Side Effects of Stopping The Birth Control Pill: How to Stop Mood Swings, Acne & More | Dr. Jolene Brighten

B: [00:00:00] almost 60% of women are taking the birth control pill primarily for symptom management. And while it's always your right to use the pill to manage your symptoms, not everyone wants to feel stuck on the pill or like they have no other choice. Hi, I am Dr. Jolene Brighton and welcome back to the Dr.

Brighton Show. Today we're talking about something that affects millions of women, but often gets little to no attention in the doctor's office, and that is what really happens when you come off of birth control. This has been a highly requested episode. Many of you know I wrote the book Beyond the Pill, which details how to come off the birth control and the.

Good, bad, ugly, and how to support yourself if you stay on birth control kind of protocols.

 So if you found this episode, maybe you've been thinking about quitting the pill. Maybe you're wondering what it'll do when you come off to your skin, your mood, your cycle. Maybe no one's told you what to expect, or all you've heard is you'll just come off and you'll be [00:01:00] able to get pregnant right away.

Which I. You'll listen to enough women's stories on the internet, or you have enough girlfriends who've done the pill, and you know, it's not that way for everyone. So listen, if you find yourself in any of those camps, this episode is definitely for you. And by the end, you'll know how to support your body, your hormones, and feel empowered every step of the way.

And by the way, I always have to say this because sure enough, anytime you question the pill, discuss the side effects of the pill or dare to call into question why it is that doctors only offer the pill only to delay diagnoses like PCOS endometriosis, you're always labeled antibi birth control. I am not antibi control.

I did the pill for 10 years. I had to use the pill during my infertility treatments, which. Was not great for my mood. So we just stopped doing that. And so for those who always try to label me antibi birth control, I say nice try and attempting to other me and villainize me because I encourage women to [00:02:00] challenge the hormonal dogma we've been fed for years.

Okay. With that said, we are gonna start this off with, there is no wrong reason to want to stop hormonal birth control, and there tends to be a narrative that something is wrong with you if you wouldn't want to just. Put exogenous hormones in your body shut down ovulation indefinitely, and especially in the current political climate.

Some people also call you things like irresponsible or stupid, like what if you get pregnant? So it's your choice whether or not to be on birth control. I hear from women every day because they're tired of side effects, like mood swings, low libido, digestive issues, repeat yeast infections. Some are planning to get pregnant soon.

I. Others just wanna feel more in tune with their body. It's not uncommon for a woman to say like, I'm doing all of these things like diet and lifestyle and like trying to improve my health, but like, what is this pill [00:03:00] doing and what am I like when I'm not on it? and then some people are just curious of like, Hey, I've been on the pill for so long.

Like, what is my body even like, I don't even know. So whatever your reason. You deserve to feel supported. It is your body. It is absolutely your choice whether or not you want to be on the pill, and if you don't wanna be on the pill, you deserve to be supported in that decision, whatever your reason is.

Now we usually save the Ask Dr. Brighton segment for the end, but this felt like a really good place to put it. So I got a question that was. I went to my doctor. I had recently come off the pill and I was experiencing acne, bloating, overall, not feeling like myself. And they said, this sounds a lot like post birth control syndrome.

So the question was, what is post birth control syndrome? This is something I've talked about extensively. It's a name that functional medicine providers came up with to help people, you know, [00:04:00] have an understanding about what can happen when you come off birth control. This is not a formal diagnosis, it is a pattern, a constellation of symptoms that often show up in the months after quitting hormonal contraception, , for the period problems that arise.

These are contraceptives that have shut down your ovulation that will often be implicated in the delay, in the return of your period. So like Depo-Provera is one. It could take 18 months before your period comes back that we expect, but sometimes it goes longer than that. Sometimes the IUD stops ovulation and the pill definitely stops ovulation.

We'll be talking more about how the pill works, so things that can show up when you stop birth control, acne returns, or new acne onset. That was me. I'd never had cystic acne before until I stopped the pill. In fact. When I just did five days of the pill during my fertility treatments, I started developing cystic acne again.

So like [00:05:00] that and the mood swings, so mood swings and anxiety can also come up. That was not for me, but you may not have those symptoms and you might experience more like irregular or missing periods. When I came off of birth control after 10 years, I lost my period for three months and it. Is very debatable, would've come back.

