What to know when coming off birth control
In the last months, I am seeing a lot of women choosing to come off birth control. Many were put on birth control by their OB/GYN to ‘manage’ unwanted symptoms during their cycle. Some want to try to have a child in the future, and others are just questioning being on synthetic hormones for their whole life. Whatever the reason you may choose to come off birth control, it is good to know how to set yourself up for a smooth transition into having a regular cycle and period. While some women are lucky and have regular periods with no obvious symptoms, it’s also pretty common to experience irregular cycles, mood changes, skin issues, fatigue, or digestive shifts. Very few, if any, were told by their prescribing doctor how birth control negatively impacts other systems in the body so they are usually surprised by how far-reaching their post birth control symptoms can be.
From a functional medicine perspective, this transition is about more than just hormones — it’s about rebalancing the systems that birth control quietly influences over time. Being on birth control affects the health of the liver, digestive system, adrenals and detox and drainage systems in the body. Long term birth control users often have nutrient depletions as well.
The Liver — Your Detox Powerhouse
Birth control is processed through the liver, which means years of synthetic hormones can place a very big burden on the liver. The liver already has a big job to do - it is responsible for regulating our metabolism, detoxifies and clears toxins, metabolic waste, nuetralizes alcohol and medications, stores nutrients like A,D,E and K, produces bile to help us break down fats and plays a role in regulating appetite and satiety, among other things. If your body has to not only clear the hormones it produces, but also daily synthetic ones, it can cause sluggish detoxification and slow down the bodys’ metabolization of hormones and nutrients.
The best ways you can support your liver is by taking in B vitamins (especially B6, B12, folate), magnesium, and milk thistle. The liver also loves beets, dandelion greens, cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), garlic, and lemon water. It is also best to limit alcohol, stay really hydrated and move your body to support circulation. I am also a big fan of using castor oil packs directly over the liver to both give the liver and the digestive system some love.
The Gut — Where Hormones and Microbes Interact
Oral contraceptives can alter gut microbiome balance, which affects digestion, nutrient absorption, and even estrogen metabolism. When I run GI-Map stool samples on post birth control clients, I often see very low levels of beneficial bacteria which can increase the inflammatory load of the body and create an environment hospitable to overgrowths of the bad guys (opportunistic bacterias or funghus). Stool testing can tell you for sure what is going on. But a good way to support your gut and microbiome with or without your data is to ‘eat the rainbow’ of veggies and fruits, add in fermented foods like sauerkraut, kimchi and kefir. Post BC clients are often depleted of zinc and magnesium, so those are 2 good supplements to add into your daily routine. I also like to recommend probiotics, and prebiotics (food for the probiotics like resistant starch ). Reduce stress, chew thoroughly, and consider mindful eating to support digestion.
The Adrenals — Your Stress Regulators
When you are taking birth control, your body essentially shuts down ovarian production of your sex hormones. When the ovaries are quieted, the body relies more on the adrenals to make stable (but very low) sex hormones. Unless you live a laidback, stress-free life meditating on Himalyan mountaintops, chances are pretty good your adrenals are already doing a pretty big job making a steady stream of stress hormones. So when you come off BC, your body has to re-learn and re-establish communication between your brain, ovaries, and adrenal glands.
You can support your adrenals in doing this hard work by eating foods such as copper-rich foods (like cashews, lentils, sunflower seeds), vitamin C–rich produce (bell peppers, citrus), and whole-food carbs to stabilize blood sugar. When under stress, your body uses a lot more of its electrolyte, Vitamin C, and B Vitamin reserves so you may want to supplement with Bs, C and magnesium. Adaptogens like ashwagandha or rhodiola can help your body weather stress better. That’s why they are called adaptogens. :) You have heard it a million times, but nothing is better to support your stress system than sleeping well and deep, moving your body (not too much, too hard or too fast - like Goldilocks and the three Bears) and of course, since I teach these things, do stress-relieving practices like breathwork or yoga.
4. Nutrient Repletion — Refilling the Tank
Birth control can deplete key nutrients, including B vitamins, magnesium, zinc, and selenium, all of which are essential for hormone balance, thyroid function, and energy. When you come off birth control, take some time to reboot your palate and eat well. Focus on a colorful, nutrient-dense plate: leafy greens, pastured eggs, nuts, seeds, grass-fed meats, and seasonal produce. Consider a high-quality multivitamin or targeted supplementation guided by lab testing. :)
Coming off birth control is not just about waiting for your period to normalize — it’s an opportunity to rebuild your foundation. Supporting your liver, gut, adrenals, and nutrient status helps your body find its natural hormonal rhythm again. Functional medicine takes a whole-body approach — not just balancing hormones, but helping each system regain its natural conversation with the others.