Click to listen to the audio version:
Update: This is a repost of a previously published article. It’s now been over three years since I went off hormonal birth control.
Over two years have passed since I opened my last packet of pills and quit hormonal birth control.
In this post, I’m going to share why I quit hormonal birth control, what happened afterward, and what I use instead.
But before I dive in, I need to heavily preface this post:
This post isn’t meant to be a sociopolitical or religious conversation. It’s not a medical conversation either. I’m not a doctor – I didn’t stay in a Holiday Inn Express last night – nor am I a medical professional of any kind. I’m not trying to make a statement about feminism or women’s rights, and I’m not trying to tell you what to do with your own reproductive health. But I believe in informed consent and your right to know all your options.
With that in mind…
If you told me a few years ago that I’d be blogging about my birth control, I probably would’ve squirmed a little bit in my seat. Fact is, in the side conversations I’ve had with friends or the email exchanges I’ve had with other women since I quit hormonal birth control, something’s become apparent:
It’s just not something that a lot of people are talking about, and women are curious to learn more.
The choice to quit hormonal birth control is a very personal one. I was at the place in my life where it made sense to seriously start questioning what I was doing and whether it was good for my health or not. As a 35-year old married woman in a stable and committed relationship, that was my reality, so I began asking around.
But let’s go back a ways first.
Let’s Just Say I Bloomed Early
Gag. I hate that term.
At 10 years old, my body went from chubby pre-teen to menstruating young woman overnight. My mom gave me a book about periods – probably because she noticed I wasn’t flat-chested anymore – and I read that a period would feel like a “low, itchy sensation.”
Well, when I was graced with menarche, it felt achy, not itchy. (Note to self: Get better at skimming.)
Not that being the first to get your period and braces is bad enough for a 5th grader, but every month I got sick. Really sick.
I hate to be graphic, but when I got my period, I’d spend the first 24 to 48 hours vomiting until bile came up. Going to school wasn’t an option, so I’d stay home and writhe in bed. After a while, mom realized this wasn’t normal, and so around age 11 – I think…my memory is a bit fuzzy – I got my first pelvic exam. Hooray!
The concern was that my cousin was dealing with a severe case of endometriosis and perhaps I had it, too. “Not to worry,” the lady doctor said, “you don’t have it. It’s just raging hormones, and you’ll outgrow it.” To be fair, I’m paraphrasing, but that was it. You’ll grow out of it.
Well, I really didn’t. And I always had a feeling something wasn’t right.
I remember calling mom to come pick me up from school once because my period started. I’d popped some Advil (knowing it wouldn’t do anything), and willed for her to get to me as fast as possible. We lived a half hour away, and I could feel myself going downhill. As she drove up, I hurled into the trash can in front of the school doors. I was 16.
At age 19, a college sophomore, I went on birth control pills.
Hormonal Birth Control “Worked”
Yep, hormonal birth control worked as promised.
I wasn’t getting as sick. I avoided pregnancy. I took my little blue pills each day like my doctor told me, and my period was very predictable.
So what was the problem?
At first, nothing.
(I did have a short break from hormonal birth control after my divorce. When I was off them, I felt so much better, but I went back on them soon after.)
But then, at age 33, my gyno diagnosed me with endometriosis after doing a tissue biopsy. FFS.
As far as I know, my endo is mostly confined to my cervical area (the location of the biopsy), but I’ve never had a exploratory laparoscopy. While some women reading this might be horrified that my fertility status could be affected by my endo, I’m not stressing about it because I’m not planning to have children.
All those years, I knew something was wrong with me, and I was right. To say that I felt vindicated and confused all at the same time would have been accurate. But I was starting to pay more attention to my health – I went paleo two years prior to the diagnosis – and putting things in my body that were working better for me.
Around the same time, my birth control prescription had to be changed, and the hormones increased. I started to feel like crap, and the side effects began to pile up. Moodiness, weight gain, low energy. Despite feeling pretty good for the previous couple years, I knew this decline was due to the change in my pills.
In the summer of 2014, a full two years after my endo was discovered, I decided enough was enough.
Considering My Options
I started considering what other options I really had because I wanted to quit hormonal birth control altogether.
