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How to Transition Off Hormonal Birth Control Smoothly

How to Transition Off Hormonal Birth Control Smoothly

Can I get pregnant after being on birth control for decades? Is it hard to get pregnant after being on birth control? What are healthier alternatives to hormonal birth control? Can I stop taking it cold turkey? 

As a Functional Diagnostic Nutrition Practitioner these are the questions I continually get from the women in my community who are wanting to transition off hormonal birth control.

Every woman and their experience is going to be different, but typically menstrual periods will resume within three months after you stop taking the pill. But if you took the pill specifically to regulate your menstrual cycle, it could take longer for it to return.

Whether it’s due to health reasons, you’re curious about your body’s natural rhythm, or you just want to explore other contraceptive options, I know it can feel super daunting. So I’ve put together some of my best tips and advice that should make your journey of transitioning off the pill much smoother, and more informative. <3

What does birth control do to the body? Are there any risks to taking it?

Unfortunately, yes. There are risks associated with hormonal birth control, but very few, if any, are typically discussed with women by their OBGYN. Some of the main risks/symptoms include:


- Low libido
- Migraines, depression and anxiety
- Nutrient and mineral deficiencies 
- Increased risk of certain cancers (esp. breast and/or cervical cancer)
- Increased risk of stroke and blood clots

        If you’ve ever had a discussion about birth control with your doctor, you may have been told, “It’ll help you balance your hormones.” But the truth is, it suppresses your hormones. It doesn’t balance them.

        Birth control pills contain synthetic forms of estrogen and progesterone. These “fake” hormones take over and prevent the body’s natural production and release of natural hormones like estrogen, progesterone, FSH, & LH that control the menstrual cycle. (aka: birth control pills override and actually turn off our natural hormone cycle!)

        Think of it like a bandaid. It may cover up your symptoms, but once you stop it (or take off the bandaid), the symptoms are just going to come back, because the root of the problem was never addressed.

        When transitioning off HBC, what are some symptoms to look out for?

        Everybody is different and may experience different symptoms, but most of my clients (and myself included!) experienced:


        -Heavier periods/cramps
        -Hair growth on the face (hirsutism)
        -Anxiety/depression/mood swings
        -Missing periods (amenorrhea) 
        -Weight gain, etc.

            It’s kind of like your body throwing a mini tantrum because it’s going through withdrawal as it adapts to the absence of all the synthetic hormones. Not fun, but super common.

            So, how do I transition off HBC?

            One of the main questions I get from my clients is, “Can I just quit cold turkey?” And I highly recommend you don’t! 

            Supporting your body for at least ~3 months before & after stopping birth control is highly recommended. I always recommend coming up with a PLAN well before you stop. 

            So, when you’re ready to make the decision to transition off, here are a few of my best tips I share with my clients on a regular basis:


            1. Discuss with your doctor and make sure this is a good option for you


            A good doctor will fully support you and your decision to find alternative natural methods of contraception, and if they don't… I recommend finding a new one!


            2. Prep your body for 3+ months through diet and lifestyle changes

            Prioritize healthy eating by consuming a colorful, nutrient rich diet that’s high in protein + blood sugar balancing. Blood sugar regulation is so important to help your body recover from the pill because of how it affects your hormones. Frequent blood sugar swings increase insulin levels which can lead to insulin resistance, chronic inflammation, weight changes, period problems, + more. When you have a lot of blood sugar spikes during the day from food, insulin will go up, telling your ovaries to make more testosterone vs. estrogen which can lead to hormonal acne or things like hirsutism (male pattern hair growth in women). Blood sugar swings also affect our cortisol levels (and cortisol levels affect blood sugar, a vicious cycle) which will contribute to more stress in/on the body, which will only make symptoms worse. 


            3. Fill nutrient gaps that the pill depleted (esp. B vitamins, magnesium, vitamin D, vitamin C + more)

            Hormonal birth control pills can affect nutrient levels in the body, likely leaving you depleted in multiple areas. This is where I put a huge emphasis on a high quality prenatal! I personally take (and recommend to all of my clients and community) WeNatal & DHA+. I LOVE WeNatal for so many reasons, but especially because it promotes overall reproductive health, egg quality, and supports nutrition all the way from preconception to nursing (if you decide to breastfeed!).

            It helps maintain healthy blood pressure and blood sugar levels throughout pregnancy, as both are extremely important for a healthy baby and mama. WeNatal also contains the recommended amount of daily folate and choline in their most bioavailable forms, + it’s free of synthetic dyes, preservatives, and has no artificial ingredients. I love taking WeNatal daily because it helps me feel confident in filling nutritional gaps (especially helpful when transitioning off the pill). <3


            4. Support your liver


            Your liver is responsible for detoxifying harmful substances, including the synthetic hormones from the pill. It also plays a role in metabolizing hormones, so supporting it will help your body clear out the last of the synthetic hormones and help transition it to its natural balance. You can support your liver with habits as simple as staying hydrated, incorporating healthy fats into your diet, increasing fiber intake, reducing/eliminating alcohol, and using supplements like milk thistle, NAC, ALA, and dandelion root. I highly recommend speaking with a Functional Medicine Practitioner to help with an individualized protocol before taking any new supplements..

            5. Support your gut

            Your gut is arguably the very first place to focus on when transitioning off the pill! According to the National Institute of Health, observational studies have suggested a link between hormonal contraceptives and inflammatory bowel disease (IBD). Oral estrogen has been shown to promote intestinal permeability (aka: leaky gut) and can also contribute to the development of inflammatory diseases (like Crohn’s disease). Some of the easiest ways to support your gut health are: taking a high quality probiotic, eating a variety of fruits and vegetables (eat the rainbow!), consuming high quality animal protein (and products like grass-fed bone broth & collagen) + limiting processed foods, alcohol, and added sugars.


