Step-by-step to coming off the pill

Coming off the pill can be a daunting time for many, as often the reason they were put on the pill in the first place was to address skin or menstrual cycle concerns, therefore when coming off the pill the return of acne and missing periods is a major concern.

It isn’t uncommon for skin to flare up 3-6 months post coming off the pill, therefore it is important to have a plan in place to support the body through this transition and minimise any symptoms flaring up at this time.

In order to best support the body through this transition, it can be a good idea to give yourself 3-6 months of prep prior to coming off the pill to ensure that we are laying the foundations we need to reduce the incidence of post-pill acne and menstrual cycle irregularities. In order to best prepare the body for the transition off the pill, there are a few key areas we need to be focusing on.

The Liver

Supporting the liver detoxification pathways to detoxify synthetic hormones from the pill and support healthy clearance of hormones and toxins is a major area of consideration when it comes to preparing to come off the pill. Optimal liver function (and subsequently bowel movements!) is essential for the post-pill time period. Ways that we can support liver detoxification include:

• Increasing intake of cruciferous vegetables (think broccoli, cauliflower, kale & Brussel sprouts)
• Ensuring adequate water intake
• Limiting substances that burden the liver, such as alcohol, caffeine, medication & environmental toxins

The Nervous System

Supporting the nervous system is a big part of helping the body to transition off the pill. Stress can increase androgen production, which can result in skin breakouts and menstrual cycle disturbances. Ways to implement nervous system supportive practices include:

• Gentle movement
• Breathwork
• Meditation or mindfulness
• Journaling
• Massage
• Reading 

The Gut Microbiome

The pill can disrupt our delicate gut microbiome, which can exacerbate acne as gut dysbiosis can lead to intestinal permeability (aka leaky gut) which impacts the ability to absorb important skin nutrients. Giving your gut some additional support through pre and probiotic foods, a diverse intake of plant foods and specific supplementation can help to reduce the incidence of post-pill acne.

Nutrient Deficiencies

The pill depletes the body of certain nutrients required for a healthy menstrual cycle, clear skin & overall health. These include B vitamins, zinc, vitamin C, vitamin E & magnesium. Assessing and addressing any nutrient deficiencies through pathology prior to coming off the pill is an important part of your post-pill plan.

The Menstrual Cycle

The pill essentially turns off our natural hormone production, and switches off the channel of communication between the brain and the ovaries. Preparing to come off the pill requires us to nurture and re-establish the brain-ovarian connection to eventually re-establish a regular menstrual cycle, which we can do through specific dietary changes, supplements & herbal medicine. Beginning to track and understand your menstrual cycle is also an important part of supporting a regular cycle post-pill.

For many individuals, it can take a couple of months for their period to return post pill as the brain and ovaries begin to communicate again. As a result, we often test hormones 3 months after coming off the pill to understand what is going on from a hormonal perspective, and assess whether any additional hormonal support is needed. 

Androgen Production

As the pill switches off our hormones, coming off the pill often results in a surge of androgens which have previously been suppressed as the body attempts to regulate its own hormone production. Excess androgens result in common post-pill symptoms such as acne, excess hair growth, oily skin & oily hair. Ways that we can reduce excess androgen production include a high quality zinc supplement, and utilising specific herbal medicines such as peony, licorice & berberine under the guidance of a practitioner.

Blood Sugar Regulation

Insulin resistance affects up to 70% of those who experience acne, and is a key driver of androgen dominance which is implicated in post-pill acne. Balancing blood sugar levels through dietary strategies and specific supplementation & herbal medicine can help to regulate insulin levels and therefore reduce androgen dominance. Ways that we can balance blood sugar levels through food include:

• Consume small, regular meals
• Ensure that you are consuming balanced meals – containing a source of protein, complex carbohydrates & healthy fats
• Add cinnamon to meals
• Take a short walk after meals

While coming off the pill can often be daunting, there is so much that Naturopathy can do to support the body during this time and ease this transition, so please reach out if this is something you are seeking support with.