It's time to learn all those things they never taught us in health class - periods, pregnancy and pelvic floor!
I'm a women's health educator, a nerd when it comes to learning "all of the things", and my obsession is teaching women how to take control of their health and create a life they love!
Ready to ditch hormonal contraceptives for good but feeling completely clueless about how to do it and what to expect?
In this week’s podcast episode, I’m talking you through the 5 steps to coming off the Pill.
Whether you’re ready to start preparing for pregnancy or you just want to explore a natural method of birth control, I’ve got you covered!
Hello, and welcome to episode 20 of The Mana Women’s Wellness Podcast. I’m your host, Rachel and today is part two of Coming Off The Pill. Now if you haven’t yet listened to last week’s episode then hit pause and have a listen to that one first because in that episode we talked all about how the pill works to prevent pregnancy, the potential effects of long-term hormonal contraceptive use and how long you should expect to wait for your period and your fertility to return to normal. It was really an overview of what the pill is all about and why I believe it is so important for women to be properly informed about what they are taking before deciding to use this as birth control. If you’ve had a listen to part one and you’re ready to learn how exactly to come off the pill, then stay tuned!
So, in this episode I’m going to talk you through the 5 key steps to coming off the pill. Now whether or not you’re coming off the pill to start preparing for pregnancy, or pregnancy is not on the cards for you right now, the first 3 steps of this process are relevant for both groups of women. The final two steps are then specifically for those women who want to chart their cycles for natural birth control. So, let’s dive in to step 1.
Now if you’ve listened to any other episodes of the podcast, you’d had heard me rabbit on and on and on about the basics of female reproduction and the menstrual cycle. I call it Menstrual Cycle 101 and I talk about it so often there are so many knowledge gaps for us women about the basics of how the female body actually works. When you think about the very beginning of modern medicine, when male doctors and renaissance men started cutting up human bodies and investigating how it all worked, more often than not they looked at male bodies. And so, a lot of modern medicine is really centered around how the male body works. And it doesn’t take a genius to recognize that the female body works in a very different way to the male body, especially when it comes to the reproductive bit where there is a completely different set of organs involved!
The female body and our menstrual cycle and driven by our hormones. It’s a cyclical process, and while it’s not exactly predictable and clockwork because we are living, breathing human beings that are affected by our environment, stress, illness, diet, all of these things, but to its core, it’s the same things happening in the same sequence of events over and over throughout our lifetime. And so, I’ve gone off on quite the tangent there to tell you that understanding the basic function of your female body is essential to understanding anything else about your fertility. You need to understand that day one of our menstrual cycle begins on the first day of menstruation. After menstruation, the body begins to prepare for release of an egg, ovulation, oestrogen is the key hormone at work and it helps the body to create an optimal environment for pregnancy to occur by opening the cervix, producing fertile cervical mucus to keep sperm alive and guide sperm towards the egg. After ovulation, there’s a shift in our hormones and progesterone becomes the dominant hormone. This surge in progesterone causes changes in our mucus, in our body temperature and closes our cervix again so once we have confirmed ovulation, it is impossible to get pregnant until our next period arrives.
There are four key phases of the menstrual cycle and when you know what happens inside the body during each phase, when you can recognize the physical signs and symptoms of each phase, when you understand how to confirm when ovulation has happened, then you have all the knowledge you need to recognize those days when you are or aren’t fertile, so that you can time sex according to your reproductive goals. So, if you know when you’re fertile and ovulation is approaching, you either avoid unprotected sex if you don’t want to get pregnant, or you have sex during your fertile window and around ovulation to maximise your chances of pregnancy. So, no more relying on apps telling you when you’re fertile, no more counting to day 14 and crossing your fingers you get the timing right. Because when you understand the basics of your menstrual cycle, you understand when you can and cannot get pregnant. And this knowledge is lifechanging.
So that’s where I want you to start your fertility journey, your post-pill journey – whatever season of life you’re in right now, if this is the path you want to go down, this is where you begin.
Your next step is to start charting what you see, which brings us to Step Two.
If you’re still on hormonal contraceptives and you want to start charting now, you absolutely can. Start tuning in to how you feel inside your body every day – mood, energy levels, food cravings, quality of sleep – all of these things will give you valuable insight into your health. But while on hormonal contraceptives, you won’t see those changes in mucus patterns or a shift in temperature because as we learnt in Part One, the pill works to suppress ovulation. It dries up your mucus and so your body doesn’t produce fertile quality mucus. Your endometrium doesn’t thicken in preparation for implantation. This is why the pill is so effective as a birth control method, because it stops all of these key processes from happening which makes pregnancy virtually impossible. And so charting while still taking these hormones, you’re not going to see a typical cycle, because you don’t have a fertile window. And so, the best time to start charting is the day you stop taking the pill, or the day your Mirena was removed, the day your body stopped being exposed to these external, artificial hormones.
