Navigating Your Hormonal Waves: A Guide to Finding Balance After Coming Off Birth Control
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Healthline: https://www.healthline.com/health/kyleena-iud/
Entering into the realm of women's health, one topic that often remains taboo is the subject of contraceptives and hormones. For women in their late 20s to late 30s, the journey to hormonal equilibrium can be both complex and crucial. A significant aspect of this journey which I have seen on the rise lately, is the decision to discontinue hormonal contraceptives, such as the pill or hormonal IUDs. While these contraceptives offer effective birth control, they can significantly impact the body's hormonal balance. Recently, I have witnessed in the news the appearance of medical gaslighting on the points around how women feel on birth control and why they decided to stop its use and how medical practitioners belittled their experiences. I know from personal experience how defeating this feels and how it can make you disconnect from your body’s own cues. However, this is due to conventional medical practice taking a look at us from the lens of one-size-fits-all. From the principal of bio-individuality we understand that no one person is the same. We are all unique and what works for one person may not for another, what works for years may change from one day to another. Hence it is also up to us to listen to our body and make those decisions that feel right using our intuition and trust that our body always knows best.
While I used hormonal contraceptives for over 10 years and started at the early age of 16, I wonder sometimes if my mother and I had the same information we do now would the discussions at that age have been different? - Maybe, but also perhaps not. The difficulty was not in being on the pill for me although I was a volatile and emotional teenager which could have been attributed partially to the added hormones (though I will never really know). The real problem came later when I wanted to come off of contraceptives (read more here) and had issues with my non-hormonal IUD becoming embedded into my uterus and becoming ineffective. Fast forward to the reason I started this blog was the final straw which was my hormonal IUD catalyzing hormonal acne after a stressful incident in my life (read about that here). My personal experiences were difficult to say the least hence why I want to help inform and address women on the waves they will experience from their menstrual cycle once getting off birth control, and be a space for women to feel heard around their experiences of hormonal contraceptives. Finally I share some strategies for the journey after discontinuing contraceptives to find hormonal balance again.
Understanding Menstrual Cycle Waves:
The menstrual cycle is a 28 - 35 (in the medically normal range) of hormonal fluctuations orchestrated by the body to prepare for potential pregnancy. My cycle is quite long and fluctuates between 35-50 days and is extremely impacted my stress and travel hence why I say medically normal because I do not believe that my cycle is abnormal. Knowing myself and knowing my body is quite sensitive allows me to feel and understand when things are going well and when my body is out of balance in terms of ovulation being delayed. The point being that this is still normal.
Source: Clue App- https://helloclue.com/articles/cycle-a-z/the-menstrual-cycle-more-than-just-the-period
Divided into distinct phases—menstruation, follicular phase, ovulation, and luteal phase—the cycle is regulated by hormones such as estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormones work in tandem to stimulate follicle growth, trigger ovulation, and prepare the uterine lining for implantation or shedding.
The Uterine Cycle:
Menstrual Phase (Days 1-5): This phase begins with menstruation, where the uterine lining sheds if fertilization did not occur during the previous cycle. Hormone levels, particularly estrogen and progesterone, are low during this phase. Women may experience symptoms such as fatigue, cramps, bloating, and mood swings.
Follicular Phase (Days 6-14): During this phase, follicle-stimulating hormone (FSH) stimulates the development of follicles in the ovaries, each containing an egg. Estrogen levels gradually rise, thickening the uterine lining. Women may feel more energetic and experience an increase in libido during this phase.
Ovulation (Around Day 14): Ovulation occurs when a mature egg is released from the ovary into the fallopian tube, making it available for fertilization. Estrogen levels peak just before ovulation, triggering a surge in luteinizing hormone (LH), which prompts the release of the egg. Some women may experience ovulation pain or spotting during this time, known as mittelschmerz.
Luteal Phase (Days 15-28): After ovulation, the ruptured follicle transforms into the corpus luteum, which produces progesterone. Progesterone prepares the uterine lining for implantation of a fertilized egg. If fertilization does not occur, estrogen and progesterone levels decline, leading to the shedding of the uterine lining and the start of a new menstrual cycle. During this phase, women may experience symptoms such as breast tenderness, mood swings, bloating, and fatigue.
