Re-balancing Your Hormones after Coming off The Pill
There are a number of forms of hormonal contraception, including the birth control pill, the vaginal ring, the contraceptive skin patch, hormone-releasing contraceptive coils, injections and implanted rods.
Although they are used in different ways, they all have a similar effect: Influencing women’s hormone levels, and preventing mature eggs from being released by the ovaries (ovulation). The birth control pill (sometimes simply called “the Pill”) is the most commonly used form of contraception.
Quitting the Pill can be a bumpy ride, the unrecognised condition of Post-pill syndrome or Post-pill withdrawal still causes controversy on the extent to which women experience the after effects. The most common symptoms include: Irregular periods, heavy menstrual bleeding, menstrual cramps, spotting, weight loss/gain, breakouts, bloating, relationship satisfaction (Roberts et al., 2014) and mood swings. A Finnish study has also shown that maternal use of oral contraceptive pills might increase the prevalence of allergic diseases among future offspring up to a year before pregnancy (Keski-Nisula, Pekkanen, Xu, Putus, & Koskela, 2006). The risk was detected mainly in boys and in children with parental allergy.
Statistically, most women regain hormonal balance within 3 months of renouncing the Pill. However, it can take up to 6 months or more.
How does the birth control pill work?
Oral contraceptives impose a very specific type of hormonal control over the body. Hormones are chemical substances that normally oversees the functioning of organs. In this case, the hormones in the Pill will eventually take control of the ovaries and uterus. By doing so, they will suppress the natural cycles of ovulation, menstruation, and hormonal fluctuation.
Placebo pills in the last 5 days of the cycle will lead to a breakthrough bleed, which is not a considered a true menstrual period. On a suppression plan, '' menstruation'' (which is also not real periods) may be as infrequent as every 3 to 12 months, depending on the type of pill.
Most birth control pills contain a combination of the hormones oestrogen and progestin, which is why they are also called “combined pills” or “combination pills.” Different pills have different doses of hormones in them and are taken in different ways. These work by preventing the ovary from releasing eggs as well as thickening the cervical mucus making it harder for sperm to reach the uterus. This method thins the uterine lining which prevents implantation.
There is also a less commonly used pill called the “mini pill”, which only contains low doses of progestin. It can be used by women who may not tolerate the conventional combined pill. The mini pill has to be taken at the same time continuously every day, many women will stop getting their periods after a while.
Tools to reset hormones when coming off the pill before trying to conceive...
Disclaimer: Always consult your health practitioner if a period of 3 months has been exceeded since having a regular cycle, or if you have other concerning symptoms.
Nutrient Deficiency
Birth control has been shown to deplete the body of key nutrients including vitamins B2, B6, B12; vitamin C, vitamin E and folate (Palan, Strube, Letko, Sadikovic, & Mikhail, 2010). The latter being vital for foetal development during pregnancy.
A recent study has also found that vitamin D levels dropped significantly after quitting the Pill (Harmon, Umbach, & Baird, 2016). Trace elements such as Selenium, Zinc, Phosphorus and Magnesium (Akinloye, Adebayo, Oguntibeju, Oparinde, & Ogunyemi, 2011) have also been shown to be negatively affected.
To replace missing nutrients, it is advised to consume nourishing and nutrient-dense foods as well as taking a high-quality multivitamin and mineral supplement. Take advice from your primary health care provider if tests show deficiencies.
Blood Sugar Balance
Research has linked the use of hormonal contraceptives with alterations in blood glucose levels and insulin resistance (Cortés & Alfaro, 2014).
Diet, regular moderate exercise and meditation (Sinha, Jain, Tyagi, Gupta, & Mahajan, 2018) have been shown to have a positive effect on blood sugar balance.
Restoring the Microbiome
The gut microbiome plays a central role in the regulation of oestrogen levels within the body. The estrobolome is the collection of microbes capable of metabolizing oestrogen (Kwa, Plottel, Blaser, & Adams, 2016): It modulates the circulation and excretion of oestrogen levels.
When the gut microbiome is healthy, the estrobolome maintains oestrogen homeostasis.
Antibiotics and hormonal contraceptives have been found to alter both the gut microbiota and oestrogen levels within the body, thus having an adverse impact on the estrobolome (Javurek et al., 2016).