To me, it was a natural evolution. I’d already been working on nourishing my body, getting stronger, sleeping better, and using fewer “chemical” products at home and on my body. Z and I were married, and I felt terrible despite the few different prescriptions I’d been switched to.
I’d also changed doctors – my old gyn wouldn’t allow an IUD because I was still “of reproductive age” even though he knew I didn’t want children – and the new one was willing to do a copper IUD. (Yes, I was fully aware of the risks.)
In fact, I felt really excited at the prospect of finally being off hormones (as pumped as a woman can be at the thought of having a little T-shaped piece of metal shoved up her hoo-ha)!
Well, despite the doctor proclaiming my uterus “measured perfectly” and going through with it, I was absolutely crushed when I went back for a checkup the following month and it had dislodged.
She asked me if I wanted to come back in another four weeks and try again. When I said no, she wrote me another prescription for birth control pills. I walked out, tore the slip up, and went on a mission to find a better way.
I decided to quit hormonal birth control because I was tired of the side effects, I knew there had to other ways to manage my fertility that worked with my lifestyle, and the risk factors weren’t worth it anymore.
Frankly, I was also really pissed at mainstream medicine for becoming a pill-and-hormone pushing machine, unwilling to help women manage underlying lifestyle factors.
Creeping Around Other Women’s Social Media
Turns out, my research was short-lived. I remembered reading something Liz Wolfe posted about how to quit hormonal birth control, so I did what any normal human would do: I creeped her Facebook page for more info. (Liz and I are actually friends, so it’s not as weird as it sounds.)
When I found her Facebook post about it, I bit the bullet and asked.
Yep, that’s a screenshot of the actual message I sent her.
Liz was a great sport and filled me in. I’m so grateful for her because this still seems like something women don’t really talk about. Add to it the fact that many doctors – though not all – prescribe hormonal birth control as the contraception default, and it’s no wonder women are confused.
Side story: I now have yet another gyn. When I first met her, we had the following conversation:
Doctor P: What are you using for birth control?
Me: I track and chart my basal body temperature plus other signs of ovulation.
Doctor P: Isn’t that a lot of work?
Me: No. (Looking puzzled.) I lie in bed for a minute every morning and take my temperature.
Doctor P: Do you know you could still get pregnant?
Me: As you can with any other form of birth control. I follow the rules for avoiding pregnancy. I don’t want to take hormonal birth control.
Doctor P: Have you considered Mirena? (Mirena is a type of IUD with “low dose” hormones.)
Me: Mirena still has hormones. (No thanks.)
Doctor P.: (changed the subject)
As much as I liked Doctor P, I absolutely loathed being treated like a dum-dum who didn’t know anything about my own fertility. (Edit: Dr. P. has since retired.)
And it galls me that women the world over are 1) being presented no other options besides barrier methods or hormones and 2) that hormonal birth control is being used to treat the symptoms of other bigger health issues. More about that later.
Enter: Fertility Awareness Method
On that fateful July day two years ago, Liz told me aboutFertility Awareness Method (FAM), and it’s changed my life and health for the better. I’ve been off hormonal birth control since then with great success.
What is FAM?
In a nutshell, with FAM, a woman tracks and charts her basal body temperature (BBT) – recorded with a special thermometer – as well as other signs like cervical fluid, cervical position, ovulation pain, PMS symptoms, etc. With this data, a woman can closely pinpoint ovulation. There are some basic rules about when to abstain from sex or use a back-up barrier method (if you don’t want to get pregnant) or when to have sex (if you do want to get pregnant).
Note: FAM is not the same as assuming that women ovulate on Day 14 of their menstrual cycle.
While 14 days is an average, it’s not absolute. It may not apply to you during every cycle even if you do tend to ovulate at 14 days.
Here are some of my own personal stats (I know, we’re getting REAL friendly here):
As you can see, data from nearly 40 tracked cycles show that I’ve ovulated anywhere from day 9 to day 20 while the “average” is day 15.
And here’s what a sample monthly chart looks like:
Case in point, once I got tattooed on Day 12 of my cycle. Because of the physical stress, I actually ovulated 4 days later than “normal.” Had I assumed “everyone ovulates at 14 days” and had sex without a barrier, I could’ve gotten pregnant. Luckily I have tracked fertility signs for two+ straight years and knew that my ovulation was delayed.