And you’re going to watch for changes in your mucus. You’re going to watch for signs that your period is coming, for signs of a true bleed which you haven’t had for the time you were on the pill. Don’t stress about taking your temperature yet, just watch for changes in your mucus. You’ll likely have a withdrawal bleed just like you would when you start taking your week of sugar pills, but unfortunately, there is no way of predicting how long it will take for your body to begin ovulating again, how long it will take for a real period to return. It’s really normal for women to see minimal mucus in the first couple of cycles after stopping hormones, or really having trouble seeing clear changes in their mucus from one day to the next. Research shows that it can take up to 9-12 cycles for everything to restore and return to your version of normal. And I know that can be really frustrating, because it’s hard to know what’s normal or what might need investigating, especially if you’re ready to conceive, and especially if you’ve done your research and you know what that textbook cycle is meant to look like but you’re not seeing it in your own.
And I hate to say just roll with it and see what happens, but this is kind of the case. But, you can support your body as best you can to regulate your hormones and support the return of healthy cycles with diet, exercise, sleep, reducing stress, those key pillars of your health and your fertility. And if you’ve come off the pill to prepare for pregnancy, then this is really the time to pay close attention to your diet and focus on those key nutrients that are essential for conception and pregnancy but can be depleted when on the pill – zinc, B vitamins, folate – you can have a listen to Episode 4, all about my top 5 fertility superfoods to learn a little more about this.
If you’re new to charting, if you feel confused by it all then find someone to help you! It’s just like driving a car. When you first started to learn how to drive a car, you had someone in the passenger seat talking you through it every step of the way. You didn’t just jump in the car, start the engine and drive off into the sunset. Charting is exactly the same. It’s takes time to get your head around, it takes time to feel really confident using this method. But if you think about how you drive now that you have a licence and you’ve likely got a few years’ experience under your belt, driving is probably second nature to you now! You know those days where you arrive home and wonder how the hell you got there because you were on autopilot the whole drive? You wouldn’t have done that when you were first learning to drive. And charting is really no different.
I have something really special coming that is going to help you make that shift from total newbie to charting with confidence, but you have options. You’ve got this podcast, you’ve got books, but I taught myself and I can say with absolute certainty that I would have gotten confident so much faster if I had someone to ask questions to! I was completely in my own little bubble trying to figure this out on my own and if I had had women to talk to who were learning too, if I had a mentor to answer my questions – because you’re going to have questions. And it wasn’t until I trained as a natural fertility educator in a room full of women just like me who had been using this method, mostly for birth control, for years and an expert up the front answering all of our questions – well that was really the game changer for me and my understanding too! So, find someone to help you through those early stages when it feels overwhelming and all too hard – and you’ll be driving on autopilot sooner than you think.
If you’re not seeing any improvements in your cycles despite your best efforts, especially once you’ve experienced a couple of cycles, then it’s worth finding a healthcare professional to work with who is experienced in this area of women’s health. A GP probably won’t help you as much as you would hope here because it’s just not their area of expertise. Charting will help you to identify how long your cycles are, when you are ovulating and when during your cycle you’re experiencing particular symptoms and you can take these charts directly to a healthcare professional and if they’re experienced in this area they will likely have some insight for you too.
So, my biggest piece of advice to you here if you’re exploring a natural method of birth control is to figure out what your back-up method of contraception is going to be. We’re talking barrier methods here because we’ve eliminated the hormones, so you need to figure out how you’re going to manage your fertile window for those first few cycles before you feel confident using charting as your primary method of birth control.
I recommend charting 3 full cycles before relying on this for your primary method of birth control. Because 3 full cycles allow you to get your head around it and understand how things can change from one cycle to the next. Of course, you can cut this window of time down if you choose to work directly with a fertility educator, but 3 months is ideal. So, in that 3 month window of time, you’re going to need to use a barrier method like a condom, a diaphragm, withdrawal, abstinence – figure out what is best for you.
When you feel confident having unprotected sex, which will take time, start in your luteal phase. So, use an alternative in that window of time between your period and ovulation, and once you can confidently confirm that ovulation has happened, wait 3 days for that mucus plug to close the cervix, for any sperm to die, for your egg to break down – and then you can start having unprotected sex in that non-fertile window after ovulation and in the lead up to your next period. If you’re nervous, start in the couple of days before you expect your period. Because you know that ovulation has happened, you know it’s impossible to get pregnant and start there.
And it’s not until you start putting all of the knowledge you have into practice that you can become confident using this method for birth control. It’s all well and good to learn and understand what happens, but it’s not until you see it for yourself that you can shift your thinking to realise that yes, this really does work. You can’t get pregnant every single day. You can only get pregnant in a small window of time in each cycle, and if you can identify that window of time with absolute certainty, then you’re golden.
And so, the final step of this process, Step 5, is that confidence is key. And you need to change your mindset. You need to re-program everything you’ve been told your entire life that you are a ticking time bomb for unplanned pregnancy if you’re not on the pill. That there is no other option that’s effective.