Diet and lifestyle are important factors that affect the gut (thus the estrobolome). The consumption of phytoestrogens, which are naturally occurring oestrogen compounds found in plants, have been found to significantly impact the gut microbiota and the risk of oestrogen-related diseases (Baker, Al-Nakkash, & Herbst-Kralovetz, 2017).
Research (although in its infancy) indicates that it may also be possible to modulate the estrobolome through probiotic supplementation with a variety of lactobacillus species (Guo et al., 2016).
Herbs
Hormonal balance can additionally be targeted with the below herbal supplementation.
Disclaimer: Always consult your health practitioner when supplementing, in addition most of the studies that show positive benefits did not exceed six months to one year of use, which is why long-term use of these type of supplements is never recommended and should be stopped in pregnancy.
* Vitex (Agnus Castus) also known as Chastetree Berry, is mostly known for its effectiveness in the treatment of premenstrual syndrome (PMS) and infertility disorder (Rafieian-Kopaei & Movahedi, 2017; Schellenberg, 2001). But may improve cycle regularity in some women.
*Shatavari is a member of the asparagus family considered the most important herb in Ayurvedic medicine for problems related to women's fertility. The name Shatavari means "a woman who has a hundred husbands" in Sanskrit. It is used as a reproductive tonic herb and a female hormone balancer .It's major bioactive constituents are a group of steroidal saponins which help with oestrogen modulation (Alok et al., 2013).
*Red Raspberry Leaf is known as “the woman’s herb,” it is naturally high in polyphenols, vitamins and minerals such as magnesium, potassium, iron, calcium, and vitamins B, A, C, and E and it is thought to help menstrual cramps and improve fertility.
*Motherwort is an emmenagogue which helps regulate menstruation, bring on delayed periods and reduce uterine muscle spasms and cramping. It can be particularly beneficial for women suffering with Hypothalamic Amenorrhea (lack of menstruation due to stress) due to its calming and menstruation stimulating effects (Romm, 2010).
* Evening Primrose Oil contains omega-6 fatty acids, such as LA and GLA, which support overall hormonal function. Supplementing with evening primrose oil can help reduce PMS and inflammation, increase cervical mucous production, and improve uterine health. It also helps in creating a healthy environment for conception (Horrobin, 1983; Kashani, Saedi, & Akhondzadeh, 2010).
* Dong Quai (Angelica sinensis) is widely used as a panacea for gynaecological problems in Traditional Chinese medicine. It is proclaimed as an invigorating herbal tonic for both women and men. Dong Quai tonifies and strengthens the uterus by improving uterine lining (which may be prone to thinning over time with birth control) (Circosta, De Pasquale, Palumbo, Samperi, & Occhiuto, 2006).
Acupuncture
From a Traditional Chinese Medicine (TCM) viewpoint, irregular periods is a result of an imbalance in the energetic systems known as the ‘Liver’ or the ‘Kidneys’. These two energetic systems according to TCM are responsible for the biological clock that determines the menstrual cycle. A systematic review has found that acupuncture and herbal medicine are quite effective in premenstrual syndrome and premenstrual dysphoric disorder with a 50% reduction in symptoms (Jang, Kim, & Choi, 2014) . Acupuncture has also been shown in several studies to affect hormonal levels and increases blood flow to the reproductive organs.
+References
Akinloye, O., Adebayo, T. O., Oguntibeju, O. O., Oparinde, D. P., & Ogunyemi, E. O. (2011). Effects of contraceptives on serum trace elements, calcium and phosphorus levels. West Indian Medical Journal.
