How to get off the pill without side effects

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So, you’ve decided to or are thinking of going off the oral contraceptive pill but are terrified of what may happen when you get off. You may be worried about the possible side effects such as acne breakouts or that your periods will come back heavier and more painful than ever. But here at Moonbox, we’ve done all the research for you so you can feel supported when coming off the pill (without the side effects!).

How does the pill work?

Firstly, it’s important to explain how the combined oral contraceptive pill (the “pill” or “OCP”) works. In a normal menstrual cycle (without the influence of any hormonal contraception), the female reproductive hormones luteinising hormone (LH), follicular stimulating hormone (FSH), estrogen and progesterone will fluctuate throughout the month. During the middle of our cycle, we ovulate and release an egg which can become fertilised by sperm to result in pregnancy. The oral contraceptive pill works by suppressing our female sex hormones to shut down ovulation and hence preventing our eggs from becoming fertilised. 

The pill contains a synthetic version of estrogen and progesterone (progestin) and individuals will take the synthetic hormones for 21 days in a row at the same time every day and then take a ‘sugar pill’ for the next 7 days. When women take the ‘sugar pills’, they experience a drop in the hormones in the pill which triggers the shedding of the endometrium. This is known as the “withdrawal bleed” and it’s different from a regular period bleed.

What happens when you stop taking the pill?

In an ideal world, we’d like to think that getting off the pill will be a breeze and that we’ll start naturally ovulating and cycling again straight away. Some women may experience this and notice desirable symptoms such as reduced fluid retention, increased libido and improved mood. However, this may not be the case for many women.  

Some women may notice that their periods won’t immediately return after getting off the pill and will wait a few weeks to a few months for their natural periods to return. “Post pill amenorrhea” is the term used to describe the absence of menstruation after women come off the pill. If you notice your period does not return after 3-4 months, it would be recommended to seek the assistance of a healthcare professional to investigate possible reasons why this may be occurring. 

Also, whilst the pill is often used for contraception, many women will be prescribed the pill for hormonal-related issues such as PCOS, endometriosis, heavy periods, irregular periods, period-related migraines and acne. As the pill will treat the symptoms of these issues and not their root cause, women will, unfortunately, find their hormonal issues to return when they stop taking the pill (very unfortunate, I know!)

What are the common side effects post-pill? 

Getting off the pill will result in hormonal fluctuations and can present as unpleasant symptoms such as:

 If women continue to experience these symptoms for months after they come off the pill- it becomes what’s known as “Post-birth control syndrome” (PBCS). This term isn’t medically recognised but is often used by functional medicine doctors. 

PBCS occurs when our bodies are trying to rebalance their hormones after having them shut down from being on the pill. Since the pill shuts down ovulation and stops our bodies from making the necessary hormones to ovulate and menstruate, it’ll take some time for our bodies to adjust and begin to menstruate on their own.  

Are there steps to limit the side effects?

It may take a while for your body to adjust to produce its natural hormones but there are ways you can support your body and make this transition easier. We recommend supporting your body with our Post-Birth Control Moonbox whilst following these tips for at least 8-12 weeks before getting off the pill to allow for the easiest transition possible.  Here are our 6 ways to rebalance our hormones post-pill. 

Get off the pill without side effects

Replenishing nutrients

The pill depletes multiple nutrients including magnesium, zinc, selenium, vitamin C, vitamin E, folate, vitamin B6, vitamin B12 and vitamin B2. The pill affects the conversion, absorption, excretion and metabolism of these nutrients and studies have shown women on the oral contraceptive pill have lower amounts of these nutrients in their blood.  These nutrients are essential for hormonal detoxification, healthy mood balance, thyroid health, preconception, energy, immunity and so much more! 

Hence women should prioritise intake of these nutrients and supplement as required (under the supervision of a trained health care professional (HCP)) to prevent possible nutrient deficiencies and their related symptoms. Researchers of a 2019 review recommended women on the pill should supplement with a B vitamin complex with folic acid, vitamin C, E, magnesium, zinc and selenium. You can effectively replenish your magnesium levels with Moon Boost Magnesium Oil. 

