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Consider These Supplements When Transitioning Off The Birth Control Pill

Whether you wish to conceive, want to try a non-hormonal birth control method, are entering menopause, or are experiencing unwanted side effects, all of the estimated 151 million women worldwide using a contraceptive birth control pill will come off of it at some point.

If you had a poor experience on the pill, coming off of it has the potential to provide many benefits, according to hormone specialist and integrative nutritionist Alisa Vitti, Founder of FLO Living, creator of The Cycle Syncing Method®, and author of best-selling books Woman Code and In the FLO. “You might experience a boosted mood, lose stubborn weight the pill was causing, have your sex drive return, and notice greater access to your creativity and focus,” she says.

Given that the birth control pill also halts your natural menstrual cycle, which has been dubbed the fifth vital sign by The American College of Obstetricians and Gynecologists, going off the pill may also offer you valuable info about your overall well-being, she says. 

The thing is, your natural menstrual cycle doesn’t instantaneously return the day you stop the pill, nor do your hormones immediately re-regulate, per Vitti. This process can take anywhere from one to six months, depending on how long you were on the pill. In that time, symptoms such as skin changes, weight fluctuations, and mood shifts are all common, according to obstetrician and gynecologist Dr. Tiffany Pham, OB/GYN, medical advisor at fertility and ovulation tracking app Flo Health. “You may also start to experience more symptoms, such as bloating, fatigue, breast tenderness, or moodiness around the time of your period,” she says. 

Thankfully, in many cases “individuals can prepare for the transition strategically with supplements to avoid unwanted symptoms associated with going off the pill, such as the acne rollercoaster,” says Vitti. Ahead, a look at four of the supplements that may help you transition off of the pill. 

  • ABOUT OUR EXPERTS: Alisa Vitti, is a hormone specialist and integrative nutritionist, founder of FLO Living, creator of The Cycle Syncing Method®, and author of best-selling books Woman Code and In the FLO. Dr. Tiffany Pham, OB/GYN, M.D., is an obstetrician-gynecologist and medical advisor at fertility and ovulation tracking app Flo Health. Dr. McElligott OB/GYN, M.D., M.P.H., is an obstetrician-gynecologist and medical advisor to women’s healthcare company Mira.

4 Supplements To Consider If You’re Going Off The Pill

1. Folic acid 

Subtracting the pill from your medicine lineup with hopes of adding a member to your family? If so, it’s time to start supplementing with folate, a B vitamin essential for fetal development that the birth control pill can diminish. 

Though 5-methyltetrahydrofolate and other methylfolate forms of this vitamin are becoming more popular, the synthetic version of folate called folic acid, has long been shown to support healthy pregnancy, according to Pham.

“Folic acid supplementation has been shown to reduce the risk of neural tube defects (NTDs), which affects approximately 3,000 pregnancies per year,” says Pham. The neural tube helps form the spine and brain during the first month of gestation. When defective, the fetus faces an increased risk of spinal cord and brain development issues, which can result in severe neurologic or physical disabilities and even death, she says. 

Read More: 6 Nutrients That Support Women’s Fertility

Adequate folate intake helps reduce the risk of NTDs by up to 70 percent. Research published in the International Journal of Environmental Research and Public Health suggests it does this by supporting an internal process called nucleotide synthesis, which supports DNA and RNA replication and ultimately the development of the neural tube in the fetus. 

Optimal levels of folate are difficult to obtain from diet alone. As such, the CDC recommends that all women trying to become pregnant consume 400 micrograms of folic acid per day. Ideally, you’d start supplementation at least a full month before conception. 

That said, because birth control pills can alter the levels of various B vitamins in the body, obstetrician-gynecologist Dr. McElligott OB/GYN, M.D., M.P.H., medical advisor to women’s healthcare company Mira, recommends that individuals going off the pill with pregnancy in mind start folate supplementation at least four weeks before stopping their medication. This gives the body time to build stores back up to at least the recommended level before it may need to supply the vitamin to the fetus, she explains. (Because, yes, some people can get pregnant that quickly after stopping the pill.)

2. Zinc

If you’re one of the 14 percent of pill users who take an oral contraceptive because of acne, you might consider supplementing with zinc, which may help zap zits during the post-pill transition. 

People often turn to the pill in cases of skin issues, such as blackheads, whiteheads, pimples, and acne nodules and cysts, per the American Academy of Dermatology Association. Why? Well, most of these skin issues are triggered by the production of a pore-clogged oil called sebum, which the pill helps modulate. 

