A Guide to Coming Off Birth Control: What to Expect and How to Support Your Hormones
For many women, birth control is an important part of their reproductive health journey, whether it’s for contraception, or prescribed by doctors to help manage conditions like PCOS, endometriosis, or irregular cycles. But it’s important to remember that the pill doesn’t treat these conditions; it often just masks symptoms while you’re on it. That’s why, when the time comes to stop, it can feel overwhelming. What will happen to your hormones? How long until your cycle returns? And how can you support your body through the transition?
At Ayla Wellness, we believe knowledge is empowerment. Here’s your gentle, practical guide to navigating life after birth control.
Understanding What Happens When You Stop Birth Control
Birth control methods like the pill, patch, or hormonal IUD work by altering your natural hormone production, mainly estrogen and progesterone, to prevent ovulation. Once you stop, your body begins to re-establish its own rhythm.
Cycle return: For some, periods return within weeks. For others, it may take a few months for cycles to normalize (Mayo Clinic).
Post-pill symptoms: Acne, irregular cycles, mood swings, or changes in hair growth may reappear, especially if you were managing PCOS or other hormonal conditions. A 2022 qualitative study explored women’s lived experiences after discontinuing combined oral contraceptives. Through in-depth interviews, participants described a wide range of physical (e.g., cycle irregularities, acne, weight changes) and psychological effects (e.g., mood shifts, anxiety, altered sense of self), as well as frustrations with limited medical guidance during the transition. The authors highlighted the need for more structured support and research on what women experience after stopping hormonal contraception (PubMed).
Fertility: Fertility can return quickly, even before your first period, so be mindful if you’re not planning pregnancy right away.
Why Old Symptoms Can Come Back
Many women start birth control not just for contraception, but to help manage hormonal disorders such as:
Polycystic Ovary Syndrome (PCOS): Symptoms like irregular periods, acne, hair growth, or weight fluctuations may re-emerge without hormonal suppression. A small prospective study of women with PCOS found that when they stopped taking oral contraceptives, androgen levels and sex hormone-binding globulin (SHBG) returned to baseline within approximately 8 weeks, indicating the hormonal “masking” effect of the pill fades in just under two months (PubMed).
Endometriosis: Hormonal contraceptives like the pill are palliative, not curative, they suppress symptoms (like pain and bleeding) but don’t eliminate endometriosis tissue. Once these medications are stopped, the symptoms commonly return (STAT News).
Premenstrual Dysphoric Disorder (PMDD) or severe PMS: Hormonal contraceptives, particularly those containing drospirenone, are often prescribed to manage PMDD symptoms. However, research is limited on what happens after stopping them. Mood swings, anxiety, and irritability may feel stronger again. One study noted increased negative mood and anxiety during the pill-free phase, but this doesn’t necessarily mirror the return of clinically diagnosed PMDD symptoms. In short, we don’t yet have clinical studies that clearly describe how PMDD behaves post-contraceptive cessation (PubMed).
It’s important to remember: birth control doesn’t “cure” these conditions, it often just masks symptoms. Coming off means your body may return to its baseline hormonal state, which can reveal or re-amplify underlying imbalances.
Preparing Your Body Naturally Before Coming Off Birth Control
If you’re thinking about stopping birth control, a little preparation goes a long way. Instead of waiting until symptoms show up, you can start laying the foundation now for smoother hormone balance. Here’s how:
Nourish with Hormone-Friendly Nutrition
Balance blood sugar: Stable blood sugar is key for steady hormones. Build meals around protein, healthy fats (avocado, olive oil, nuts, seeds), and fiber-rich carbs (vegetables, whole grains).
Micronutrient boost: Birth control can deplete certain nutrients, including B vitamins, magnesium, zinc, and vitamin C. Replenish these through leafy greens, legumes, nuts, seeds, and citrus, or consider a high-quality multivitamin (Pub Med).
Anti-inflammatory foods: Omega-3 fatty acids (found in salmon, sardines, flax, chia) help reduce inflammation, which is particularly supportive if you have PCOS, endometriosis, or painful periods.
Support Your Liver & Detox Pathways
Your liver processes excess hormones and medications, so supporting it before you stop birth control can ease the transition.
Eat cruciferous vegetables (broccoli, kale, cauliflower, Brussels sprouts) to support estrogen metabolism.