In each phase of your cycle your body needs different things, and functions in specific ways. In the follicular phase of my cycle I feel (and this is a generalization) energized, less hungry and stable because of the hormone estrogen rising. While during the last two weeks of my cycle, I feel slower, hungrier and more irritable as I get closer to my period because in addition my progesterone hormone takes longer to produce (longer hormonal cycles). Due to my cycle being long, I also get irritable because I don’t know exactly when my period is coming which can drive me into further frustration.
Hormonal Contraceptives:
Hormonal contraceptives, including the pill which was launched in the 1950’s and linked to the swinging 60s and the free love era, was a combination of the hormones estrogen and progestin created, by the American biologist Dr Gregory Pincus. This was something that created significant freedom for women and can never be discounted as an important step for women’s rights. Hormonal IUDs, were invented shortly thereafter in the 1970s and 1980’s to mimic the pill but in a localized way to the uterus. These two contraceptives aid in protecting you from pregnancy by changing the natural rhythm of your cycle by introducing synthetic hormones into the body. While effective at preventing pregnancy, these contraceptives suppress the natural fluctuations of estrogen and progesterone, essentially overriding the body's hormonal communication system. As a result, the menstrual cycle becomes more predictable, but at the cost of disrupting our balance of hormones. This in itself is not necessarily negative but it is important to note for when you intend to end the use of your contraceptives. In addition since most of us get on birth control at such a young age, our hormones never have a chance to fully stabilize and the hormonal cycle goes through a shock when it is forced to stabilize on its own after years of being automatically “tuned” into a rhythm.
Challenges of Stabilizing Hormones After Discontinuation:
Upon discontinuing hormonal contraceptives, many women experience a period of adjustment as their bodies strive to regain hormonal balance. The first six months post-discontinuation are often characterized by irregular periods, mood swings, acne flare-ups, and other hormonal symptoms, potentially depressive episodes and weight gain. This adjustment period, commonly referred to as "post-pill syndrome," highlights the challenge of reestablishing the body's natural hormonal equilibrium.
One aspect often overlooked in the journey to hormonal balance is the role of gut health. Research indicates a strong connection between the gut and hormonal health, with the gut microbiome playing a pivotal role in hormone metabolism and regulation. However, hormonal contraceptives can disrupt gut health by altering the composition of gut bacteria and compromising digestive function. Especially when contraceptives have been used for long periods of time such as in my case (10 years), With the addition of the added stress on your liver that will spend time detoxifying the synthetic hormones from your body on a regular basis.
Now let’s PAUSE, don’t let this stress you out as this is also normal. Your body is a magical self-healing machine capable of creating and reversing any side effects that have been created. The same way that your cuts turn into scabs that heal and turn to tiny nearly invisible scars will be the same way your body regenerates itself and restabilizes your hormones. All you have to do is give it right support.
Creating a Supportive Environment and Choosing All Natural Support:
To support yourself and your hormonal balance post-contraceptive use, prioritizing good digestive health is critical. Alongside a compassionate and gentle approach to your body’s fluctuations. Incorporating foods rich in fiber, prebiotics, and probiotics should be the focus to nourish the gut microbiome and promote healthy digestion. Additionally, addressing any digestive issues and determining any intolerances could be helpful as those could be tied to your hormonal imbalances, symptoms can include bloating, gas, or irregular bowel movements. Restoring gut function is essential for good hormonal balance. Finally, I always recommend to add liver detoxifying teas and a general period of boosting supplementation to help your body’s natural healing ability to reset itself after this long period of synthetic hormone control over your cycle.
Why Journalling is so Important
For me, I went through phases of weight gain, weight loss, hormonal acne, very lengthy menstrual cycles and heightened stress. It helped me to keep a journal and to write often especially to express my feelings and moods fully and without judgment. Often I was so deep in emotions I would forget that this could just be a low of my hormone stabilization point. However, I know and understand that all this was also critical in learning my body’s way of speaking to me and regaining its trust to let it self-regulate its hormonal cycle. Journaling let me release those emotions and judge myself less for what I was going through.
