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Have you recently come off hormonal birth control (HBC) and noticed your PCOS symptoms for the first time?
It’s common for certain types of birth control to trigger the symptoms of PCOS like acne, hair changes, and irregular cycles when you stop using them.
The good news is these are usually temporary.
The key thing to understand about this root cause is that if you had the symptoms of PCOS before going on HBC, you don’t have true Post-Pill PCOS.
Coming off birth control can trigger your existing symptoms to flare up, however it didn’t cause your PCOS.
In this situation, we need to dig deeper and work out what was driving your PCOS before you took birth control.
It’s common to be prescribed HBC because of the symptoms of PCOS.
This is because the synthetic hormones can help to reduce acne and unwanted hair growth while you take HBC.
HBC can also make you feel like you’re having a regular bleed by shutting down your ovulation (jump back to chapter two for more on why the pill can’t regulate your period).
If you were given HBC to help you deal with the symptoms of PCOS, they went away while you took HBC, but returned after you stopped, you don’t have Post-Pill PCOS – you have a different root cause.
HBC essentially masks the symptoms of PCOS by suppressing your natural hormone levels.
See the other chapters in this section for more information on the other three types of PCOS to work out which one you have.
"If, however, you didn’t suffer from irregular cycles, severe acne or hair changes before you started HBC and are experiencing these for the first time – you likely have Post-Pill PCOS."
This PCOS type is caused by a withdrawal from the synthetic hormones in HBC.
Some types of HBC are more likely to cause Post-Pill PCOS than others.
The most common are birth control pills that contain drospirenone or cyproterone. Common brands of these pills include Yaz, Yasmin, Diane, and Brenda.
Unlike the other root causes of PCOS, this type is temporary and will likely resolve in 12 to 24 months.
In the meantime, there is plenty we can do to suppress your body’s overproduction of androgens and encourage your cycle to become regular again.
We’ll cover this in more detail in the next section.
Janice joined one of my group programs after she had been on the pill since age 14.
Her doctor had prescribed the pill to help her manage her mild teenage acne.
It worked – her skin was clear and she didn’t have to worry about getting pregnant before she was ready.
She had recently gotten married and at 29, decided it was time to start trying to get pregnant.
Without giving it too much thought, Janice stopped taking the pill. She had one bleed when she first stopped, and then...nothing.
Months went by and she had no signs of a period returning.
To make matters worse, the acne from her teenage years came back with a vengeance!
She visited her doctor who diagnosed her with PCOS and told her if her cycle still hadn’t come back after six months, she would need fertility treatment.
Like so many other women, Janice had gone from spending most of her life terrified of falling pregnant, to being 110% ready to have a baby NOW.
This desire was all-consuming and she came into the group program desperate for any advice to make her cycle return naturally.
I explained to Janice that it can take several months for your body to find “normal” again after being on the pill for so many years.
We put her on an androgen blocker to manage her acne and this cleared up within a few months.
Meanwhile, we assessed her for nutrient deficiencies and corrected these.
Janice had regular bloating and we discovered this was driven by low stomach acid, so we added some nutritional support to improve her digestion.
Right before the looming six-month mark, Janice had her first post-pill period.
The very next month, Janice was pregnant naturally with a healthy baby boy.
Unfortunately, there is no test that can conclusively confirm Post-Pill PCOS.
This PCOS type is specifically related to when your symptoms started.
If you’re not sure if you had PCOS symptoms before you went on birth control, go back through the other three types, and take the quizzes to rate your likelihood of having these root causes instead of Post-Pill.
If you are confident you have Post-Pill PCOS, you can skip ahead to chapter 15 for the core treatment for this PCOS type.
There is only one essential checkbox in this section.
If you aren’t able to tick this box, you are dealing with a different root cause of PCOS.
Read on to discover if Inflammatory PCOS is your root cause.
Hormonal birth control (HBC), like the pill, works by shutting down ovulation in order to prevent pregnancy.
When you stop using HBC, most women find their cycles return within a few months without a fuss.
For a smaller portion of women however, this suppression of ovulation continues for months or even years.
Alongside this, a temporary surge in androgen production is common, particularly with brands of birth control pills that contain drospirenone or cyproterone like Yaz, Yasmin, Diane, and Brenda.
This is why post-pill acne is a common symptom.
While your body finds balance again after being on the pill, it’s common to be given a diagnosis of PCOS.
Unlike the other three types of PCOS, this type is temporary.
However, the symptoms can last for up to two years.
In the meantime, following the core treatments below will help to reduce your symptoms and speed up your return to regular cycles.
Ashley and I worked together after she had been on and off the pill four times in the past two years. She was ready to be free of medication and find a natural way to avoid pregnancy.
Each time, she would boldly stop taking the pill and tell herself, “This is it – this time I’m sticking with it”.
Then three or four months later, her skin would be flaring up so badly that in sheer desperation for relief, she would end up back on the pill.
I explained to Ashley that post-pill acne flare ups usually peak around three to six months because of the unopposed sebum production and androgen surges from your ovaries (see chapter 9).
This is why so many women give up hope and end up back on the pill at the three- to six-month mark.
If you can wait it out just a little longer, things will improve.
Before quitting the pill again, we started Ashley on Nourished Androgen Blocker, removed some triggering foods from her diet like cow’s dairy and processed sugar and worked on some underlying gut issues she had been dealing with.
After two months on this protocol, Ashley felt confident to stop taking the pill once and for all, knowing she had a treatment plan in place.
She had some mild symptoms in the first few months, but nothing she couldn’t handle.
She has now been free of HBC for more than 12 months and no longer qualifies for a PCOS diagnosis because her skin is clear and cycles are regular.
If you are currently taking HBC and planning to come off, I suggest implementing the core treatments in this chapter for around two months before stopping HBC.
If you can do this, you will have a much easier withdrawal process with minimal symptoms.
If you have already come off HBC and are experiencing symptoms, hang in there.
Follow the core treatment principles in this chapter, especially taking an anti-androgen supplement for quick symptom relief .