Stay hydrated, aim for at least 2 liters of water daily.
Limit processed foods and alcohol that add extra burden to your liver.
Reduce Stress & Support Your Nervous System
Chronic stress raises cortisol, which disrupts reproductive hormones like estrogen and progesterone. Build calming practices into your daily life:
Yoga, meditation, or breathwork can lower stress hormones.
Gentle movement like walking or Pilates balances stress without overwhelming your body.
Prioritizing sleep, 7-9 hours nightly helps regulate hormones and improves cycle regularity.
Consider Gentle, Targeted Supplements
Magnesium to ease stress, PMS symptoms, and support better sleep.
B-complex vitamins to replenish nutrients often depleted by birth control.
Probiotics to restore gut health, which plays a role in hormone balance.
Some women find gentle support from nutrients like magnesium or B-complex vitamins, but always check with a healthcare provider before starting something new. For a deeper dive into which supplements may support hormonal balance, read our guide on supplements for hormonal health.
Reconnect with Your Cycle Early
Even before stopping, start tracking your mood, sleep, skin, and digestion. This baseline helps you see what changes when you come off and makes it easier to identify what your body needs.
Tracking Your Body’s Signals
One of the most empowering steps after birth control is reconnecting with your cycle.
Cycle tracking: Use an app or journal to note changes in your period, cervical mucus, and mood.
Basal body temperature (BBT): Tracking BBT can help you understand when (and if) ovulation occurs.
Patience is key: Cycles may take 3–6 months to fully regulate, especially if you had irregular periods before birth control.
When to Seek Medical Guidance
While some irregularity is normal at first, reach out to a healthcare professional if you experience:
No period after 6 months (known as post-pill amenorrhea)
Severe acne, hair loss, or new symptoms that interfere with daily life
Difficulty conceiving after 12 months of trying (or 6 months if over 35)
Honouring Your Journey
Coming off birth control is a deeply personal decision. For some, it’s the first step toward conception. For others, it’s about reconnecting with their natural cycle or managing health holistically. Wherever you are, know that your body is wise and capable of finding balance again, with the right support, nourishment, and patience.
At Ayla Wellness, we’re here to walk alongside you, providing evidence-based guidance and gentle reminders that hormonal health is not a straight line, but a journey.
References
Mansour D, Gemzell-Danielsson K, Inki P. Fertility after discontinuation of contraception: a comprehensive review. Contraception. 2011;84(5):465–77.
Girum, T., & Wasie, A. (2018). Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contraception and reproductive medicine, 3, 9. https://doi.org/10.1186/s40834-018-0064-y
Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ; International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018 Aug;110(3):364-379. doi: 10.1016/j.fertnstert.2018.05.004. Epub 2018 Jul 19. PMID: 30033227; PMCID: PMC6939856.
Mayo Clinic. Birth control pill FAQ: Benefits, risks and choices. Mayo Clinic [Internet]. 2025 [cited 2025 Aug 24]. Available from: https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/in-depth/birth-control-pill/art-20045136
Niemann, J., Schenk, L., Stadler, G., & Richter, M. (2022). What happens when you stop using the combined contraceptive pill? A qualitative study protocol on consequences and supply needs for women who discontinued the combined contraceptive pill in Germany. BMJ open, 12(6), e057089. https://doi.org/10.1136/bmjopen-2021-057089
Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13. PMID: 23852908.
Sánchez LA, Pérez M, Centeno I, David M, Kahi D, Gutierrez E. Determining the time androgens and sex hormone-binding globulin take to return to baseline after discontinuation of oral contraceptives in women with polycystic ovary syndrome: a prospective study. Fertil Steril. 2007 Mar;87(3):712-4. doi: 10.1016/j.fertnstert.2006.07.1507. Epub 2006 Nov 21. PMID: 17118366.
Lindeman T. Millions of people take birth control to treat endometriosis — but it doesn’t work. STAT. 2023 Apr 4 [cited 2025 Aug 24]. Available from: https://www.statnews.com/2023/04/04/birth-control-for-endometriosis-does-it-work/
Noachtar, I. A., Frokjaer, V. G., & Pletzer, B. (2023). Mental Health Symptoms in Oral Contraceptive Users During Short-Term Hormone Withdrawal. JAMA network open, 6(9), e2335957. https://doi.org/10.1001/jamanetworkopen.2023.35957
