If your periods were regular before going on birth control but have yet to come back after coming off birth control, you may want to inquire about post-birth control induced PCOS.

How Birth Control Affects Your Hormones 

Birth control "turns off" the hormonal signals between the pituitary gland (an area in your brain) and your ovaries. For some women, once stopping birth control, this signal returns and ovulation and menstruation returns. For others, this signal is somewhat lost.

Because ovulation is not occurring, polycystic ovaries may be present upon ultrasound. Blood work may show elevated luteinizing hormone (LH) relative to follicle stimulating hormone (FSH) (a high LH: FSH ratio is something like 3:1 or 2:1), or elevated prolactin (a hormone that helps produce breast milk). There may also be acne present.

Get Back on Track by Nourishing the Basics and Supporting the Liver

The best way to help get your cycle back to a healthy rhythm is to nourish the basics, the pillars of health. Every single thing serves as communication to your brain, your hormones and vice versa. So master those pillars of health - you can read all about them here.

It’s also incredibly important to support your liver. The liver is one of the body’s key organs of elimination and plays a critical role as your body transitions off of hormonal birth control because it is involved in excreting waste products, toxins and excess hormones. The liver also protects the body from external sources of toxins, all of which contribute to our overall toxic load. A heavy toxic load can interfere with the body’s hormonal functions. So it’s important to help the liver do its job. There are a number of natural ways to do this.  

Liver-Loving Food:

Ensure you eat ample amounts of the following liver-supportive foods:

Brassica vegetables — Broccoli, Brussels sprouts, cabbage, cauliflower and kale

Alliums — Onions, leeks and garlic 

Other Vegetables — Asparagus, beets, cucumber, peppers, sea vegetables (kelp, spirulina, chlorella), leafy greens (especially bitter greens like dandelion and mustard greens), carrots, daikon radish, fresh ginger, sprouts 

Fruit — Apples, pears, citrus, strawberries, raspberries, blackberries, peaches, cherries, rhubarb, dark grapes, plums

Seeds — Flax, pumpkin, sesame and sunflower. See the section on seed cycling below for details on how you can use these seeds throughout your cycle for optimum effect. 

Healthy Fats — Extra virgin olive oil, seeds and seed oils (see above), almonds, fish oil 

Plant-Based Protein — Organic, non-GMO tofu and tempeh, other legumes

Whole Grains — Amaranth, millet, oatmeal, rye, quinoa  

Culinary Herbs and Spices — Turmeric, black pepper, basil, bay leaf, cardamom, cumin, fennel, dill, ginger, rosemary, mint

Sour Foods — Apple cider vinegar, citrus, sauerkraut

Beverages — Green tea, chamomile tea, ginger tea, mint tea, miso soup (dissolve miso paste in warm water)

Try to limit foods that cause liver stagnation, such as red meat, eggs, dairy, refined vegetable oils (canola, soy, sunflower), margarine and alcohol. 

Herbs and Homeopathics

Certain herbs in combination have been found to help with post birth-control PCOS.  Vitex can help to reduce elevated prolactin, but can worsen LH:FSH ratios.  Peony and licorice root combined is a Traditional Chinese Medicine remedy that has been shown to reduce LH:FSH ratios. ⁠

Before starting any herbal or homeopathic remedies, speak with a qualified professional to get appropriate recommendations and dosages. Herbs have many contraindications. For example: licorice can increase blood pressure and is contraindicated in individuals with high blood pressure. You want to make sure you’re using the appropriate remedies in a way that is specifically tailored for you and your symptoms. ⁠

Supplements

There are several supplements that can offer nutritional support for the liver’s natural detoxification process. 

• N-acetyl cysteine — 500 mg 3 times daily

• Curcumin — 500 mg 3 times daily 

• Vitamin B complex — at least 100 mg daily

• Choline — 250 mg 3 times daily

• Selenium — 200 mcg daily 

• Zinc — 50 mg daily 

• Magnesium — 300 mg daily 

• Indole-3-carbinol or DIM — 150 mg 2 times daily 

• Calcium D glucarate — 500 mg 3 times daily 

• Alpha lipoic acid — 150 mg 2 times daily 

• Probiotics containing Lactobacillus and Bifidobacterium — 2 capsules daily 

Not all of these supplements should be taken together. And not all of these supplements may be indicated for you. Consult a practitioner prior to starting any supplement to ensure it is right for you!

Seed Cycling 

Seed cycling is the rotation of different types of seeds — flax, pumpkin, sunflower and sesame — at specific times during the menstrual cycle to help regulate levels of estrogen and progesterone, the main hormones responsible for hormonal symptoms. Each of these seeds contains specific nutrients that have a modulating effect on hormones. By adjusting which seeds you consume and when, you can help manage hormonal symptoms throughout your cycle. 

Aim to consume one to two tablespoons of seeds per day as follows: 

Follicular Phase — Days 1-14: flax and pumpkin seeds

• Flax seeds contain fiber and lignans to help balance out the effects of excess estrogen and also help eliminate excess estrogen.

• Pumpkin seeds contain zinc and vitamin E to help make progesterone later in the menstrual cycle. 

Luteal Phase — Days 15-28: sesame and sunflower seeds

• These seeds contain zinc and vitamin E that stimulate progesterone, which thickens the lining of the uterus to prepare for implantation and to support pregnancy. 

• These seeds also contain lignans and selenium to help eliminate excess estrogen. 

Castor Oil Packs

Castor oil is a naturally-derived plant oil that helps the lymphatic system and liver eliminate toxins from the body, including by-products from medication such as the birth control pill. The lymphatic system collects toxins and delivers them to the liver for filtration before they are excreted through the GI system. Castor oil also has immune-enhancing and anti-inflammatory properties, and is helpful for relieving PCOS and other menstrual irregularities. Using a castor oil pack on a regular basis is an effective practice for overall health. 

Castor oil is used topically by applying a pack made of flannel or cotton cloth directly over the abdomen. Castor oil can be purchased at a health food store. Make sure to buy organic and ideally cold-pressed oil. You can purchase a high-quality castor oil pack here; use code SAMANTHA10 for 10% off your order.

Castor oil should not be used during ovulation, menstruation or pregnancy. If you have questions or concerns about how to safely use castor oil, consult a holistic health practitioner. 

If it sounds like you’re struggling with post birth control PCOS, I hope this info gives you hope that your cycle can return! If you need support with getting your cycle back in balance after transitioning off birth control, I specialize in this and am here for you! (include a way for people to contact you). 

Reference:
Dr. Sat Dharam Kaur, ND, Dr. Mary Danylak-Arhanic, MD and Dr. Carolyn Dean, ND, MD. The Complete Natural Medicine Guide to Women’s Health (Robert Rose, 2009).