Support the liver 

Both our gut and our liver are responsible for clearing out excess hormones, and this includes the synthetic hormones in the OCP. Hence supporting both our gut & liver’s functions in clearing out the hormonal build-up we’ve accumulated from taking the pill is essential for optimal hormonal balance.  

There are many ways in which we can support our liver, and these include increasing the intake of liver-loving foods and reducing our intake of liver loaders. Liver loaders include alcohol, trans fats, refined sugar and processed foods. Liver supporting foods include cruciferous vegetables (bok choy, broccoli, cabbage, cauliflower, maca and kale), dandelion, milk thistle, turmeric and green tea. Cruciferous vegetables contain a nutrient called “indole 3-carbinol” which boosts the metabolism and excretion of estrogen. 

We recommend drinking our Half Moon Tea which is our natural, liver supporting tea that contains a beautiful mix of hepatoprotective (“liver protective” herbs) to optimise hormonal detoxification.

Support the gut

The pill can disrupt our gut microbiome and thus focusing on restoring a healthy microbiome is important post-pill. In a healthy gut, we have a subset of microbes (“estrobolome”) that help metabolise estrogen. When we have an imbalanced microbiome or inflamed gut, this affects our estrobolome’s ability to maintain the balance of estrogen resulting in hormonal imbalance. Women who use the OCP are also at a higher risk for developing gastrointestinal diseases such as Crohn’s disease, ulcerative colitis and irritable bowel disease. 

So how can you support your gut through diet? Through eating a diverse range of whole foods. Our gut loves diversity and eating a wide range of foods helps keep our ‘good bugs’ happy and thriving. So next time you’re in the fruit and vegetable aisle in your supermarket or farmer’s market- pick out something you’ve never tried and look up recipes to use it. If you love cooking like me, you’ll find this exciting and who knows- you may find yourself with a new favourite vegetable! 

Our gut also needs fibre to maintain its healthy balance in addition to keeping us regular. We recommend adding Earth Seeds into your meals daily for an easy fibre boost.  Other great sources of fibre include unpeeled fruits and vegetables, legumes, whole grains and nuts.

Reduce inflammation

The pill can increase inflammation in the body, as measured by C-reactive protein (CRP) levels in the blood. When we’re chronically inflamed, it significantly increases our risk for major diseases such as diabetes, heart attacks, cancer, Alzheimer’s and inflammatory bowel disease.  

So how can we fight the inflammation caused by pill? Through our diet, specifically, through anti-inflammatory foods. Consume organic (where possible) and seasonal produce, healthy fats (such as flaxseeds, Earth Seeds and avocados), wild-caught fatty fish and minimally processed whole grains (or pseudo-grains for all you coeliac/gluten-sensitive folk). Cooking our foods with herbs and spices is also a great way to boost the antioxidant content of our meals. Ginger, turmeric and cinnamon are some of my favourite anti-inflammatory spices to cook with. You can find these delicious herbs and spices in our Luna’s Gold and Luna’s Lover.

Also, stay away from foods such as refined carbohydrates, fried foods and highly processed foods. Many of these heavily processed foods are inflammatory and contain a long list of artificial colours, sugars and additives.

Go good fat, not no fat

Fats and cholesterol are what hormones are made from and it’s important to focus on the right types of fats if we want our body to produce adequate amounts of our female sex hormones. Choose monounsaturated and polyunsaturated fats found in nuts, seeds, avocado, oily fish, walnuts and extra virgin olive oil. Reduce your intake of trans-fats and saturated fats found in fried foods, baked goods and vegetable oils as these are inflammatory and can do more harm than good.

Stress less

 I know you’ve heard us harp on and on about it before but it’s for a good reason! When cortisol (the stress hormone) is elevated, this can reduce our female sex hormones and increase our androgen (male sex hormone levels). Some women will also find that their periods become irregular or even absent when they’re stressed. Journaling, having a big belly laugh with your best mates, boxing, Moon Boost, a Moon Soak bath and meditation are all great ways to kick stress away.

Alternatives to Hormonal Birth Control

If you’re using the pill for contraception and you’re not looking to get pregnant, it’s important to know that there are other non-hormonal birth control methods out there and these include the copper IUD, diaphragm, condoms, fertility awareness method and the withdrawal method.

