How to Transition Off Hormonal Birth Control (or IUD) With the Least Amount of Side Effects

If you’re reading this, it’s probably safe to assume you’re recently off the pill (or hormonal IUD) or considering it in the near future. Maybe you’re ready to try for a baby (congratulations!) Or maybe you’re tired of unwanted side effects as a result of hormonal BC. Or, if you’re someone who’s been on the pill for a decade or more, you might just be curious to see how your body responds and ready to explore alternative birth control methods. Regardless, your goal coming off of birth control should be to restore monthly ovulation and a regular cycle, even if you have no intention of conceiving now or ever. Why? Ovulation for women in their child-bearing years is often referred to as the “5th vital sign.” Ovulation and a regular cycle are signs that you are overall healthy and your body considers itself safe and able to conceive and grow a baby. 

In this blog, I’ll share with you common side effects of quitting BC plus actionable steps you can start taking today to reduce those side effects and restore your natural hormone balance.

Common side effects of quitting birth control:

  • Heavy, painful periods

  • Irregular periods

  • Post-pill amenorrhea (no period)

  • Post-pill acne

  • Mood swings/anxiety

  • Digestive issues

  • Loss of libido/fatigue

  • PMS 

  • Nutrient deficiencies

Not all women will experience these symptoms, but many will experience at least one or a few. That being said, it’s not all bad! Some women may actually notice increased libido, more energy, better moods and stronger skin, hair and nails. 

Why does coming off the pill (or hormonal IUD) lead to these side effects?

To understand why these side effects happen, it’s helpful to remember how these methods work. The pill provides your body with synthetic hormones (both estrogen and progestin) that turn off your body’s natural hormone production, preventing your body from ovulating, and thus preventing pregnancy. Hormonal IUDs use only progestin (a synthetic version of progesterone) and work by thinning the lining of your uterus which prevents implantation, thickening cervical mucous so sperm can’t swim and suppressing ovulation. 

So why the side effects when you quit the pill or have your IUD removed? It will take your body time to metabolize and detox the synthetic hormones while also restoring normal hormone synthesis and function. There will likely be a period where your hormones are out of whack and trying to come back into balance. Additionally, many women are prescribed birth control for reasons other than pregnancy prevention such as PCOS, endometriosis, irregular cycles or acne. Unfortunately, BC doesn’t solve these issues but masks their symptoms. So you may find that some of the symptoms you experienced pre-BC return.

 

The good news is that there is plenty you can do to restore your body’s natural hormonal rhythm and address some of the potential negative side effects of stopping hormonal BC. 

 

1. Support Your Body Before You Stop Taking the Pill

I recommend implementing the dietary and lifestyle recommendations outlined in this post 2-3 months prior to coming off the pill or removing your IUD. This will help mitigate any potential negative side effects. If your intention is to eventually conceive, I recommend giving your body roughly 6 months off the pill or IUD before trying. This will give your body time to balance hormones, restore ovulation and replete nutrients.

2. Gentle detox/liver support

Your liver and your digestive system are primarily responsible for detoxing the synthetic hormones out of your system. The more efficient your body can be at deactivating and eliminating the synthetic hormones, the sooner it can restore normal hormonal synthesis and balance. Recognize that this will not happen overnight, but a gentle approach to detoxification can support your liver and nourish your digestive system. 

  • Eat 2-3 servings of cruciferous vegetables daily (broccoli, cauliflower, Brussel sprouts, etc.) Cruciferous veggies are your liver’s best friend helping you break down estrogen and support phase 2 detoxification. 

  • Eat plenty of fiber - 25-30g daily. Fiber nourishes your GI tract to gets things moving and binds to estrogen on the way out. 

  • Sweat most days, move daily

  • Full elimination (aka poop!) daily. Pooping is how we excrete excess hormones. 

  • Incorporate a low-sugar, anti-inflammatory diet (see below).

  • Lower your overall toxic load by reducing exposure to exogenous toxins found in your home and personal care products. Start with the things you use daily and go from there - ex: soaps, body wash, lotion.

  • Consider supplemental support. Supplements such as DIM (diindolylmethane), milk thistle, N-acetyl-cysteine (NAC) and dandelion root tea.   