I don't know. I did a lot of work to try to get my period back. Some people also experience hair loss and digestive complaints. There are a lot of ways that this can show up. It can be return of the symptoms you previously had. It can be the onset of new symptoms, but I want you to know they're not in your head symptoms, okay?

It's not that you're just making these up. This is a result of years of hormonal suppression and in fact, there is a researcher, Dr. Lyn Pryor. Who has a theory that the earlier we'll put on the pill and we disrupt the brain and ovarian maturation process, so the hypothalamic [00:06:00] pituitary ovarian access, because that's what the pill does.

It disrupts it. We do that. The younger we do that, the more disruptive it is when we come off because we have to go through that maturation process again. Unsurprisingly, there's not a whole lot of research that is like supporting ovulation outside of the primary, just pregnancy narrative, and there are a lot of benefits to ovulation.

We can certainly have another episode on that. But what I wanna say about post birth control syndrome and help you understand is that if you started the pill and you had irregular periods and you had acne, we're gonna expect to see that when you come off the pill. So a provider making a blanket statement of like, you just come off and everything's fine.

No, it's not, in fact, fine. And when we see that, you know, almost 60% of women. Are you using the pill for symptom management? Well, then we expect that those symptoms are gonna come back. And [00:07:00] unfortunately, the answer often is you go to your doctor and you're like, Hey, I am having period problems. I'm having acne moving my skin.

And they say to you, do you wanna have a baby? No, not right now. Great, get back on the pill, but, but I don't wanna do the pill. What's wrong with you? Why wouldn't you wanna do the pill? You have the pill. Women like wanted access to the pill forever. Like do not know. Like, listen, she said she didn't wanna have the pill, and she also shouldn't be just reduced to whether or not she wants to have a baby in terms of whether or not you'll actually give her treatment .

So we can have the return of symptoms or we can have new onset of symptoms. This is usually where doctors will gaslight the hell out of you and they, I mean, this happened to me. I lost my period. I got cystic acne, I had oily skin, and my doctor literally said, oh, I think you've just had PCS this whole time.

No, I didn't have PCS. I had heavy, horrible, like horrific, painful periods. I counted down every single day towards my period, like it was doomsday. It was coming for me. I was like, oh [00:08:00] God, I'm dreading it. They were regular. He's like, you're misremembering your period. I'm like, mm-hmm, mm-hmm. No, you don't misremember something that bad, that traumatic breathe.

Bleeding through your clothes at school. Thank God in the nineties, we like wore sweatshirts around our um, waist. Like that was cool because I was always having to cover that up Anyhow, this is where doctors will often gaslight you and say like, no, it's either just the return of symptoms that you always had, or this isn't actually happening.

It's not as bad as you think you are. Misremembering. Women know their bodies, you know the body you're living in. You know you're normal. Better than anyone else, so please don't let people gaslight you. I have a whole episode on painful periods and I go through the statistics of gaslighting and talk about it in depth.

I will link to that. So it is possible that you come off birth control. Everything's fine. Those women exist too, and I love that. For them, it wasn't me and it's not the patients who come to [00:09:00] see me ' cause why would they come to see me? Everything's fine. They don't need to see me, but I've heard enough women's stories and in fact, at one point in my clinical practice, people would call my office and they would say, I heard you're a doctor who actually believes women's birth control stories.

And that struck me of like, what the hell are we doing in medicine that women are using that language. It would be on their intake forms. You actually believe women, like everybody should believe. Women Like what? Okay, so. Let's keep going into why these things can happen as you come off birth control.

'cause birth control is doing a lot of things while you're on it, besides just preventing pregnancy. And we do love that pregnancy prevention part.

So what happens in your body after stopping the pill? Let's break this down. Hormonal birth control works by suppressing ovulation and altering your natural hormonal rhythms. It does this through brain [00:10:00] ovarian communication disruption, basically brain and ovary. Stop talking so you are taking a large enough dose of hormones that your liver still gets to metabolize.

Break it down. But it's still so much that it sends a negative feedback loop to your brain and says, Hey. Plenty of hormones, no need to tell the ovaries to make more, so as a result, your ovaries stop working. So no FSH, no LH from the brain. No stimulation of the ovaries, no ovulation. We love that.