Alok, S., Jain, S. K., Verma, A., Kumar, M., Mahor, A., & Sabharwal, M. (2013). Plant profile, phytochemistry and pharmacology of Asparagus racemosus (Shatavari): A review. Asian Pacific Journal of Tropical Disease. https://doi.org/10.1016/S2222-1808(13)60049-3
Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas. https://doi.org/10.1016/j.maturitas.2017.06.025
Circosta, C., De Pasquale, R., Palumbo, D. R., Samperi, S., & Occhiuto, F. (2006). Estrogenic activity of standardized extract of Angelica sinensis. Phytotherapy Research. https://doi.org/10.1002/ptr.1928
Cortés, M. E., & Alfaro, A. A. (2014). The effects of hormonal contraceptives on glycemic regulation. Linacre Quarterly. https://doi.org/10.1179/2050854914Y.0000000023
Guo, Y., Qi, Y., Yang, X., Zhao, L., Wen, S., Liu, Y., & Tang, L. (2016). Association between polycystic ovary syndrome and gut microbiota. PLoS ONE. https://doi.org/10.1371/journal.pone.0153196
Harmon, Q. E., Umbach, D. M., & Baird, D. D. (2016). Use of estrogen-containing contraception is associated with increased concentrations of 25-hydroxy Vitamin D. Journal of Clinical Endocrinology and Metabolism. https://doi.org/10.1210/jc.2016-1658
Horrobin, D. F. (1983). The role of essential fatty acids and prostaglandins in the premenstrual syndrome. Journal of Reproductive Medicine for the Obstetrician and Gynecologist.
Jang, S. H., Kim, D. I., & Choi, M. S. (2014). Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: Systematic review. BMC Complementary and Alternative Medicine. https://doi.org/10.1186/1472-6882-14-11
Javurek, A. B., Spollen, W. G., Johnson, S. A., Bivens, N. J., Bromert, K. H., Givan, S. A., & Rosenfeld, C. S. (2016). Effects of exposure to bisphenol A and ethinyl estradiol on the gut microbiota of parents and their offspring in a rodent model. Gut Microbes. https://doi.org/10.1080/19490976.2016.1234657
Kashani, L., Saedi, N., & Akhondzadeh, S. (2010). Femicomfort in the treatment of premenstrual syndromes: a double-blind, randomized and placebo controlled trial. Iranian Journal of Psychiatry.
Keski-Nisula, L., Pekkanen, J., Xu, B., Putus, T., & Koskela, P. (2006). Does the pill make a difference? Previous maternal use of contraceptive pills and allergic diseases among offspring. Allergy: European Journal of Allergy and Clinical Immunology. https://doi.org/10.1111/j.1398-9995.2006.01201.x
Kwa, M., Plottel, C. S., Blaser, M. J., & Adams, S. (2016). The intestinal microbiome and estrogen receptor-positive female breast cancer. Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djw029
Palan, P. R., Strube, F., Letko, J., Sadikovic, A., & Mikhail, M. S. (2010). Effects of Oral, Vaginal, and Transdermal Hormonal Contraception on Serum Levels of Coenzyme Q 10 , Vitamin E, and Total Antioxidant Activity . Obstetrics and Gynecology International. https://doi.org/10.1155/2010/925635
Rafieian-Kopaei, M., & Movahedi, M. (2017). Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus. Electronic Physician. https://doi.org/10.19082/3685
Roberts, S. C., Little, A. C., Burriss, R. P., Cobey, K. D., Klapilová, K., Havlíček, J., … Petrie, M. (2014). Partner Choice, Relationship Satisfaction, and Oral Contraception: The Congruency Hypothesis. Psychological Science. https://doi.org/10.1177/0956797614532295
Romm, A. (2010). Botanical Medicine for Women’s Health. In Botanical Medicine for Women’s Health. https://doi.org/10.1016/B978-0-443-07277-2.X0001-3
Schellenberg, R. (2001). Treatment for the premenstrual syndrome with agnus castus fruit extract: Prospective, randomised, placebo controlled study. British Medical Journal. https://doi.org/10.1136/bmj.322.7279.134
Sinha, S., Jain, A., Tyagi, S., Gupta, S., & Mahajan, A. (2018). Effect of 6 months of meditation on blood sugar, glycosylated hemoglobin, and insulin levels in patients of coronary artery disease. International Journal of Yoga. https://doi.org/10.4103/ijoy.ijoy_30_17
DR NAUF ALBENDAR
My name is Dr Nauf AlBendar and I am the founder of The Womb Effect. As a medical scientist with a BSc in Molecular Genetics and Genomics, an MSc in Nutrition & Food Science and a PHD in clinical medicine, I have developed a deep appreciation and understanding for the developmental origins of health and disease.