 

3. Low sugar, anti-inflammatory diet

Food is medicine! Incorporating a low-sugar, anti-inflammatory diet will make all the difference in your transition off the pill or IUD.  

  • The focus of your diet should be on non-starchy veggies (especially cruciferous), starchy veggies (like sweet potatoes, carrots and squash), leafy greens, fresh fruit, plenty of healthy fats (avocado, nuts, seeds, olive oil, grass-fed butter or ghee, coconut oil), high-quality animal protein and moderate amount of gluten-free grains like quinoa, brown rice, beans and lentils. 

  • Aim to drink half your body weight in ounces of water per day.

  • Choose organic, grass-fed, free-range, pastured, hormone-free animal products whenever possible.

  • Avoid processed foods and refined sugar (check labels for added sugar content - avoid anything 7g or more per serving.) Natural sweeteners like honey or maple syrup in moderation are fine. 

  • When opting for packaged food, choose the least processed, minimal and recognizable ingredients, no preservatives, additives, artificial flavors or colorings.  

  • Avoid conventional dairy as their cows are often injected with hormones

 

4. Replete nutrients

Birth control depletes folate, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc. If you are looking to conceive in the near future, it’s even more important you replete these nutrients prior to conception. Incorporating the diet above will certainly help but you could also consider supplementation with some of these nutrients for 3-6 months until you are nutrient replete. Even if you aren’t looking to conceive (or if you are), a high-quality prenatal vitamin will typically contain all of these nutrients that birth control can deplete. My favorite prenatal is PlusOne by Metagenics and would be a great option for repleting these nutrients. Magnesium (glycinate) is one supplement I would recommend taking in addition to a prenatal as it’s difficult for a prenatal to physically fit in a meaningful amount of magnesium. 

 

5. Support your gut

Research has shown us that oral contraceptives negatively impact gut flora and therefore estrogen metabolism. A healthy gut is always important, but especially when on hormonal birth control and/or transitioning off. It’s important your gut is healthy and you’re pooping every day to get the excess hormones out of your system. A healthy diet low in sugar and refined carbohydrates and rich in fiber is a great place to start. Incorporating fermented foods like raw sauerkraut, kimchi, pickled veggies, unsweetened coconut or grass-fed yogurt will provide a variety of healthy microbes into your diet. You can also consider a probiotic or other gut-nourishing supplements like L-glutamine, aloe vera, marshmallow root, slippery elm or deglycyrrhizinated licorice (DGL). 

 

6. Reduce stress and get enough sleep

Your body is smart and intuitive. It will translate excessive stress as a dangerous environment and one not suitable for a baby (a problem even if you’re not looking to conceive). If your body is living in a “fight or flight” state, your hormones may be impacted and ovulation may be affected or suppressed altogether. In addition to your standard day-to-day stressors, factors like overexercise and calorie restriction can also send your body this message. I recommend identifying and incorporating a stress management routine that you enjoy and look forward to on a daily basis - especially as you transition off birth control and the months to follow. Eat regular, dedicated and balanced meals throughout the day, go easy on the caffeine and get plenty of sleep. Ensure you’re not overexercising and also be sure to eat enough calories and plenty of healthy fats. 


What next?

If you don’t want to get pregnant and want to explore other non-hormonal birth control methods, check out this blog post written by hormone expert, Dr. Jolene Brighten. If you aren’t going to use hormonal birth control, I would highly recommend tracking your cycle (see below) for the sake of understanding and familiaring yourself with your own body.

If you want to try to get pregnant in the near-ish future, I recommend starting to track your cycle (there are lots of helpful apps out there like Clue, Kindara, Flo or Natural Cycles) and eventually ask your OBGYN or Primary Care Physician to check your hormones/ovulation. You can also check your own ovulation at home using an at-home ovulation kit. I’d wait until your cycle is back and your hormones have balanced out to do this. 

For most women, implementing these suggestions will be enough to return to a normal cycle within 1-6 months. If you’re still experiencing cycle irregularities 6 months after going off the pill or IUD, I recommend working with someone 1:1 to support you. 


If you ARE wanting to conceive in the near future and want to learn more about optimizing your health for conception - get my Preconception Prep Checklist here!

PreconceptionNatalie Betzerbirth control, IUD