Secondary mechanism is that progestin can thicken the cervical fluid to help prevent sperm from making it through. If you read and beyond the pill, or you caught this back in the day, Kim Kardashian talked about how being on the pill shrinks your ovaries. Yes. So we don't do a MH anti-malaria hormone, uh, testing for fertility, and we're not gonna do a transvaginal ultrasound and expect to [00:11:00] see.

Normal size functioning ovaries. This is reversible, by the way, so she freaked everybody out when she said that, but it's because the ovaries are in hiatus. They're not working. So by the way, so if you're like, well, when do I test an A MH? We wait at least three months when you come off the pill to test your A MH, because otherwise.

Your ovaries look old, but it's artificial and it's temporary. Okay. Um, I just really wanna emphasize that because people get really into panic when they hear that. And also they get really into panic when their doctor runs an A MH and they're on the pill and their doctor's like, you are never gonna be able to get pregnant.

You have like no egg stores. It's like. Follicles are not being recruited, they're not being built. We're not ovulating. 'cause that's how the pill is meant to work.

Now once you stop the pill, your body, your brain and ovaries get to relearn how to do the [00:12:00] cycle all over again. And for some women that happens immediately. Ovulation comes back within a few weeks. Um, but for others it takes time, especially of those who went on the pill for regular periods. Or PCOS, polycystic ovarian syndrome.

It can take months, sometimes six months. Is not abnormal. And for other women who started it really young and have been on it for a really long period of time, like decades. It can sometimes take longer. Like I said, there's research suggesting that there's an entire maturation process that we should not be interrupting in young women.

And I know that's sticky and that's hard because like we also don't want 14 year olds to get pregnant, and sometimes the pill feels like the best choice. So this is where just understanding and having a true informed consent about what the pill is doing and what it might look like when you come off.

Now I'm gonna go through key symptoms to track and how to support your [00:13:00] body through this. There's really five areas that I look at in supporting someone who's coming off the pill. So number one is replenishing nutrient stores. Number two is supporting your hormonal detox pathways through your liver, your gut, your kidneys, making sure that we are healing the gut, addressing any gut issues that are going on, identifying what your hormonal issue might be, or your hormonal imbalance, especially the one that may have driven you on there.

Like is it PCOS? Is it hypothyroidism? And then we need to examine, do we need to reverse the metabolic mayhem that can come with being on the pill? Now I wanna start talking about nutrient depletions because this is one of the most overlooked aspects of the birth control pill, and it's something that we've known about since the 1970s.

And research studies have said if you have someone on the pill, they should be taking a multivitamin or prenatal. And why is that? Well, because the pill fails with [00:14:00] typical use. The pill is going to fail in some people. They're gonna get pregnant, and if the pill is depleting you of key nutrients like B six, B12, and folate, you need all of those if you get pregnant and you wanna maintain that pregnancy.

So really important that we make sure that we have those nutrients coming in. So if you're listening this, you're on the pill, you're not ready to come off the pill. Multivitamin or prenatal because the pill is also depleting. Magnesium, zinc, selenium, antioxidants like vitamin E, vitamin C, coq 10, which as we age, we make less.

Coq 10. So that's not fun. Um, so we just really have to be mindful that if we're ever on a medication, and this is what's weird, any other medication that you're on that's known to deplete nutrients, they're like statins. Oh, coq 10 give you that. Um, you know, we, we know that like metformin, there's possibility of B12.

Make sure that we give you that. We're monitoring that. The pill does [00:15:00] all of this, but the pill is the golden child of women's medicine. And it cannot be touched. It cannot be questioned. We must put it on an altar, like why not give the insurance policy of a quality multivitamin or prenatal gather's some junk ones out there that are just expensive urine or poop.

But like women need to have these nutrients and not everybody's diet's perfect. Especially, I mean, how was your diet when you were a teenager? Mine wasn't so great. So these nutrient depletions, they can affect you, they can affect thyroid function, anxiety, your mood overall, your energy levels. So snap number one in coming off the pill is replen.

Seeing these nutrients, I always start with food first and then we look at high quality supplementation. We have to work on the dietary aspect, but we have to acknowledge that not everybody's diet's gonna be perfect. Food deserts exist. Access to food can be an issue, and yet people need to use the birth control pill, or they might be coming [00:16:00] off.