If you are trying to transition off hormonal contraceptives and are working on hormonal balance, these are my go-to strategies that are key to supporting this process:
Nutrient-Rich Diet:
Focusing on healthy-fats such as avocado, olive oil and nuts. Adding in nutrient-dense foods such as fruits, cruciferous vegetables will support your diet with additional vitamins and minerals. Good protein intake is important as it can provide essential nutrients for hormone production and balance. Limiting any processed foods and significant sugar intake is also important as insulin plays an important role in our hormonal balance. Too much insulin can easily throw off the hormonal cycle. PCOS and those who suffer from PCOS are often on a rollercoaster of blood sugar balance and need to address sugar/starch intake to keep a balance in hormones.
Stress Management:
Another key aspect of finding hormonal balance is to minimize cortisol spikes. In any transition phase prioritizing stress-reducing activities such as yoga, meditation, deep breathing exercises, or spending time in nature will have the double effect of letting your body naturally heal itself but also will help support adrenal health. Reducing your cortisol levels is imperative to allowing your body to feel safe enough to ovulate and to find its rhythm. From personal experience, when you and your body do not feel safe and it is in survival mode - it will not ovulate. That is the beauty of our biological survival instinct that our body will deter ovulation until it feels safe again.
Hormone-Supportive Herbs and teas:
I highly recommend to all my clients to try a supportive herbal teas for cycle support but also for liver support. My favourite cycle support brand (full disclosure: I invested in the brand because I loved the brand’s ethos so much) are the healing herbatas from theSABI.co, find them here. I suggest to all my clients who have period pain, bloating issues and need additional cycle support to try an all-natural tea to help smooth out those hormonal waves. For liver teas, I also suggest Gallium Verum or lady’s bedstraw or milk thistle to help support liver detoxification. Consider incorporating herbs such as maca, chasteberry (vitex), and dong quai, known for their hormone-balancing properties.
Regular (and Lighter) Exercise:
Engage in regular physical activity to support overall health and hormone regulation. Aim for strength training, and flexibility exercises especially in the beginning months of your journey to balanced hormones. Resistance training is highly beneficial for hormone balance as it targets the development of muscle mass and strength, directly impacting the production and regulation of essential hormones such as testosterone, human growth hormone (hGH), and insulin-like growth factor 1. The more muscle mass you have the better your insulin regulation is which will help combat any PCOS symptoms as well. In addition, long walks have helped me to feel strong and gain endurance (uphill, speed-walking or hiking). I would suggest to limit any HIIT training as well to avoid those extreme spikes in cortisol.
Patience and Self-Compassion:
Understand that rebalancing hormones takes time and patience. Be gentle with yourself and listen to your body's cues throughout the process. Find ways to journal, connect with your body and find moments of self-care to truly allow yourself and your body to go through this period with grace and to trust that it knows best. After a long period of your body’s natural rhythms being pushed away in favour for regulation by a pill, your body will also have to learn how to react to environmental stressors, diet stressors, to determine how and when it feels safe. It’s normal to go through the emotional ups and downs and the journey that comes along with our hormones. Accept this phase and try to address it with non-judgment.
I know the journey of hormonal balance is not easy and even two years after taking out my hormonal IUD there are still things that affect my hormonal balance, my ovulation and my cycle regularity. Though I can proudly say I had my first cycle of 35 days after one and a half years and am looking forward to the cycle being more predictable. However, I know and trust my body now more than ever to give me those cues that its under stress, that it needs more support, care and stability which has also given me my power back to make decisions in tune with my cycle. Most importantly by acknowledging the impacts of this enormous change while prioritizing self care I truly believe women can navigate this transition with greater ease and empowerment. Finding balance is not about perfection but about honoring the body's innate wisdom and striving for harmony in mind, body, and spirit and isn’t that our ultimate goal anyway.
