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Ditching the Pill …and other hormonal contraceptives

An excerpt from Marilyn M. Shannon’s book, Fertility, Cycles & Nutrition.

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Congratulations on your decision to discontinue birth control pills or other hormonal contraceptives! You have taken a giant step toward better health. As hormone specialist Diana Schwarzbein, M.D., has written, you cannot achieve optimum hormonal balance while you are on the Pill, because hormones interact with each other.[1]

On the other hand, when you discontinue birth control pills, your body may have to go through a period of readjustment to its own natural hormones. Coming off the Pill or other artificial hormones used for contraception may be followed by delayed ovulation, a pattern of constant less-fertile mucus, and possibly heavy menses. As an NFP instructor, I have seen many charts from women who have recently discontinued hormonal birth control. My experience has been that about half of them have very regular cycles immediately after coming off the Pill, whereas the other half have one, two, or three irregular cycles of adjustment, especially cycles with poor mucus patterns.

Diet and supplements for better cycles post-Pill

Many women who are coming off the pill view it as an opportunity to improve their health generally. Whether or not your cycles are immediately regular, why not read through Part I of this book and consider general dietary improvements? Eating more fresh whole foods, reducing your intake of trans fats, sugary treats, and artificial sweeteners is a good place to start. Use the 80-20 rule (Rule 12 in Chapter 1) so that you do not get discouraged. Aim for improvement, not perfection!

When it comes to vitamins, minerals, and essential fatty acids, research evidence shows that oral contraceptive users have a significant decrease in vitamin B12[2], vitamin E, and beta-carotene levels in their blood.[3] They have a significant decrease in the essential fatty acids and in the healthy EPA.[4] They have a significant increase in vitamins A and D, which drop once the Pill is discontinued.[5] Use of the Pill is also associated with higher levels of the “bad” LDL cholesterol levels and lower levels of the “good” HDL cholesterol.[6]

Dr. Ellen Grant, a British medical doctor who formerly conducted research on the birth control pill but who now considers them unsafe, recommends zinc, magnesium, essential fatty acids, vitamin E, and B vitamins for those recovering from Pill use.[7] Cod liver oil contains EPA as well as vitamins A and D, which both drop after the Pill is discontinued. You may wish to use flax oil as a source of the essential fatty acids, but either fish oil or flax oil should be taken along with vitamin E, as explained in Chapter 3. Fish oil and vitamin E are well known to have positive effects on blood cholesterol composition.

Any of the multivitamin/multimineral brands suggested in Chapter 3 contain the zinc, magnesium, B vitamins and vitamin E recommended by Dr Grant. Professional Prenatal Formula, ProCycle, or Potivite all come close to “covering all the bases,” but if you choose to use Optivite, you may wish to include extra folic acid, at least 400-800 mcg in addition to the 200 mcg in the full dose.

Other problems related to the Pill

The Pill is known to worsen PSM in some women. It has also been associated with yeast overgrowth. Chapter 5 covers PMS, and “Yeast Overgrowth” is the topic above. If you were on the Pill to lighten heavy bleeding or reduce menstrual cramping, you will find natural answers to these problems in Chapter 6. [Editor’s note: Also available in our new booklet, “Shorter, lighter, pain-free periods.”] If you were on the Pill to “regulate” your cycle, try referring to the section on low thyroid function, underweight, overweight, or other relevant section of Chapters 7 and 8. If you have been using the Pill in an attempt to overcome acne, you may be interested to read Chapter 8, which covers polycystic ovary syndrome (PCOS). The high levels of “male” hormones typical of PCOS are a major trigger for acne. See also Chapter 16, “Questions & Answers: Part II” for nutrition to help overcome acne.

— Marilyn M. Shannon is a tenured, part-time instructor of biology at Indiana University Purdue University at Fort Wayne, Indiana, where she has taught human anatomy and physiology for more than 30 years. Her book, Fertility, Cycles & Nutrition is a staple for many NFP families and is available here


[1] Chavarro, J., Willett, W., and Skerrett, P. The Fertility Diet (New York: McGraw-Hill 2008, p. 183).

[2] Chavarro, J., Rich-Edwards, J., Sosner, B., et al. “Dietary fatty acid intake and the risk of ovulatory infertility” (Am. J. Clin. Nutr. 2007, 85:231-237).

[3] Chavarro, J. Personal communication to M. Shannon (Mar. 17, 2008) “In the overwhelming majority of cases the underlying condition affecting ovulation was PCOS although there were other conditions that we considered as accurate reports of ‘ovulatory infertility’ such as anovulation due to hyperprolactinemia, hypothyroidism, hypopituitarism and premature ovarian failure.”

[4] Chavarro, J., Willett, W., and Skerrett, P. (2008, pp. 147, 184).

[5] Gittleman, A. Get the Sugar Out!, 2nd ed. (New York: Three Rivers Press, 2008, pp. 14-16).

[6] Chavarro, J., Rich-Edwards, J., Rosner, B., and Willett, W. “A prospective study of dairy foods intake and anovulatory infertility” (Human Reprod. 2007, 22:1340-1347).

[7] Dhingra, R., Sullivan, L., Jacques, P., et al. “Soft drink consumption and the risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community” (Circulation 2007, 116:480-488).