Generally, individuals produce sebum at higher rates when their testosterone levels are higher. “Testosterone typically binds to a protein called sex hormone binding globulin (SHBG) in the body, but sometimes small amounts of testosterone left can act on other receptors in the body, such as those in the skin,” Dr. Pham explains. When testosterone acts on these skin receptors, it can cause an increase in oil (sebum) production, which may lead to acne. 

“When you take hormonal birth control—in particular, the combined pill—there is an increase in SHBG, and therefore more of the testosterone in the body bound up to this protein,” says Pham. This leaves less testosterone floating in the body to act on those other receptors. The result: less pore-clogging oil and therefore less acne overall. When a person goes off hormonal birth control, however, their SHBG levels return to pre-pill levels, Pham says. For individuals who saw skin improvements while on the pill, this can lead to a re-appearance of skin issues and acne. 

Supplementing with zinc before going off of the pill may help your skin, as well as overall well-being, given that the pill has been shown to impact zinc levels, too. One study published in the International Journal of Research in Dermatology found that the majority of patients who supplemented with zinc twice per day for three months saw more significant improvements in their complexion. Meanwhile, a second study published in the Journal of Clinical and Aesthetic Dermatology in 2021 found that zinc supplementation may be as helpful for those with skin concerns as common medical treatments.

That said,acne is a complex condition that often requires different forms of therapies to manage,” says Pham. She recommends working with a dermatologist to find a treatment plan for your particular skin issues that does not involve the birth control pill

3. Probiotics 

“The synthetic hormones in the hormonal birth control pill can disrupt the gut microbiome,” says Vitti. Indeed, one 2021 study published in the journal Environmental Microbiology found that the combination birth control pill led to changes in the diversity of the gut bacteria. 

A diverse bacterial make-up in the gut is essential for everything from maintaining a healthy gastrointestinal tract and immune system, to mood stabilization and overall well-being. When bacterial diversity dips, as it can when on the pill, individuals face an increased risk for GI issues. In fact, both constipation and diarrhea are common side effects of the pill, according to Vitti. Notably, one 2016 study published in Drug Safety also found a link between oral contraceptives and inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. 

Read More: Your Skin Issues May Be Starting In Your Gut

Unfortunately, the bacteria in the gut don’t automatically return to normal on your first day without the pill. “The impact of the pill on the microbiome will last long after you stop taking it without concentrated actions to replenish good gut bacteria,” says Vitti. As such, she suggests starting to supplement with a probiotic at least two to three months before your last planned dose of the synthetic hormones to support a smoother transition and revitalize gut health. 

Probiotic supplements, Vitti explains, contain live bacteria and thus can supply additional ‘good’ bacteria to your gut microbiome, which may have been depleted from the pill. She recommends opting for a probiotic supplement with multiple strains of beneficial bacteria, such as Lactobacillus and Bifidobacterium.

4. A multivitamin 

“Hormonal birth control has been shown to prevent the absorption of micronutrients, including vitamins and minerals,” says Vitti. In particular, it has been found to interfere with the absorption of B vitamins, magnesium, vitamin C, vitamin E, and zinc

Adequate levels of these nutrients are essential for hormonal health, as well as overall health. “Continued deficiency could lead to worsened or new hormonal issues post-pill,” Vitti says. Long-term vitamin C deficiency, for example, has been linked with fatigue, widespread connective tissue weakness, and capillary fragility. Meanwhile, sustained magnesium deficiency can cause abnormal heart rhythm, seizures, muscle cramps, and personality changes. 

In most instances, the levels of the micronutrients naturally return to healthy levels within one to three months of an individual stopping the pill, according to Pham. Still, supplementation can help speed up the process and thus counteract symptoms associated with nutrient deficiencies, such as fatigue, impaired muscle function, and brain fog. 

Taking a well-rounded multivitamin while on or coming off of birth control is likely sufficient to make up for any deficiencies of vitamins and minerals from birth control, according to Pham. 

Checking in with a Healthcare Provider

Technically speaking, “When you are ready to stop taking birth control, you can simply stop the medication,” says Pham. Your body will recognize the lack of external hormonal input as soon as you stop taking the pill each day. In response, “your internal production of hormones will start to slowly ramp up as a part of the brain called the pituitary gland starts to send out signals to the ovaries to increase its production of hormones once more.” 

Still, Vitti recommends consulting with a healthcare professional before halting use. “These are serious medications and you need to take coming off of them seriously,” she says. The right provider will be able to answer axillary questions you might have about alternative birth control options, fertility, or family planning. They will also be able to suggest lifestyle interventions and/or a supplement line-up customized to your particular body and needs that can help your system handle the transition of going off the pill. 

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