And I get it. You can understand all of this logically, but if pregnancy is an absolute no-no for you right now you need that experience and that confidence to actually make this method work. You can have all of the knowledge and book smarts, but if you can’t overcome that fear of getting pregnant, if you can’t overcome that mindset shift, then you’re never going to feel confident using this method. So that’s why you start after you have confirmed ovulation, you use a back-up method of contraception if you’re not sure – and this is still the case years down the track – if you have a day where you’re just not sure, you use a back-up.
And so now, I’m talking to the women who are not ready for pregnancy. The ones who are currently taking hormonal birth control and who want another option. But aren’t even sure if there is one. I’m talking to the women are just like I was and believe that the only way to get complete control over their periods and really avoid pregnancy is with the pill. This is a really common belief and something I believed for a long time.
Even if you’re not ready to get pregnant right now, but it’s on the cards in the next couple of years. It’s recommended that you stop taking the pill 1-2 years before you’re ready to start trying so that your body can rebalance and recover from the effects of the pill, and sometimes it takes that long for your period to return and start looking like a regular healthy menstrual cycle again.
A lot of women could be taking the pill for 10 years or more before they’re ready to start a family. Often it was prescribed in the first place as a band-aid solution for complaints they experienced as teenagers, not even for birth control in the first place. Symptoms like painful periods, headaches, acne – signs of a potential underlying health problem that has never really been addressed because the pill has masked it for all those years. And you know what happens when you stop taking the pill? All those symptoms come back. And now that you’re ready to start a family, you need to get to the bottom of all these underlying issues before you can really start planning to conceive. That all adds up to time wasted – months, potentially years – and so much added pressure and strain on your relationships because suddenly your timeline for starting a family has changed. You need to get to the bottom of these problems now!
Let go of that fear. Let go of whatever it is that’s holding you back right now. As a woman, you have the power inside you to create and grow life. That is incredible and something that we really don’t celebrate enough. And this feminine power that we all have inside of us this female power oozes into all areas of our lives. And yes, I can teach you how to really use this power in your everyday life from one stage of the menstrual cycle to the next, and it goes ever further than that. And I think this is why so many women describe losing their libido when they take the pill, because these artificial hormones are suppressing this incredible knowledge and power within us. So why should we? Why should we suppress and block out everything that makes us women with artificial hormones and stop ovulation in its tracks and place us in a state just like menopause? Why would we do this to our bodies when there is another option that is just as effective at preventing pregnancy – without the long term consequences?
Once you can get over the initial fear of coming off the pill, or stopping whatever hormonal method of birth control you’ve become dependent on, you will notice these bonus, special unexpected gifts that go alongside this change. Not only will you get your sex drive back, you might not even have realised it was missing or lacking in the first place. But you’ll feel more like yourself. Some women describe a new kind of mental clarity, feeling more in tune with themselves and their bodies, improved moods, more physical energy. These are all things most women didn’t even realise the pill was affecting in the first place! And if you’re taking hormones out of fear, it’s time to let go of that fear.
If you want to learn more about getting started with your fertility journey, I have a brand new freebie for you – my fertility roadmap! This is my super simple 3 step system to understanding your body’s natural fertile signs and pinpointing ovulation day so that you can use this knowledge to achieve (or avoid) pregnancy. If you want to say goodbye to hormonal contraceptives and the potential effects that we’ve talked about today, or if you’re ready for pregnancy and you want to improve your chances of conceiving quickly and naturally, then head over to fertilityco.com.au/roadmap, check out my beautiful new new website and get your hands on this roadmap, because this knowledge is truly life-changing.
To wrap up today, I want to recap the 5 steps to coming off the pill.
You can get today’s show notes with everything I talked about in this episode, as well as links to freebies and other related episodes at fertilityco.com.au/20
If you learnt something new or found value in today’s episode, I’d love to hear from you! Send me an Instagram DM and let me know where you’re at in your fertility journey. If you need some advice, or even a pep talk about taking the plunge, I’m always happy for a chat. And of course, please let me know what you want me to talk about on upcoming episodes.
I will see you next week, where I’m sharing why now, in February, is the very best time to really start working on your new year’s resolutions. There’s a reason for this, I promise, and I’ll be sharing it with you next week.
Ok, bye for now and don’t forget that knowledge is power!
When you truly understand your body, you are empowered to make informed decisions and take control of your health!
Until next time.
Want to say goodbye to hormonal contraceptives and their weird and unpleasant side effects?
Want to improve your chances of conceiving quickly and naturally?
You need my Fertility Roadmap – My simple 3-step system to understanding your body’s natural fertile signs and pinpointing ovulation day so that you can use this knowledge to achieve (or avoid) pregnancy.
Episode 19 – Coming Off The Pill (Part I)
Does your pelvic floor need a little extra TLC? Take the Pelvic Floor Quiz and find out how to start strengthening your pelvic floor today!
Want to make sure you’re exercising safely during your pregnancy? Get your Free Guide: 10 Exercises to Avoid During Pregnancy.
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I'm obsessed with all things periods, pregnancy, pelvic floor and helping women just like you to navigate all of life's major milestones!
I'm a physiotherapist and natural fertility educator and my passion is teaching women how to take control of their health.