Copper IUD

The copper IUD is a small T shaped device that’s placed inside the uterus for either 5 years or 10 years. The copper IUD prevents pregnancy by producing local inflammation in the uterus which is toxic to sperm and eggs. It’s a very effective and reliable use of contraception (99.5% effectiveness rate) and desirable for women who may forget to take the pill at the same time every day. 

However, due to the localised inflammation caused by the copper IUD, some women may experience heavier and more painful periods. Hence, this is not a recommended method of contraception for women who already experience menorrhagia, dysmenorrhea and/or low iron levels. Additionally, the copper IUD may alter the vaginal microbiota which in turn increases the risk for bacterial vaginosis.   

copper iud non hormonal contraception

Diaphragm or “cap”

The diaphragm is a silicone dome that’s inserted into the vagina before sex, and like the condom is also a barrier method of contraception. However, the cap must be kept in place for a minimum of 6 hours after sex to ensure sperm have died (sperm can live and reside in the vagina for a few hours).  

In Australia, the only type of diaphragm available is known as the “Cap” and it’s recommended that women seek the assistance of a health care practitioner to check that it is inserted and fit correctly before using it. Additionally, it’s not as effective as other contraceptive methods (94% effective, although this effect can increase if a spermicide is used at the same time) and doesn’t protect against sexually transmitted illnesses (STI’s). 

diaphragm non hormonal contraception

Condoms

Condoms are a barrier method that is used on the male (or female although female/internal condoms are less common) to prevent sperm from entering the vagina. Condoms also protect against STI’s and can be used with other methods of contraception such as the pill, copper IUD and depo shot. When correctly used, male condoms are 98% effective and condoms are widely available. 

We recommend Jonny’s condoms – a vegan, natural condom made from natural latex. They’re free from all the nasties (parabens, glycerin, petrochemicals, flavours, fragrances, spermicides, benzocaine and nitrosamines) which can change the pH of our vaginas and increase our risk for urinary tract infections (ouch!). 

How to get off the pill without side effects

Fertility awareness method (FAM)

FAM is a natural form of contraception where a woman will identify when she is ovulating during her menstrual cycle to prevent pregnancy. Women monitor signs of ovulation by checking their basal body temperature, cervical mucus and cervical position. When women are close to ovulating or ovulating, they may choose to abstain from sex or use contraception (e.g., a condom).  

This method when used correctly can be incredibly effective (99% effective) however this method is most reliable when women have a regular cycle and requires 3-6 months of consistent practice. Factors that may affect its reliability include recent infections or illnesses, travelling through different time zones, breastfeeding, irregular periods, stress etc. 

We recommend downloading a period app on your phones such as Clue or Flo to help track your cycle or looking into Daysy an intelligent fertility checker that calculates your fertile window for you.  

How to get off the pill without side effects

Withdrawal method

The withdrawal method relies solely on the male’s ability to ‘pull out’ before ejaculation to prevent sperm from entering the women’s vagina. If the ‘pull out’ is ill-timed or if the pre-ejaculation fluid contains sperm, then this can cause accidental pregnancies. However, it is a convenient and free method with no side effects. 

Moonbox Recommendations

If, however, you’re looking for additional hormonal support whether you are on hormonal contraception or not- we’ve got the perfect products for you. Our Post-Birth Control Moonbox is designed to help support your body whilst on HBC to help safeguard against the side effects, as well as support your body in the transition OFF the pill to help make it less symptomatic. These essential products included in our Post-Birth Control Moonbox support our liver’s ability to metabolise and excrete synthetic hormones, optimise your adrenal health, reduce inflammation and boost antioxidant levels.

A holistic approach is key so we also recommend the Healthy hormones, Happy periods eBook Bundle which covers topics such as nutrition, lifestyle, our gut, the liver and environmental factors in more detail. This eBook bundle is designed to educate you on how to optimise your hormonal health and wave sayonara to all your period issues. 