Okay. Now supporting detox and elimination is important. Some people have mistakenly said like, you cannot detox the birth control pill unless you're doing specific things. Your body runs detox pathways, but it does require certain inputs, right? Your kidneys detox. But how do they do that? Without water?

You have to take in water. Now the liver is what's playing a huge role in clearing these synthetic hormones from your system. They also clear your endogenous hormones, what you make and the metabolic waste that you generate. So during this transition, we wanna love up the liver by including things like cruciferous vegetables.

Broccoli, arugula, cauliflower, Brussels sprouts, kale, all of these, um, I love to have people include in daily rotation of their diet. Broccoli sprouts as well, about two tablespoons. This was really important for me to start clearing [00:17:00] my acne, and if you're someone who's scared about acne. Definitely making sure we're bringing on those nutrients.

Sometimes we do bring on supplements like calcium, deg, glucarate, dim sulforaphane, selenium to help support detox pathways, as well as looking at making sure we're getting enough protein. We need amino acids to be able to do that as well. And staying hydrated, making sure that you are drinking plenty of filtered water.

Moving your lymph with dry skin, brushing, gentle massage or doing exercise can also be helpful. And then of course, daily bowel movements. ' cause if you're not pooping, you're not detoxifying. That is one of the primary ways that we move metabolic waste out of our system. And I've got. Um, interviews with gastroenterologists that I will, um, link to, uh, who talk about how important it is to make sure that your bowel movements are regular.

So [00:18:00] speaking of bowel movements, we also need to talk about gut health. So the birth control pill isn't all just absorbed and metabolized. In the upper part of your gi, it can make its way to the lower intestine, which is where all of the good little probiotic guys live. Hormonal birth control can disrupt the microbiome.

It has been shown to increase intestinal permeability, and it may even trigger inflammation in some sensitive individuals. So intestinal permeability. When it's the hyperpermeability, that's what people call leaky gut. You get gaps in the tight junctions. Things get through that shouldn't. Now we've got inflammation, we've got issues going on.

Some people also experience bloating, food sensitivities, constipation, IBS like symptoms when they come off the pill. I want you to know the gut hormone connection is real. This is [00:19:00] something that some people are like, no. I mean, even still now, people are like, no, it's not that big of an issue. And it's like, well, there's this entire estrobolome that we actually don't understand a whole lot about, but part of its job is to make sure estrogen gets out and then estrogen sticks around when we need it.

Estrogen influences our microbiome greatly. We see this from the menopause research, especially as we get into menopause and we lose estrogen, we have less microbial diversity. That's definitely a problem that's more matched to our male counterparts. We understand that estrogen interfaces and plays a very big role with our gut microbiome and our gut microbiome plays a big role with estrogen.

These things cannot be ignored.

Okay, so with establishing the gut hormone connection is real. Let's talk about how to support your gut health. Number one is we gotta eat fiber daily. The goal should be 25 to 35 grams from a variety of plants to feed the good bacteria. But if you're not eating fiber now, don't start with 35 grams. You are gonna [00:20:00] start where you're at, add five grams to that daily, and then after seven days increase to another five grams.

So if you start at 10, you are gonna do 15 for a week. The next week we're gonna bring you up to 20. We also may need to use things like L-glutamine, zinc, carnasine, collagen to support the gut lining. It depends on what's going on, and in those situations, it's wise to work with a provider and we need to reduce gut stressors.

So alcohol, all those cocktails, not a great idea. If you're dealing with chronic stress, we wanna address that. And of course, ultra processed food. We understand. Less is more. Uh, we don't wanna be consuming a diet primarily of ultra processed food because that isn't great for our microbiome. Sometimes we wanna consider probiotics, especially if you're someone who's had the recurrent yeast infections, UTIs, you've had antibiotic use, you are having gas, bloating, constipation, [00:21:00] diarrhea, and what probiotic is best for you may depend.

I like a combination of spore forming organisms and lactobacilli for women. So a healthy gut is gonna help you clear estrogen, it will help you regulate inflammation. It can help with stabilizing mood. We don't wanna skip the step of tending to gut health because really, I mean, the seat of all health is how we're interacting with our environment in a positive way.

And since that's the way that things come in and the tube interacts with the external world, we want to tend to that, make sure we have the best health. Now, once you've been off hormonal birth control for a few months, you might start seeing patterns in your hormones emerge. So maybe your periods are too light, they're less than two days, or they're too heavy, they're more than seven days.