            6. Get all the information you can


            Educating yourself is advocating for yourself when it comes to your health. <3

            A few of my favorite books for transitioning off the pill are:

            • - WomanCode by Alissa Vitti 
            • - Beyond the Pill by Jolene Brighten
            • - Period Repair Manual by Dr. Lara BridenBody Love by Kelly Leveque (this one is more about balancing blood sugar when I was dealing with PCOS!)

            7. Follow the DRESS protocol


            DRESS stands for:

            • D = diet. Think colorful, blood sugar balancing, protein rich, gut friendly foods.
            • R = rest. Lots and lots of it. If you’re getting less than 7-8 hours at night, you’re already at risk for hormonal imbalances.
            • E = exercise. Enough, but not too much. Over exercising is going to spike your cortisol through the roof, which can then cause other hormonal imbalances. 
            • S = stress. You have to manage your stress in whatever way possible. I used to be a workaholic, running on caffeine and 5 hours of sleep each day, leaving me in constant fight or flight mode. When this happens, reproductive health takes a back burner to other functions in the body (like basic survival needs).
            • S = supplements. Our levels of essential vitamins and minerals make a huge impact on fertility!

            My biggest advice is to stay consistent! Depending on how long you’ve been on the pill, transitioning off HBC and getting back to your body’s natural balance can typically take anywhere from 3-12 months, sometimes even longer. But it will get better and your body knows what to do, it just needs the right time and support! Trust your body and trust the process.

            What are some alternative ways to prevent pregnancy without HBC? 

            Fertility Awareness Method (FAM)

            FAM (also known as Natural Family Planning) is a natural way to track your fertility cycles to either plan or prevent pregnancy. It involves observing and recording different body signals to determine when you are most fertile. Here’s how you can use it:


            1. Track Your Menstrual Cycle:


            Keep a daily record of your menstrual cycle on a calendar or an app. I like the Natural Cycles app best. Day 1 is the first day of your period. This record will help you notice patterns in your cycle length over time.


            2. Monitor Your Basal Body Temperature (BBT):

              Take your temperature each morning before you get out of bed using a basal body thermometer (you can also use something like Oura ring integrated with Natural Cycles app for this as well, or TempDrop is another tool for tracking BBT). Your BBT slightly rises by about 0.4 to 1.0 degrees F after ovulation, and this higher temperature lasts until your period. Charting this temperature daily over several cycles can help you predict when you usually ovulate.


              3. Check Your Cervical Mucus:


              Examine the color and consistency of your cervical mucus every day. After your period, you may have a few dry days followed by mucus that gradually becomes more plentiful and slippery. When your mucus is clear, stretchy, and resembles raw egg whites, you are likely at your most fertile.

              FAM takes practice to understand and correctly interpret your body's signals. It's also important to have a consistent routine, especially with BBT, to ensure accurate data. Consider consulting detailed guides, taking classes on FAM, or speaking with a healthcare provider experienced in fertility awareness for additional guidance and accuracy.

              Organic Condoms

              Condoms are 98% effective (if used correctly) and also reduce the chances of STIs (sexually transmitted infections). Organic condoms don’t contain synthetic chemicals, parabens, or other additives. I recommend the Sustain brand (you can find them on Amazon!). Your vagina is like a sponge and soaks up toxins, so anything you put up there should be organic!

              Copper IUD

              Copper IUDs work by releasing copper ions into the uterus, which creates an environment toxic to sperm, preventing fertilization. But the copper ions remain within the uterus, and don’t affect the rest of the body’s hormonal balance, so are considered a hormone-free birth control option. It also works by thickening cervical mucus to prevent conception. They can last for several years so it’s nice to not have to always think about it!

              The downside though is that it can be painful, increases cramping, and copper can be toxic, even though it’s a hormone-free option. 


              Phexxi is another hormone-free birth control that you only use when you need it. Phexxi is only effective when used immediately before (or up to 1 hour before) vaginal sex. Once inserted into the vagina Phexxi maintains a normal vaginal pH and works to keep vaginal pH in the 3.5-4.5 range, which lowers sperm mobility. It’s considered 93% effective.

              Phexxi isn’t a great option for you if you are prone to yeast infections though, because vaginally inserted forms of birth control can increase your chances of yeast infections and UTIs. 

              If you have questions about any of these forms of birth control, I highly encourage you to speak with your doctor. A good doctor will explain the pros, cons, and risks of each method and help you make the best decision for you! 

              Okay… how are you feeling? That was a LOT of info! <3 Like I mentioned earlier, transitioning off the pill can feel so overwhelming, but with a plan it can be much more manageable and you can mitigate a lot (if not all) of the “post birth control” symptoms that many experience. Remember, it’s important to listen to your body and give it time to adjust. 

              If you’d like to learn more about my 1:1 coaching services and get more personalized support in your health journey, you can download my service guide here or email me at if you have any questions. We would love to help you!

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              Maddie Scannapieco, FDN-P

              Maddie Scannapieco (Scan-Uh-Peek-Oh) is a Functional Diagnostic Nutrition Practitioner specializing in women's gut and hormone health. She helps women get to the root cause of and heal frustrating symptoms like acne, PMS, IBS, thyroid conditions, infertility struggles and more by understanding the "why" and restoring function in the body to get back to optimal health. She uses functional testing in her practice like GI Map, DUTCH and HTMA testing and follows a "test vs. guess" methodology to get life changing results based on individualized data.

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