“Post birth control syndrome” is a term typically used to describe the adverse side effects of oral contraceptive use when women discontinue hormonal birth control (the pill, IUD, the ring).
Although, in clinical practice, I find post birth control syndrome may also exist and persist if you’ve been on birth control for an extended period of time. Many women describe feeling “just off.”
Whether you were on the pill for 3 months or 13 years, when you start and stop taking exogenous estrogen and/or progesterone physiological shifts can occur in your natural hormone balance. Your hormones—especially estrogen and progesterone— are like your body’s orchestra, helping keep the “tunes” of other bodily processes in sync.
On hormonal birth control, even low dose hormonal birth control, your body gets a steady supply of synthetic hormones, sometimes referred to as “xenoestrogens” As a result, your HPA axis (hypothalamus-pituitary-adrenal axis) is “cued” to halt or suppress the natural production and regulation of your hormones, also known as the “negative feedback loop”, to stop ovulation and prevent pregnancy.
This is fine and dandy for not getting pregnant, however as you come off birth control—or continue taking birth control, it’s as if your body and your natural hormone balance is riding a bike again for the first time in years—a little wobbly.
Not to mention, cortisol levels (your stress hormones) can get discombobulated as well. The estrogens in hormonal birth control increase a blood protein called cortisol binding globulin, which acts like a sponge to hold onto cortisol. When the amount of cortisol binding globulin increases, the total amount of cortisol in the body increases as well.
Consequently, the “side effects” from these hormonal imbalances are real.
Side Effects: Post Birth Control Syndrome
Common side effects similar side effects to those many get when going on the pill, including:
- Skin breakouts and acne
- Shifts in weight
- Bloating and constipation
- IBS and SIBO (small intestinal bacterial overgrowth)
- Anxiety and mood swings
- Hormonal imbalances
- Irregular cycles
- Nutrient deficiencies
No two bodies are alike and therefore, not all women will experience the same symptoms, if any. However if you find your body feels “out of balance” post-BC (birth control), you are not alone (I work with women just like you every day).
Additionally, the length of time your body was on birth control, as well as the initial age you were when you first started using it, may contribute to the prevalence and severity of your symptoms.
Case Studies: Meet Sarah, Allie & Michelle
Sarah, 22, was a college girl headed towards law school when we started working together. She came to me initially with the chief complaints of bloating and IBS with constipation— “No matter what I eat, I always feel like I am 3 months pregnant!” As we discussed her health history, she also noted the hormone imbalances (irregular and missing cycles) and skin problems she’d had since her early teens. To “solve” her problems, her pediatrician prescribed hormonal birth control and she’d been on it for over 7 years—a big link to our puzzle. After her initial lab test workup, we discovered Sarah has SIBO (small intestinal bacterial overgrowth), a common finding in women with a long-term history of birth control—the synthetic estrogens had up-regulated the estrogens in her “estrobolome” —the gut bacteria that degrade excess estrogens. It was too much for her gut to handle and yielded a disrupted gut microbiome. Voila! Answer to her gut problems. Solved.
Then there was Allie, 42. Mother of 3. Twenty-something year long history on birth control—off and on—between her pregnancies. Off the pill now for two years. Chief complaints: Irregular cycles, horrible mood swings and stubborn weight gain—15 pounds in the past couple years without trying. Allie’s bloodwork and urine metabolites hormone panels revealed a common finding noted on other women’s panels as well: “tanked” estrogens and progesterones and elevated cortisol. Her body (and hormones) still recovering from the disruption.
And Michelle. 30. No cycle back—after 6 months off the pill, low energy and pimples she’d not had since she was 16. Another one “bites the dust?” Can you relate?
8 Essentials to Mitigate Post Birth Control Syndrome Symptoms & Heal
So what to do about post birth control syndrome? Are symptoms inevitable?
The short answer: No. The “horrible” side effects of post control syndrome do not have to be your fate—particularly to the degree you may read in threads on Facebook or Dr. Google—if you take a proactive, supportive approach to restoring your hormone balance naturally.
As you can imagine, there are many ways to “support” your body’s balance, but here are 8 functional medicine-based essentials I’ve found helpful to help women mitigate post birth control syndrome symptoms so you can heal:
#1. Support Your Liver & Gallbladder
Your liver and gallbladder are a tag team, like Batman and Robin, that work together to detox, filter through, recycle and clear out toxins, nutrients, wastes and hormones—both natural and exogenous.