Maybe you have mid-cycle spotting, or you have some [00:22:00] amazing weeks and then some awful weeks. These are signs that your hormones are communicating to you. It's not that your body's broken. Your body is saying, hi, we need help. Can you please pay attention? So here's a quick breakdown of some of the most common issues that I see after coming off the pill.

I go through these, there's actually a quiz in the on the pill that takes you through all of these so you can identify what's going on. So number one, uh, is what people will call estrogen dominance or a hyper estrogen state is what you'll see in the research. So. PMS, heavy periods, breast tenderness, irritability, and it's often coupled with low progesterone where we have anxiety, insomnia, short luteal phases like ovulation happens, and we don't make it 10 days or more past ovulation, so our periods are coming too soon.

When there's androgen excess, which can be testosterone, dihydrotestosterone, DHEA, this shows up as acne typically [00:23:00] along the jawline. Oily skin thinning hair, um, and you can start to have irregular cycles because of that as well. Now, if you're having low estrogen, and this can be really common, so if you are, you went on the pill really young and then you didn't come off until like 45.

And now you're like, oh, I'm feeling really dry, dry vagina, dry skin, uh, dry joints. I'm tired. I'm brain fog. I struggle with my libido. More fine lines and wrinkles. My breasts are drooping. That's low estrogen. And it may very well be that you came off the pill and the ovaries are like, why should we start now?

We're so close to menopause. So you can confirm these with doing hormone testing, but again, you need to be enough months away from the pill. Otherwise it won't be accurate. Um, if you're not cycling, you do wanna get lab testing and figure out what's going on. If you're younger than [00:24:00] 45, let's figure out what is going on.

We don't wanna guess. We wanna get curious. We want to, we wanna track things, we want to test, we wanna treat with intention, and I also want you to understand that. Thyroid issues can be really common coming up during this time. So that's another panel that shouldn't be skipped. I will link to an episode about thyroid health.

Now, I talked about reversing metabolic mayhem, as I call it. So I wanna talk about your metabolism because birth control can impact through that too. It's crazy to me. There are people who are like, no, it will have no impact. And it's like, but we see. That with perimenopause and menopause and postpartum, like we see all these changes with hormones that like, yeah, they do impact our metabolism.

So studies have shown that the pill can alter insulin sensitivity, blood sugar, balance, . Even muscle building capacity, and that's before we ever get to thyroid and cortisol involvement. [00:25:00] So I just want you to understand that. I don't wanna scare you, I just want you to know that if you are feeling like something is real, I.

That I'm talking about here? It probably is. So let's talk about what you can do though to like help with this metabolic chaos that can come. So number one is stabilize blood sugar. Eat protein fi fiber at every meal. No skipping breakfast. Black coffee does not count as breakfast. Gotta stop doing that.

Lifting weights, uh, resistance training helps build insulin sensitivity, boosting mitochondrial function. We love that so that you get more energy and you're supporting your metabolism in a really effective way. This is also great if you're having mood symptoms as well. We also need to look at reducing chronic stress.

I feel like I talk about this all the time, but it's such a huge impact on women's health, so elevated cortisol. That can lead to like tanking progesterone and it can increase belly fat, as can insulin resistance, [00:26:00] and low levels of estrogen. So we've got to make sure that we're operating, um, in the like nutrition lifestyle space, but being very mindful of our hormones.

Don't undereat. Especially during this phase, as you come off of birth control, your body needs nutrients. It needs nutrient dense food. It needs to be nourished, not restricted. So while you may be tempted to hit a 1200 calorie diet, you're an adult, you are not a child. You need more calories than that. And if you're dealing with stubborn weight, fatigue, hangry crashes, post pill, this is definitely where to focus because it's not that your metabolism is broken, it's just kind of like overwhelmed and it needs your support.

I did a whole episode on perimenopause weight loss, that has really good guidelines for metabolic health 'cause that's how I come at things. I'll also link to that for you. Now the question always comes up, should I [00:27:00] balance my hormones before I quit the pill? Like what? What should I do here? So the reality is you can't do anything with your ovarian hormones.