In the past, I’ve also ovulated “late” after a very long international flight and while I was sick with food poisoning.
How FAM Works
Like all other forms of birth control, there are detailed and specific rules for doing FAM. I used the book Taking Charge of Your Fertility by Toni Weschler as a primer.
Every morning when I wake up – before getting out of bed – I lie there and take my temperature orally with a special basal body temperature thermometer. This takes a minute or so. (If a doctor tells you this is harder than taking a pill every day, gee, you might rethink your choice of providers. I did.)
Then, I log my temperature with a fertility tracking app. I use Fertility Friend because it’s the one I found years ago. There are other apps without all the pink and purple flowers if you like your fertility tracking without the stereotypically girly motifs.
Edit: As of August 2017 I’m waiting to test Daysy so stay tuned for an update on that.
Edit: Daysy is pretty awesome, and I think it would be especially useful for women who are just getting started with a FAM-style approach. It really simplifies the process. Click here to learn more about Daysy.
I also log other signs like cervical fluid changes, breast tenderness, when I exercise or travel, etc.
If you’re sitting here thinking you could never do it because that’s “gross,” I’ve gotta say this: Having knowledge about how your body works is not gross.
It’s empowering, and it’s your right. For too long, women have been prescribed hormonal birth control that allows us to be completely oblivious to what is happening in our bodies. Periods aren’t talked about. Or when they do, they’re often joked about or seen as taboo.
- Have you ever completely freaked out because your period was late? I have. Tracking actually gives you the power to know if / when a late period could really be a pregnancy.
- Have you ever panicked because you had vaginal discharge? I have. Turns out, discharge around ovulation is normal. (“Egg white” cervical mucus actually helps sperm get to the egg.) Tracking can help you know if that’s normal for the time of month or if you could have an infection.
- Have you ever felt a sharp pain in your side around the middle of your cycle and thought you could be having an appendix problem? I have. That could actually be ovulation pain.
My point is that so many women are disconnected from what is normal in their bodies and what’s not. To me, FAM is a tool that allows me to be more in sync with what is happening from month to month.
Edit: I wrote about this on Instagram recently: FAM also helps me know when to adjust my training. The response was crazy! So many women didn’t know that hormonal fluctuations could make their strength levels fluctuate. (More on that in a coming post.)
⚠️PERIODS & TRAINING ⚠️ Ladies, we need to chat. Did you know that where you’re at in your menstrual cycle can seriously affect your training? It’s NOT all in your head. . In the first week of your cycle, estrogen starts to rise. You may notice a decrease in cravings (especially carbs) / appetite and you may feel very strong in the gym. Now’s the time to go after PRs, heavy training volume, high-intensity, etc. Immediately prior to ovulation (approx day 14 though this varies!!), estrogen peaks. You’re likely to feel very strong in this first half of your cycle and a little extra randy (wink). . After ovulation, estrogen drops and progesterone rises. You’re likely to retain more water and crave carbs. As this luteal phase continues, progesterone also drops off which initiates your period. ❗️In the few days before your period, IT’S NOT UNCOMMON to feel like your normal working sets are way harder and that you’ve got little gas in the tank. Don’t beat yourself up for feeling a little “off!!” . I bring this up because I used to think something was wrong with me. But once I started tracking my cycle very closely (I measure my basal body temp and a couple other signs), I realized that how I felt in the gym matched up really well with my cycle. Of course, every woman is different and some have more difficult cycles than others. . But I want to empower you to know that if you have leeway in your training plan, going a little easier the week before your period is okay. Saving the heavier stuff for before ovulation and the lighter stuff, metcons, etc for later may work better for you. If you’re a coach this may help you understand your female lifters better. . And with all that in mind I’m super glad this is a deload week 😉 Worked up to 3 sets of 5 strict press at 75% today. See the rest of my training in my IG Stories. . And for more info about healthy periods, follow these ladies: @drjolenebrighten and @larabriden #TheMoreYouKnow #NormalizePeriodTalk #StrengthTraining #WomensHealth
[bctt tweet=”So many women are disconnected from what’s normal in their bodies and what’s not.” username=”stupideasypaleo”]
FAM isn’t perfect. If you don’t follow the rules, you could get pregnant. (I’ve seen estimates of 0.6% failure rates if followed exactly.)
