have heard of the side effects of long-term birth control use.
If you started birth control to manage symptoms of irregular or heavy periods, I highly encourage you to continue reading and consider alternative therapies to balancing hormones.
With that being said, if you want to stop taking birth control it is a good idea to know what you may be dealing with come the next few months. It is not necessarily an easy process, but it is worth it! Stick with me.
Stopping Birth Control
If you have recently stopped birth control, or are thinking about it, keep in mind that it may take a few months for your body to get back on track.
A good rule of thumb is to expect your period to come back in 3 months if you had regular menstrual cycle prior to starting the pill. If you had irregular cycles prior to starting the pill, you will want to give your body 6 months to bounce back.
The reason you need to give your body some time after stopping birth control is because there are a few adjustments that need to occur.
Birth control is known to deplete vital nutrients in the body including B vitamins, magnesium, vitamin C, vitamin E, selenium, and zinc.
Birth control stops the communication between your brain and ovaries necessary for ovulation. These systems can take a little time to get back in sync.
There is also likely inflammation present in the body. Think of inflammation as fog, it slows down systems and needs to be properly cleared from the body in order for the body to function optimally.
The recommendations in this article for nutrition and lifestyle will help support and regulate your body’s natural menstrual cycle.
If you are not ready to stop birth control, these tips can also be helpful in preventing digestive or hormonal imbalances from developing.
But before we get to the good stuff, let's touch on some symptoms that can develop when stopping birth control.
Post-Birth Control Symptoms Include:
Menstrual Irregularities: heavy bleeding, painful periods, and shorter cycles (<24 days).
Ammenorrhea: lack of period for several months (4-6 months).
Hormone Imbalances: acne, hair loss, hirsutism, tender breasts, infertility, hypothyroid, etc.
Digestive issues like constipation, diarrhea, bloating, gas, and reflux.
Increased headaches or migraines.
Changes in body weight or difficulty losing weight.
Mood Changes including anxiety, depression, PMS, or mood swings.
Increased inflammation and poor immune system.
Working with a health professional is important when stopping birth control because you want to manage symptoms individually as they appear so that things do not get out of control. In my practice I meet with clients at least every two weeks as they are working to balance hormones because natural fluctuations are unavoidable so we want to stay on top of symptoms.
There is an increased risk if your period was irregular before starting the pill that you may not be able to get your period back without further intervention. To start, we need to gather specific data showing hormone levels in the body. We can gather this data through lab testing.
Tests to Complete When Your Period is Missing.
If it has been three months with no period, or you have an irregular cycle, I recommend having the following tests drawn.
FSH, LH, and Estradiol. Test on the 3rd day of your cycle. Both FSH and LH are hormones that are produced by the pituitary gland in the brain. These hormones signal the ovaries to produce follicles and thicken the uterine lining, both essential for ovulation and therefore menstruation. Estradiol is the main form of estrogen in a menstruating woman’s body. Estradiol can become dominant in the body and cause other hormones to decrease, leading to a common hormone imbalance.
Progesterone Test between days 19-22 of your cycle. Progesterone will rise after ovulation has occurred. Progesterone’s main role in your cycle is to thicken the uterine lining so implantation and growth can occur during pregnancy. You can also identify a hormone imbalance by comparing estradiol and progesterone levels.
Full Thyroid Panel The thyroid panel includes pituitary (brain) hormone TSH as well as the thyroid hormones - T3, T4, reverse T3, and thyroid antibodies. We can look at the communication between the brain and thyroid when a full thyroid panel is done.
Cortisol Cortisol is best tested through saliva and should be collected periodically in a 24-hour period in order to have the most comprehensive and helpful reading. Cortisol will fluctuate throughout the day, so we want to make sure it is rising and falling in a normal pattern. Elevated cortisol levels can be another reason why progesterone levels are too low.