Several human and animal studies have shown that estrogen (especially in excess) increases the risk of developing “gallbladder congestion” and inflammation in the liver-gallbladder pathway.
The liver itself also has estrogen receptors, hence the presence of external estrogens (like birth control) triggers cholesterol saturation in the bile (an inflammatory marker). In fact, a common finding in women with hormonal imbalances or a history of birth control use is elevated cholesterol markers—not indicating heart disease, but instead inflammation. Gallbladder and liver problems is also a BIG reason why women experience symptoms like hormonal acne, weight gain, sugar cravings, constipation and lower bowel gas.
If your gallbladder and/or liver are congested or can’t do their job properly, you end up with higher amounts of both circulating estrogens and/or other hormones like cortisol in the body.
After months or years on birth control, there’s a good chance that your gallbladder and liver need some love to cleanse and balance hormones effectively.
For my patients, I typically recommend a gentle homeopathic and nutritional “drainage” support, targeted at “opening up” the drainage and detox pathways.
#2. Rebalance Your Estrobolome
Your estrobolome is a cool word for the “estrogen balancing gut bacteria” in your biome. The estrobolome is altered in the presence of synthetic hormones as gut bacteria become overwhelmed and cannot keep up with the degradation and break down of excess estrogens, up regulating an enzyme called “beta glucuronidase”, spurring on excess inflammation and a dysbiotic environment in the biome. Hence why symptoms like bloating, constipation, IBS and SIBO are common in post birth control syndrome.
Many of the tactics here will help mitigate this, but you can also supplement with Calcium D-Glucuronate to help breakdown excess estrogens in the gut, as well as supplement with probiotics, prebiotics and digestive enzymes to rebuild the biome.
My favorite practitioner-grade formulas can be found HERE on the Fullscript store and include:
- Soil Based Formula: Orthospore Biotic (Orthomolecular)
- Saccharomyces Boulardii: RestorFlora (Microbiome Labs)
- Lactic Acid & Bifidobacteria Formula: Therbiotic Complete (Klaire Labs) or Seed Probiotic (sold here)
- Fiber (Recommendation: Paleo Fiber)
- Butyrate (Recommendation: Tributyrin)
- Digestive Enzymes (Recommendation: Holozymes)
#3. Poop Daily
Your daily poo is your body’s daily report card of how balanced it feels inside. If you’re not pooping daily, Houston, we have a (big) problem. Poo also helps clear out excess hormones (like estrogens and cortisol), toxins and wastes that cramp your hormonal style. Try one (or several) of these poo hacks:
- Take digestive bitters with meals and/or at night before you sleep (Like these or these or these)
- Supplemental magnesium (like Upgraded Formulas)
- Smooth Move Tea
- Coffee enemas (if needed)
- 1 cup organic coffee daily (natural digestive bitter; like Kicking Horse or Purity)
- Walk or gentle movement after meals
#4. Cleanse Synthetic Estrogens (Xenoestrogens)
Speaking of “cleansing”, while you’re supporting your poo, also mitigate the excess estrogens that fight to compete with your natural estrogens in your body. Synthetic estrogens or “xenoestrogens” mimic estrogen, so your body’s natural production remains altered.
Birth control is just one form of xenoestrogens. Others include things like BPA in plastics (water bottles, tupperware), conventional (toxic) makeup and other cosmetics, tap water, pesticides in conventional fruits and veggies and grain-fed animals.
No, we cannot live in a bubble, but aiming for the least toxic products and foods by shopping organic at the grocery store, drinking clean filtered water (like the Berkey) and gradually swapping out your products for non-toxic alternatives (like Ilia makeup and other A+ brands on the Think Dirty app).
#5. Boost Your Mitochondria
Mitochondria are the primary energy sources or “powerhouses” of all cells and tissues—hormones included. If our body is under “oxidative stress” from excess estrogens (xenoestrogens), then our hormones will naturally be depleted. Support your mitochondria (powerhouses) with both lifestyle factors and supplements:
- Supplement Supports: Like this one
- Vary up your exercise: Keep your body guessing! Mitochondria need a balance of yin and yang exercise. Aim for 3 to 5 days of weight and strength based exercises, 2 to 3 HIIT or sprint type of exercises (short intensity—15 to 20 minutes or a bootcamp style workout) and plenty of walking and yoga. Limit long-drawn out cardio sessions (like running every single day) to promote and restore body balance.
