What if you as a coach could help your clients restore their menstrual cycles after hormonal birth control — and help them feel empowered in the process?
Ovulation is how women make most of their reproductive hormones. In order to prevent pregnancy, the oral contraceptive pills (OCPs) shuts off a feedback loop between the brain and ovaries, known as the hypothalamic-pituitary-ovarian (HPO) axis, preventing the release of an egg from the ovary and stopping ovulation.
Whatever her reason for transitioning off OCPs, it's essential to support the HPO axis to regain ovulatory menstrual cycles, restoring hormonal levels to a healthy range . And as a reminder- reproductive health is about so much more than making babies!
In addition, beyond pregnancy prevention, many women may have started hormonal birth control to help “fix” symptoms such as acne, heavy bleeding and mood swings. We know that these symptoms can be signs of dysfunction elsewhere in the body, or even a short- term response to an accumulation of stressors. Stopping a cycle isn’t the same as addressing the root causes behind its symptoms. Those underlying root causes may rein their ugly head if not supporting the body before, during and after coming off birth control.
By paying attention to and supporting key areas that nurture hormonal health and a female’s resilience as a whole, you can not only facilitate communication between the brain and ovaries—giving the body the tools it needs to ovulate after birth control—but also help prevent those symptoms from returning when she stops the pill. This is why we suggest having these conversations and nurturing key areas before ending the last pill in the pill pack.
Everything in the body is interconnected, by addressing areas such as gut health, liver function, blood sugar regulation, and stress management - we can ensure that all systems are working together to restore balance.
The overarching goal is for the body to feel “safe” enough to ovulate. This post will guide you, as a coach, through some of those key areas to focus on to do that and for a smoother transition off hormonal birth control.
Supporting the Circadian Rhythm
Getting enough deep sleep and having a regular sleep routine is foundational for all systems of the body - reproduction very much included!
A lack of sleep is a stressor, and when the body senses excess stress, it will divert resources away from reproduction and ovulation. Not a good time to be making babies! We want to prioritize 7-9 hours of sleep a night, avoid blue light before bedtime, and expose yourself to natural light in the morning to help optimize sleep quality.
Blood Sugar Regulation
Maintaining stable blood sugar is a must for hormone balance and overall well-being. Blood sugar and cortisol are closely tied together. If blood sugar is swinging high and low, cortisol most likely will be as well, leading to a downstream negative effect on sex hormones negatively.
Habits for regulating blood sugar include eating every ~3-4 hours, creating balanced meals with at least 25 grams of protein, healthy fats, and fiber, and being cautious about any extended fasting.
These habits help aid in the body feeling “safe” to reproduce, and remain insulin sensitive.
Nutrition and Nutrient Status
Many women are unaware that OCPs are associated with various nutrient deficiencies. Key nutrients such as B-vitamin, zinc, magnesium and selenium are a must for regular ovulatory cycles.
Deficiencies or inadequacies can also hold someone back from achieving her performance and physique goals because of the critical role they play in the body. A lack of nutrients may also exacerbate side effects experienced with oral contraceptives such as anxiety.
Rebuilding nutrient status post-lil looks like encouraging a diverse diet with plenty of whole foods, as well as considering supplementation. NOT being in a deficit is often best practice at this time, too.
Gut Health
An area we always want to nurture! Especially in our females with a long history of birth control use. OCPs may lead to increased intestinal permeability and potentially alter the gut microbiome. A healthy microbiome is crucial for maintaining optimal nutrient status. Nutrient absorption may also be further impaired in females on oral hormonal contraceptives due an association with low stomach acid, impairing absorption of protein and nutrients.
Gut infections such as H Plyori or even general dysbiosis can be sources of underlying inflammation, contributing to total stress on the body as well as further hindering nutrient absorption. These issues may also impact other areas of the body, such as the thyroid.
Liver Support
The liver is in charge of processing and packaging used hormones so they can be eliminated from the body. Birth control pills place a strain on the liver as it processes synthetic hormones. We can help the liver do what it does best by including nutrient-dense foods (e.g., dark leafy greens, bitter foods, berries, cruciferous vegetables, and liver-supportive herbs), staying hydrated, ensuring enough soluble fiber is in the diet, reducing toxin exposure, and adding in lymphatic support such as sauna sessions and diaphragmatic breathing.
If you aren’t sweating, breathing properly, pooping, staying hydrated, and moving your body, you’re not detoxing effectively! Do you need a "cleanse" or detox protocol to do that? Probably not... and if you are starting to support the liver before stopping birth control, we would actually not recommend any aggressive cleanses or detoxes that could impact the pill's effectiveness as a contraceptive without having a back up birth control in place.
Managing Stress
High cortisol and adrenal activity send a signal to the brain that it’s not safe to reproduce. Prolonged mental and emotional stress (stemming from various sources) can lead to HPO axis dysfunction.
Thyroid, sex hormones, gut health, immunity, mood, blood sugar, blood pressure, sleep cycles, muscle growth/recovery, etc.- all impacted here and make the goal of restoring ovulation more challenging in a female coming off birth control .
In addition to lowering allostatic load (or cumulative stress) with the above intervention, we can encourage more mindfulness, deep breathing, community, mental health counseling and FUN into one’s routine are musts to prevent burnout and help the body feel safe to reproduce.
A final ingredient here is time. Depending on how long a female’s brain/ovary communication has been “off” (whether from birth control, low energy availability, or something else) and individual epigenetic factors, it may take time to restore a cycle or get hormones in an optimal spot.
We cannot predict the response someone will have after relying on synthetic hormones. Some women get their cycle back right away, while for others, it takes months. The goal is to make the transition as smooth as possible by taking an individualized, holistic approach. It’s important to remind clients that this “work” not only supports hormonal health but also enhances performance, physique, and life goals!
As a Coach, you can serve a big part in this big phase of a female's life. By reviewing with her her health history, labs, and current nutrition and lifestyle, you can adjust her programming to focus on the areas that will help restore ovulatory cycles and ensure a smoother transition off hormonal birth control. Supporting the body’s natural processes during this transition can help encourage not only the return of regular cycles but also overall well-being.
Always encourage collaboration with licensed medical providers to ensure a safe and effective approach tailored to individual needs.