I don't know, I'm doing air quotes there. You can't do anything with your ovarian hormones when you are on the pill. Medications, shutting them down. They're done. They're out. You can start to support your thyroid, your adrenal glands. Um, you can support your gut like these other systems if you're on there.

But if you started the birth control pill for symptoms, then giving yourself a good 30 to 90 days of prepping before coming off can help. So people will say like, should I just stop cold Turkey? Should I do something before prepping your body for at least 30 days before quitting? You can soften the landing.

It can always be great for everybody, and I detail this in beyond the pill. I also provide you recipes to help. But if you. Only started it for pregnancy prevention, then you may be able to come off and maybe things will be fine and we would love that for you. But if you started it for symptom management, let's [00:28:00] try to start working on what was going on before then so that when you come off, you're more successful.

So in that we have to identify the hormonal imbalance that may have pushed you on the pill, like was it PCOS, you had hyperandrogenism and you know, insulin issues. Or maybe you had an underlying issue of endometriosis. If you can figure out what was going on that can help you target how to support your body best, and I want you to think of this as like a reset, not just coming off the pill, but really reclaiming your hormonal health.

So when you approach it, don't approach it from like coming off this medication because my body was so dominant it didn't work. It's like, no, no, no. This is an opportunity for you to get to know your body again and support your body.

And the reason I bring up TCS and endometriosis is those are the two. Two of the top conditions that women are prescribed the pill without even knowing. They have these conditions and their doctors like regular [00:29:00] periods, heavy periods, painful periods, acne, put you on the pill, deal with it later, decades later, it's like, oh, well you have to use us now.

Now you can't get pregnant. Sorry, because like, we've gotta work on all these other things. Or you have endometriosis is so progressed. You can't get pregnant. But what if you're not wanting to get pregnant? ' cause I know that's a question as well. So if you're not wanting to get pregnant then and you stop the hormonal birth control, what if you do ovulate right away?

Okay. So we gotta be cautious that I actually go through in the on the pill, chapter 13, all of the other things that you can do. To protect yourself from pregnancy, like barrier methods like condoms, diaphragms, non-hormonal, IUD, the copper IUD, um, fertility awareness method. I talk about what fertility awareness method is because it's not the rhythm method and your doctor's wrong if they say that and they need to redo their education.

Um, the apps that can work and just what to know. So just because you [00:30:00] wanna come off the pill and you're like, I wanna go natural, that doesn't mean unprotected. We want to plan ahead. So that really probably is the first thing. Before you come off the pill, make sure you have a backup method if you do not want to get pregnant, because there are some people who do come off the pill and ovulation comes before menstruation, okay?

You don't have a period the whole time you're on the pill because you're not ovulating, you're not having a cycle, you're having withdrawal bleed. Language matters because especially when you go to the doctor and you're like. Oh, I haven't had a period in three months. And they're like, oh, okay. Well, actually, let me say this.

So like with amenorrhea, there's a threshold of how long it's had to be since you had your last period before you get a workup. And if you report regular periods. And it's less than three months. You may not get that workup, except that being on the pill was never a regular period. So you need that workup now.

You don't need to wait three months to see like, oh, whether or not my period comes back. Especially if you are someone who's like, I'm trying to get pregnant, [00:31:00] and you're like 38, you ain't got time to kill. Okay. Doctors need to stop wasting women's reproductive time. I'll just say that and that's where it's a good idea often to like ditch your ob gyn and go straight to the reproductive endocrinologist.

If your insurance or your means will help you do that because you're gonna get the answers you need a lot quicker and get to your goal, which is a baby in your arms. Okay, so going back.

To the whole pill bleeds, not periods. Um, understanding like how your cycle works. Ovulation comes first, menstruation comes second. When you stop that pill and you get that first bleed, that's not your period. We are now waiting for ovulation to come, and you don't know when that's gonna be. That means fertility awareness method's not gonna work when you base it off the data of being on the pill, you don't know when ovulation is gonna be.

When you get the next period, ovulation occurred typically 10 days or more before then. So that's really [00:32:00] important to understand because just because you don't have a period doesn't mean you can't get pregnant. I. Ask every postpartum mom that got pregnant in the first three months and is like, I wish I would've known that.

Why doesn't health Eds teach us this? Why does medicine, you're just as guilty of this and health education gate? Keep the information about how ovulation works and that you can't get pregnant every day outta the month. It's one day. Sperm lives five days, and it's a very finite window. However. It happens before you get your period, and you need to be aware of that.