But I’d rather deal with that risk compared to the shitty things that hormonal birth control does to a woman’s body and how terrible it was making me feel.
After I Quit Hormonal Birth Control
Within two months after I quit hormonal birth control, I had normal cycles. Maybe I’m lucky? Maybe I had worked hard on improving my foundation of health prior to quitting and it paid off? I like to think it was more the latter. Everyone is different, and I acknowledge that 1) not every woman is an ideal candidate for FAM and 2) there are other non-hormonal methods besides FAM (ex: copper IUD, condoms, etc) that work well for other women.
But I have to make this plea:
If you’re dealing with hormonal issues (PCOS, endometriosis, acne, irregular periods, amenorrhea, female athlete triad, etc.), hormonal birth control is often a band-aid that covers up the problem instead of heals it.
The pill and other hormonal birth control methods have so many downsides that women have come to, frankly, put up with because it’s often presented as our only viable option.
I used to think I needed hormonal birth control to make my skin better or make my periods less painful. Turns out, that was not true. I may get a pimple here or there, especially around my period, but my skin is great thanks to a nourishing, anti-inflammatory diet, good sleep, the right amount of exercise, and reducing my stress.
I do take Advil on the first day of my period, but I don’t vomit anymore. My endometriosis pain is very manageable. Yes, there was a transition period where I had a little more acne, for example, but that wasn’t enough to make me run back to the pill.
Note: Endometriosis is now gaining recognition as an inflammatory disease. That means that factors that ramp up inflammation in the body (ex: certain foods like gluten, dairy, and sugar; poor gut health; environmental toxins; and more) can make endometriosis worse. When I consider my family health history, especially my maternal line, I see several autoimmune / inflammatory diseases present: rheumatoid arthritis, psoriasis, gout, and endo to name a few. People may think paleo is a fad, but for me it’s meant a significant reduction in the amount of inflammatory foods I consume.
Please learn more before you just stop cold turkey.
I highly recommend the following resources:
- Dr. Lara Briden
- Dr. Jolene Brighten
Not only are both women personal friends of mine, but their depth of knowledge and their passion for helping others improve their health is palpable. Go check out their work. There are far more downsides to hormonal birth control than what I listed here, especially when used to manage other hormonal / health problems. (Get Dr. Briden’s book to learn more.)
In the two years since I quit hormonal birth control, not only have I amassed a lot of data about my menstrual cycle, but I also feel like I’m far more in tune with my body than I’ve ever been.
- I know which day I’m going to get my period because my temperature drops back down.
- I know that the week before I get my period is not the ideal time to lift really heavy (more about that in an upcoming post), and if I’m having an “off” day around my period, it’s normal.
- It’s been far easier to build and maintain muscle mass now that I quit hormonal birth control.
Every woman’s transition of hormonal birth control is different, and my story might not reflect yours. However, staying on hormonal birth control just because coming off it was uncertain stopped jiving with me.
Quitting hormonal birth control is one of the best things I’ve done for my health, but it may not be for everyone. Flashing back to age 19, FAM (fertility awareness method) probably wouldn’t have been the best choice. FAM does not help prevent STIs.
FAM has pros and cons, like every method of pregnancy prevention, but for me the benefits far outweighed the downsides.
Talk to your doctor and educate yourself so you know what your choices are. Your self-advocacy can make all the difference. Be informed.
Hormonal birth control methods, though often used to “treat” other problems, are not cures. They are synthetic analogues to your body’s natural hormones and are not without risk. Repairing your hormonal imbalances can be achieved through work with a cooperating practitioner and lifestyle changes.
Sometimes, traditional methods must be used when more natural treatments don’t work. It’s not a failing on your part, and it’s not necessarily wrong, but you should at least be aware of natural treatments before being pressured into surgery or other interventions. My goal here was to share my own story of finding another way.
We covered a lot of ground in this post, and I said a lot of adult words like vaginal, sex, and discharge that might make you squirm, but you stuck with it to the end.
I hope this post about why I quit hormonal birth control empowers you to consider your best options and make the best possible choice for your health.