Healthy Hormones Ebook Bundle
Healthy Hormones, Happy Periods E-Book Bundle

Products Mentioned

Flo (period tracker app): https://flo.health/

Clue (period tracker app): https://helloclue.com/

Daysy (fertility tracker): https://daysy.com.au/

Jonny’s condom : https://jonny.com.au/

Caya (cap/diaphragm): https://www.caya.eu/en/

References

Achilles, S., Austin, M., Meyn, L., Mhlanga, F., Chirenje, Z., & Hillier, S. (2018). Impact of contraceptive initiation on vaginal microbiota. American Journal Of Obstetrics And Gynecology, 218(6), 622. doi: 10.1016/j.ajog.2018.02.017
Admin, A. (2021). Why Fertility-Awareness. Retrieved 18 March 2021, from https://www.airrm.org.au/why-fertility-awareness/

Assad, S., Khan, H., Ghazanfar, H., Khan, Z., Mansoor, S., & Rahman, M. et al. (2017). Role of Sex Hormone Levels and Psychological Stress in the Pathogenesis of Autoimmune Diseases. Cureus, 9(6), 1315. doi: 10.7759/cureus.1315

Barnhart, K., & Schreiber, C. (2009). Return to fertility following discontinuation of oral contraceptives. Fertility And Sterility, 91(3), 659-663. doi: 10.1016/j.fertnstert.2009.01.003

Buonomo, A., Scotto, R., Nappa, S., Arcopinto, M., Salzano, A., & Marra, A. et al. (2019). The role of curcumin in liver diseases. Archives Of Medical Science, 15(6), 1608-1620. doi: 10.5114/aoms.2018.73596

Contraception. (2021). Retrieved 18 March 2021, from https://www.fpnsw.org.au/health-information/individuals/contraception

Divani, A., Luo, X., Datta, Y., Flaherty, J., & Panoskaltsis-Mortari, A. (2015). Effect of Oral and Vaginal Hormonal Contraceptives on Inflammatory Blood Biomarkers. Mediators Of Inflammation, 2015, 1-8. doi: 10.1155/2015/379501

Fihn, S., Boyko, E., Chen, C., Normand, E., Yarbro, P., & Scholes, D. (1998). Use of Spermicide-Coated Condoms and Other Risk Factors for Urinary Tract Infection Caused by Staphylococcus saprophyticus. Archives Of Internal Medicine, 158(3), 281. doi: 10.1001/archinte.158.3.281

Khalili, H. (2015). Risk of Inflammatory Bowel Disease with Oral Contraceptives and Menopausal Hormone Therapy: Current Evidence and Future Directions. Drug Safety, 39(3), 193-197. doi: 10.1007/s40264-015-0372-y

Khalili, H., Higuchi, L., Ananthakrishnan, A., Richter, J., Feskanich, D., Fuchs, C., & Chan, A. (2012). Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut, 62(8), 1153-1159. doi: 10.1136/gutjnl-2012-302362

Pahwa, R., Goyal, A., Bansal, P., & Jialal, I. (2021). Chronic Inflammation. Retrieved 20 March 2021, from https://www.ncbi.nlm.nih.gov/books/NBK493173/

Peebles, K., Kiweewa, F., Palanee-Phillips, T., Chappell, C., Singh, D., & Bunge, K. et al. (2020). Elevated Risk of Bacterial Vaginosis Among Users of the Copper Intrauterine Device: A Prospective Longitudinal Cohort Study. Clinical Infectious Diseases, 703. doi: 10.1093/cid/ciaa703

Postpartum Birth Control. (2021). Retrieved 18 March 2021, from https://www.acog.org/womens-health/faqs/postpartum-birth-control?utm_source=redirect&utm_medium=web&utm_campaign=otn#how

Straub, R. (2014). Interaction of the endocrine system with inflammation: a function of energy and volume regulation. Arthritis Research & Therapy, 16(1), 203. doi: 10.1186/ar4484

Wakeman, M. (2019). A Review of the Effects of Oral Contraceptives on Nutrient Status, with Especial Consideration to Folate in UK. Journal Of Advances In Medicine And Medical Research, 1-17. doi: 10.9734/jammr/2019/v30i230168

What Is Post-Birth Control Syndrome + How to Heal. (2021). Retrieved 19 March 2021, from https://drbrighten.com/post-birth-control-syndrome/

When will my periods come back after I stop taking the pill?. (2018). Retrieved 18 March 2021, from https://www.nhs.uk/conditions/contraception/when-periods-after-stopping-pill/