I wanna talk through the 30 day post pill action plan so that you can, you can have a plan of like where to get started. So you come off the pill. What should we do for the next 30 days? Support detoxification with lots of veggies. Lots of veggies, like six servings a day. Fiber hydration movement. That's an important part of [00:33:00] detox as well.

We wanna replenish nutrients, so we're building a nutrient-dense diet, and we may bring on a multivitamin or a prenatal, maybe some magnesium as well, if you need that. I have a whole supplement chart and protocol and be on the pill, but I want you to understand that. If you are planning on getting pregnant, you wanna be on that prenatal for ideally three months before you try to conceive.

We wanna track the symptoms that come up. We wanna track our cycle if it comes back, even if it's irregular at first, we wanna know, we wanna have the data. We wanna know what's our normal, what's happening in our body, so that we need help from a provider. We can convey that information to them.

Um,

Make sure that, so I talked about moving gently for helping with lymph and circulation.

We wanna make sure that we have an exercise in plan, in place where we start strength training, maybe it's body weight, then we start with light weights, then we're doing heavier weight. But we wanna make sure that we are supporting our body with our insulin, with stress reduction, with our [00:34:00] mood. We also need to prioritize sleep.

Your body heals while you sleep. Your hormones need you to sleep. It is really important that we are tending to our sleep. I've done enough episodes on this. I can link to some that have sleep routines in them to help you. And the last thing is to be kind to yourself. This is a transition. It's not a test where you pass or fail.

One of the number one things I see is. Uh, women get acne and they go right back on the pill and they feel like they failed. So what do you do if your acne returns or your periods are unbearable? Does that mean you have to just go right back on birth control? I. Well, what it means is that your body is talking to you, so symptoms are your body's way of communicating, and it's asking for deeper support so you can go back on the pill.

That's always an option. Or you can start looking at. What could these [00:35:00] signals mean? And this is where it's great to partner with a provider who believes in listening to patient's data, their story, and that patients know their body.

And I wanna remind you, because we get this narrative all the time, that hormones are your enemy. Therefore, you need to take the pill and suppress the bad guys, when in reality your hormones are your superpower. And when they're supported properly. You feel amazing in your body. Your skin looks amazing, like everything is amazing, and that's my goal for you in this podcast is I always wanna help support your body in feeling amazing, whether you're using a medication or you're not.

I. And I do wanna acknowledge that coming off birth control isn't always easy for everyone, but it can be empowering, like to feel informed about your body, and you deserve to feel informed about this medication and your body. You should feel supported and confident in your body's ability to thrive and your provider's ability to support [00:36:00] you in your choices.

So if this episode has helped you or you think it could help someone else, please share it. Subscribe, leave a review, check the show notes for resources. I am gonna do some ask Dr. Brighton questions here, but I just wanna remind you, you're not alone. You're definitely not broken. You're just coming back home to yourself, and that journey can be a little windy sometimes when you've been leveraging a medication to prevent pregnancy or manage your symptoms.

So with that said, let's get into some Ask Dr. Brighton questions.

I.

So Sarah asks. Is no birth control better? I have never been on any form of birth control, but my doctor is telling me that the progesterone in the pill could help my moods. There's no progesterone in the pill, none. It's progestin, which is the synthetic form of progesterone, and it has to be because that's how patents work.

Now what's important to know is [00:37:00] that if your doctor thinks progesterone would help your mood, it's likely that they're talking about anxiety and maybe trouble sleeping. Now, how does progesterone help? It gets metabolized and the metabolite called allopregnanolone stimulates the GABA receptor in your brain.

The GABA receptor in your brain just basically puts the brakes on everything, like, shh, it's okay. Don't freak out. Let's go to sleep. Progestin does not have the ability to do that, and medicine and research. Often confuses the two. You'll often, you'll see research studies that say, oh, progesterone, and then you get into the methods and they're like, they use progestin.

And I'm like, well, that's not the same thing structurally, progestin. So if you look at the chemical structure, it's different than progesterone. It doesn't have the same benefits on our mood or even on our brain health that progesterone does. So if your doctor is recommending progesterone. For your [00:38:00] mood.

Oral micronized, progesterone prometrium is what we have as a bioidentical. That is a prescription is the better route than the birth control pill 'cause again, no progesterone.

