Coming off the oral contraceptive pill

Article published in Natural Health Magazine Dec 2005

Whether it is because you want to have a baby, your life situation has changed, you are sick of the side effects or you just want to experience how your body naturally feels, at some point in their lives most women stop taking the oral contraceptive pill or OCP.

In many cases women experience a light bleed several days later and within a month or two their natural cycle has returned and they are able to conceive.  This also means that if you don’t want a baby and you are in a relationship you must use some other form of contraception.

Although most textbooks claim that a woman’s natural cycle will return within two months, this is not always the case.  In my practice I have encountered women who come off the pill only to feel bloated and stuck or if their period returns it is erratic and very different from what they remember it to be.

The good news is that unless you are in your late 40s or 50s, you are unlikely to be going through menopause just yet.  Nevertheless an absence of period is potentially a serious medical condition, known as secondary amenorrhoea, that may require some attention.

The most obvious cause for missed or absent periods is pregnancy.  Even if you faithfully took the pill at the same time each day, you still could be pregnant as the success rate for the OCP ranges from 97 – 99.5%.  This means that one woman in a hundred is likely to become pregnant and it is possible that you are the lucky one.  Of course if you miss pills or are forgetful in taking them, the chances of pregnancy increase significantly.

If, however, you are not pregnant and your period still has not returned, there are a few things you can do.

The most important thing is not to worry or panic.  Your menstrual cycle is triggered by hormones generated from the hypothalamus and pituitary glands but if you are stressed, exercise excessively or have lost a lot of weight, these glands will not produce the correct amount of hormones.  As a result your menstrual cycle may be erratic or absent.

This often happens if you come off the pill in order to become pregnant and you don’t conceive straight away as the anxiety only exacerbates the problem.  My advice is to do some relaxation therapy such as meditation, yoga or gentle walks and use some relaxing aromatherapy oils such as lavender and patchouli.  Porridge for breakfast is also really good because as well as filling you up with a nutritious high fibre breakfast, oats are a natural nerve tonic.  Kinesiology is also excellent for releasing pent up stresses as is regular massage.  Some herbs which may help include Withania (taken as tablets or liquid), Skullcap and Passionflower (which I usually blend and take as a tea).  Tissue salts containing magnesium (such as Mag Phos) or PPMP mineral celloids may also be of benefit since magnesium is the ultimate nerve and relaxation mineral.  B vitamins are essential since adequate B vitamins are necessary for good nervous function and the OCP is known to deplete B vitamins (especially folate).

Take it easy and use this time to prepare your body for pregnancy by eating well (meaning lots of fresh fruits and vegetables), giving up smoking, reducing alcohol intake and taking herbs and supplements to tone the uterus and nourish the baby when it is conceived.

Since the OCP is essentially a medicine, once it does its job of putting the ovaries to sleep and inhibiting the growth of your endometrium (lining of the uterus), it needs to be cleared by the liver.  If you happen to live in a city, work in a office and are exposed to nasty chemicals as most of us are, your liver has a full time job just clearing these toxins from your body.  If you also happen to smoke, drink alcohol and do the occasional “party” drug, then chances are your liver is well and truly overloaded.  If this is the case, your liver will not be able to clear the hormones from the OCP properly or fast enough leaving an imbalance of hormones in your body.

In cases of any possible hormone imbalance, I recommend a good detox which involves a combination of both stop and start therapy.

Stop smoking, drinking alcohol and caffeinated beverages (such as coffee, tea, chocolate and cola drinks).  Stop eating fatty deep fried foods, processed foods, preserved meats (such as salamis and hams), cheese, sauces and refined carbohydrates (white foods such as white bread, pasta, cakes, sugar and biscuits).

Start drinking filtered or spring water and herbal teas (except green tea which is naturally high in caffeine),  Start eating whole grains (brown rice, barley, millet), pulses (beans, chickpeas, peas) and lots of fresh vegetables and fruit.  Since fruit, especially summer fruits, are naturally high in sugar, limit the quantities to between three and five serves per day (where a serve is what comfortably fits into your hand).  Eat more fish (yes, canned is OK but watch the salt content), free range chicken and good quality lean meats (which are nutritious and an excellent source of iron).  You may also include small quantities of raw almonds, walnuts and brazil nuts.

Instead of coffee try dandelion coffee (which consists of ground roasted dandelion root).  The bitter taste help stimulate the liver to work more effectively and it has a gentle cleansing effect on the bowels.  You can also squeeze some lemon juice in your water as this also stimulates the liver.  Herbs such as Silymarin (St Mary’s Thistle), Burdock root (very, very bitter) and Globe Artichoke are excellent liver tonics as are B vitamins, choline, inositol and glycine which are required for detoxification.  Sulphur containing foods such as garlic and onions also help the liver detoxify chemicals.

If despite this, your period does not return within 6 months, you should visit your gynaecologist for a check-up and to reassure yourself that nothing is physically wrong.  Once you have the all clear, your naturopath or herbalist may prescribe herbs such as Blue Cohosh, Dong Quai, Chaste Berry and False Unicorn root which help regulate and rebalance the reproductive cycle.  Since everyone is different, you should make an appointment to see a naturopath or herbalist yourself to get the best herbs for your body, rather than pot shot by self medicating or trying something that worked for a friend.

David Neiger is a qualified naturopath, remedial masseur and kinesiologist who practices at the Bentleigh Health Group in Melbourne, Australia Ph  03 9017 5555.  He can be visited on-line at www.pathforhealth.com where he will be happy to answer your questions.