- Try heat or hot-cold therapy. Heat therapy, like sauna use, increases mitochondrial efficicy, including better use of oxygen in the blood through a process called oxidative phosphorylation (OXPHOS). You can also try a ‘cold plunge’, ice bath or cold shower post heat session for a further mitochondrial booster.
- Meditate or do yoga. Daily. Stress–both mental and physical—alters mitochondrial function; ‘fight back’ with anti-stress tactics.
- Sleep 7 to 9 hours nightly. Mitochondria regenerate the most while you sleep. If you “can’t sleep”, nix the screens at night, get morning sun exposure first thing and make sure you sleep in a pitch black, cool room (68 degrees or below).
- Balance blood sugar and eat every 4 to 6 hours (versus multiple mini-meals per day). This allows for less start-stop-start-stop stress in your digestive system. For a meal timing schedule that mimics your natural circadian rhythm, eat 3 meals per day at 8 am, 12 pm and 5 pm.
- Consume plenty of essentially fatty acids. Aim for at least 1 to 2 sources with each meal—like extra virgin olive oil, wild caught salmon, raw nuts and seeds, avocado, ghee, animal fats (tallow, duck fat). Avoid hydrogenated oils like canola oil, vegetable oil and grapeseed oil.
- Kick the restaurant takeout (frequent) and processed foods. One word: oxidative stress….which leads up to point #6.
#6. Eat an Anti-Inflammatory Diet
We feel like what we eat. Eat greasy pizza, bloating-causing diet soda, dry lifeless salads or 6-month-old frozen Lean Cuisines as your nourishment, and you may not feel as fresh live foods like: color-rich, fresh veggies and fruits, clean organic proteins, healthy fats (like avocado, raw nuts and seeds, extra virgin olive oil). or even a delicious homemade cauliflower pizza crust with spinach, pineapple, basil pesto, chicken and a sprinkle of fresh goat cheese. Your hormones and overall body balance will thank you.
Let food be thy medicine! If the idea of changing your diet overwhelms you or you have a funky relationship with food, consider working with a functional medicine nutritionist (who gets it) to support you in your healing journey.
#7. Restore Essential Nutrients
Birth control pills strip your body of nutrients that are essential for feeling balanced, like B6, Folate, B12 and zinc for brain and mood function; magnesium, thiamine and riboflavin for hormonal metabolism; and Vitamin C, Vitamin E and selenium for cellular energy.
To “restore” your losses, Feel Even is a great (much needed) multi-vitamin on the market; paired with your anti-inflammatory diet (because you cannot out supplement a bad diet).
#8. Chill Out Your Cortisol
Birth control alters cortisol (your stress hormone) balance; consequently, coming off birth control also alters cortisol. Although the adrenal glands don’t necessarily “pump out” more cortisol, as aforementioned, plasma level of certain hepatic binding proteins, including cortisol binding globulin, increase in women using oral contraceptive pills—meaning more cortisol is bound or trapped inside. Over time, this builds up. Hormonal oral contraceptives also have been shown to decrease hippocampal volume in the brain, related to depressive mood and mood swings, as well as decrease the overall resiliency of users to deal with stress.
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Adaptogenic herbs can be helpful for the transition off of hormonal birth control to mitigate some of the effects of high bound cortisol in the body, such as ashwagandha and cordyceps.
Bonus: Explore Natural Birth Control Options
Hormonal birth control is not the “only” option for BC and protection. Other options women consider include:
- Good ol’ natural family planning—99% effective when you learn to tune into your body and know that “time of the month” when you are fertile (ie. Only 1 in 100 women will become pregnant with this method)
- Condom use
- Plant-based spermicide creams like Smart Women’s Choice with natural active ingredients that immobilizes the sperm in the vagina
- Non-hormonal IUD and ring
Recover from Post Birth Control Syndrome
You can heal and feel amazing in life after birth control. Connect with our clinic HERE to apply for and schedule an initial Health Strategy Session today.
We will create a personalized “game plan” for you and your healing journey.