DUTCH Hormone Panel This is by far my favorite and most comprehensive test out there for hormones. I run this test in my practice often and has been extremely helpful in identifying the hormones and detoxification pathways that need to be supported for healing and balance. The DUTCH panel is a simple at-home collection since it uses dried urine as the sample. You can collect your sample at home and send it back to the lab through the mail. This test should be interpreted by an experienced health provider for you to get the most out of the results.
The loss of your period can be overwhelming to try and figure out on your own. Finding a health professional who can help you understand the process and guide you through a supportive and natural healing process is key.
Regulating Your Menstrual Cycle Naturally
To start, make sure you have downloaded my “Tracking Hormones Guide”. This guide will help you set up tracking so that you have the data you need to make effective changes.
A Whole Food, Low Sugar Diet
Cutting out a few foods is key. Eliminate added sugar, alcohol, and refined grains. This is your typical white breads, crackers, cookies, etc. that is recommended for every healthy diet.
Work on increasing fiber in your diet. I want this to be from whole foods and not a supplement. Your goal of 30 grams per day. You want to slowly increase fiber, about 5 grams every few days, to prevent constipation or GI distress. To increase natural fiber, choose foods like berries, greens, flaxseed, chia seed, whole grains, avocado, and almonds.
Eat high quality protein with your meals to help balance blood sugar and keep you full. For animal proteins make sure to choose organic. Plant-based proteins include beans, legumes, nuts, seeds, nut butter, and grains. If you are having trouble getting enough protein in your day, you can add a clean ingredient protein powder. Here is a favorite of mine.
Use plenty of spices and herbs in your cooking. Both spices and herbs are what I like to call, food medicine. They have long been studied and used in Ayurvedic medicine. These foods play a role in our metabolism, detox, hormone production, digestion, and more. Include foods and flavorings like ginger, turmeric, cinnamon, garlic, rosemary, basil, oregano, etc.
A High Quality Supplement Regimen
Supplements help to replete nutrients in our body, support production of hormones, and decrease inflammation much quicker than if you were to try and use only whole foods. Unfortunately our food today is just not as powerful and rich in nutrients as it used to be.
Omega-3 Fish Oil with at least 1000 mg EPA + DHA
Vitamin D3 - 2000 IU daily
Magnesium - 350 mg daily
You can find my favorite brands and recommendations for supplements on Fullscript dispensary. Create your free account and search through my protocols or click the links above.
Detox is especially important for estrogen dominance, but also helpful for overall inflammation control and liver support. For a supportive, whole food detox we want to make sure you are eating plenty of vitamins, minerals, and fiber in your diet.
Eat at least 30 grams of whole food fiber daily. High fiber foods include vegetables, grains, beans and legumes, berries, nuts, and seeds.
Add 2 cups cruciferous vegetables into your day. This includes broccoli, kale, cauliflower, Brussels sprouts, cabbage, and radishes
Dandelion root tea, 1 cup daily
Emotional Support and Stress Management
As I have said throughout this article, it is not easy to deal with hormone imbalance especially mood swings. We can feel completely disconnected from our bodies. Some days you may feel like a completely different person due to mood swings, anxiety, and irritability. I always make sure to include positive emotional techniques to help strengthen your mind and emotions.
Stress is also a common reason for hormone imbalance since it triggers the body to produce more cortisol. Higher cortisol production leads to lower progesterone production. Remember progesterone is our nice calming hormone that helps us to sleep better, improves mood, and anxiety. Helping your body to balance hormones and regulate your cycle will promote production of progesterone and alleviate related mood disorders.
Interested in taking next steps to balancing hormones and healing your gut? Check out my Hormone Hub group program!
Liz Riesen, Registered Dietitian
specializes in digestive and hormone imbalances. Often these conditions coexist and share common disruptive symptoms including mood changes, bloating, pain, irregular cycles, inflammation, and more. Liz is trained in identifying and healing food sensitivities, as well as balancing hormones naturally through nutrition and lifestyle.
Join me in the Hormone Hub and learn all about digestion & hormones.