Melanie asks, can getting off the pill trigger autoimmune disease? Here's what we know about autoimmune disease. You have to have a genetic predisposition. So if you don't have the genes for the autoimmune disease, you're not just gonna get it out of the blue unless maybe we'll get some research that shows that like mutations are happening due to environmental factors.

But typically speaking, if you have the genes for Hashimoto's, you can get Hashimoto's. But it doesn't mean you're gonna get multiple sclerosis unless you have the genes for that. Now you need to have the genes. Intestinal hyperpermeability, the leaky gut that we talked about usually accompanies that. So being on medications that can induce that, that is another risk factor.

And we talked about how the pill can be one of those, and then you have to have a triggering event. So it's three ingredients that goes in the cake of, woo-hoo, happy [00:39:00] birthday. You got an autoimmune disease. I have autoimmune disease. So triggering events for women can look like hormonal changes. Starting your period menarchy for the first time postpartum.

So having a baby going into postpartum, perimenopause and menopause, and perhaps the transition of coming off the pill as well. We need more robust studies to understand the impact of the pill on the immune system. This is unsurprisingly not prioritized in women's medicine. This is not a conspiracy.

And it's ridiculous. Anytime you bring up and question the, uh, capitalistic and monetary incentives of pharma that people are like, you're just Antip Pharma. I'm like, I don't know. I take a thyroid medication every day to live just that, but whatever. Sure. Label me whatever you want, because it's inconvenient that I question or help bring up the number of lawsuits that have been won because of pharma doing shady things.

[00:40:00] So here's what to understand about the pill. The first medication to ever be introduced into the population that did not need a doctor's diagnosis. It just needed that. You had ovaries, you had ovaries, and they were functional. So we put you on the pill. In fact, they can be not functional and we'll put you on the pill.

So it was a huge money making opportunity for pharma. This is not something that. Is out there. I mean, this is irrefutable. Okay. It was like a marketing drool session. Um, sure. When they were like, oh my God, we can get women, 50% of the population on a medication. Anyhow, with that being said, there hasn't been a lot of incentive when you talk to researchers and honestly.

Not a lot of them even wanna say it on the camera, on the Dr. Brighton show. When you talk to researchers, they will tell you that you'll be penalized if you are asking negative questions about the pill. And if you're asking [00:41:00] things that would put the pill in a negative light. So we have to see that there is monetary incentive.

There is also major medical misogyny. We don't get funding. I mean, male pattern bald gets more funding than endometriosis does. Oh man. So we don't get funding, so we don't have the studies right now. Is it a possibility? Absolutely. When you look at all of the other times in a woman's life where she's susceptible, it is these hormonal moments.

And there's some people in the population who are very hormonally sensitive and they tend. To also fall within the neurodivergent category. Um, or, and, and, and then those are people who can be at higher risk for immune dysregulation and for autoimmune disease. So is it possible? Yes. Is it the only triggering event?

No. There's lots of other things, but when you look at [00:42:00] these major hormonal shifts in women's lives, it's like anyone who's telling you coming off the pill is not a major hormonal shift. Like, excuse me. I went from not ovulating, not having my brain and ovaries function, um, and, you know, talk to each other.

Your brain's still functioning by the way, but your brain's not talking to your ovaries, and then it flips. And now they are like, this is something where, you know, we would expect to see that there's possible issues in immune function. Also, when we understand that estrogen, testosterone, and progesterone all interact with the immune system, the Ute receive interacts with the immune system.

So is it possible? Yes. Do I have tons of studies to back that all up? No will I in my lifetime. I ain't holding my breath. I am not holding my breath for that, uh, for the fact that I am making it to my mid forties. And I still haven't seen the amount of data we need on PCS on endometriosis on so many [00:43:00] conditions that primarily affect women.

And this is where I say I don't have time anymore. I don't have time anymore to wait around for a randomized control trial to prove what something that hundreds of thousands of women have been. Saying for generations, millions. Actually, I don't have time to wait for that. I need to start working on anything I can to improve my health.

 

Anyhow, I wanna say thank you for listening. I will see you on the next episode of the Dr. Brighton Show. Please leave a review, subscribe, let me know what you think. You always drive the conversation, so let me know what you wanna hear more of.