The Pill and your period

A woman's body needs the ovarian hormones estradiol — a form of estrogen — and progesterone that are released during the menstrual cycle, according to the Period Repair Manual. These hormones have many benefits beyond reproduction, including bone development, mood, muscles and metabolism.

The synthetic version of these hormones in birth control pills stops ovulation by disrupting communication between the hypothalamus, pituitary and ovaries. 

Although these synthetic hormones, such as ethinylestradiol and the progestin levonorgestrel, are molecularly similar to natural estradiol and progesterone, they don't carry the same benefits as the estradiol and progesterone your body makes, as the Period Repair Manual notes.

Progestin, for example, is more similar to testosterone than natural progesterone, according to the Period Repair Manual. Some synthetic progestins, such as levonorgestrel, may cause hair loss due to testosterone-like qualities.

Although you still bleed once a month on hormonal pills, that's generally due to your body reacting to the loss of the synthetic hormones when you take placebo pills — not an actual period. Doctors call this withdrawal bleeding. 

Nicole Jardim, a certified women’s health and functional nutrition coach with a specialty in hormonal and reproductive health, told MedTruth each individual’s body responds differently to synthetic hormones, in part due to receptor sensitivity. Receptors receive and respond to stimuli like hormones. People with sensitive receptors may do fine on hormonal birth control, whereas those whose receptors aren’t as sensitive need more hormones than the pill is giving them to feel their best.

Post-Pill side effects

Once I stopped taking the pill, it took three months for my period to come back. In that time, I noticed I was losing more hair than normal, my energy flagged and my mood felt variable and off. 

Most people get their period back within three to six months, according to Jardim, but it may take longer. Not having a period is called amenorrhea, or the absence of menstruation, and many people experience months without a period after quitting the pill. One study on the discontinuation of oral contraceptives found it took up to nine months for women’s cycles to regulate.

Jardim called this stage “post-pill amenorrhea.” 

“Your body hasn't been doing that whole song and dance for so long between your hypothalamus, your pituitary and your ovaries that it doesn't really know what to do,” she explained. 

When you go off synthetic hormones, there’s a rise in androgens, especially testosterone, which may lead to amenorrhea, along with acne and hair loss. This is referred to as androgen rebound.

Other side effects include low sex drive, painful sex and mood disorders. A rarer but more serious condition is primary ovarian insufficiency, or premature ovarian failure, which is when the ovaries stop working.

If you have any underlying issues masked by the pill, those may resurface when you come off hormonal birth control, Jardim said. 

“It's hard to diagnose really anything when a woman is on the pill because of the fact that it's all just fake hormones, basically, and a fake period,” she said.

As for me, it’s now been five months, and my body is starting to adjust. Each month, my cycle gets closer to the typical 28-day cycle, and closer to what it was like before I went on the pill. My fluctuations in mood and energy have mostly leveled out.

Although my journey is not yet complete, each day my body works toward aligning with its natural rhythm.

What can you do to help balance your hormones?

Experts suggest balancing your hormones after going off hormonal birth control with a mix of dietary and lifestyle changes. 

Start tracking your cycle. Pay attention to the symptoms you experience on the pill versus when you stop taking it.

Eat nutrient-dense foods. Beyond eating a balanced, whole foods diet, Jardim recommends increasing your intake of leafy greens and cruciferous vegetables. 

“The birth control pill does a number on your gut health,” said Jardim. “It's clearly causing an inflammatory response and possibly triggering an autoimmune response too, so what we have to do is calm that inflammation down.”

Detox your liver. Eat lots of fiber, which Jardim says helps push used-up hormones out of the body. Dandelion tea may also be protective for the liver.

“I also focus on high fiber diets so that those hormones don't get recirculated back into your bloodstream from your gut, because that can happen with specific gut bacteria known as estrobolome. They have a role in how estrogen is processed in your gut. If there is a significantly high level of unhealthy bacteria that make up the estrobolome, what can happen is they can reconjugate or reconvert estrogen into a usable form, and that estrogen goes back out into your bloodstream and causes problems.”

Stabilize your blood sugar. Get enough healthy fats and proteins in each meal.

“What happens is if insulin is too high, it can actually cause your ovaries to make more testosterone and less of the estrogen that they need to make so that ovulation can actually happen,” explained Jardim.

Consider discussing supplements with a medical professional. Magnesium, selenium and zinc may improve ovarian function, according to Jardim. Fish oil may reduce inflammation and improve liver function.

Reduce stress. Stress can also affect how your body adjusts. Liz Moody, writer and host of wellness podcast Healthier Together, told MedTruth that people should “really listen to and be in a supportive place with their body,” rather than expecting their hormones to bounce back and their period to return immediately. She added, “I think that just sets you up to feel stress, which can be the number one inhibitor toward balancing your hormones again and getting back on track.”

Moody recommends doing “things like meditating and not doing as intense of workouts, eating foods that make you feel good, making sure that your sleep is optimized, all of the things that really make your body know that it can relax and that it doesn't have to be in a defensive fight or flight mode.”

Advice from the experts

Nicole Jardim, certified women’s health and functional nutrition coach

“I truly believe that we should all be educated on how our bodies are working. It is going to be the most empowering thing you ever do for yourself. Because at the end of the day, we're the ones who care most about our bodies.”

Liz Moody, writer and host of the wellness podcast Healthier Together

“Be careful of the stories that you're telling yourself. I think that you need to do what's best for you and for your body and for your relationship."