Coming Off the Pill After Long-Term Use (Episode 490)

Full Transcript: Episode 490

Lisa: Today I’m sharing another brand new episode in my FAM reality series. I’m joined by Alayna, who was a member of my most recent Fertility Awareness Mastery Live group coaching program. Alayna shares her experience on the pill, which was actually relatively positive overall. She didn’t have major side effects while using it for over 15 years — but her story is full of nuance and important takeaways.

Lisa: Alayna, welcome. Let’s start with your first period — how old were you, and what were your early cycles like?

Alayna: I was about 12 or 13. I got it in middle school — I remember it happening at school, in the bathroom, and one of my best friends had to help me. It was a whole thing. I don’t remember much about my early periods, but when I got to high school, I started getting really bad cramps. That’s when I went on birth control — I was about 15.

Alayna: My doctor said it would help reduce the cramps and regulate my cycle. There wasn’t much conversation beyond that, and since my mom had been on the pill too, it felt normal. I stayed on it for 16 years without a break.

Alayna: Later in college, I started experiencing more cramping again. My OB told me I could just skip the sugar pills and not have a withdrawal bleed. I did that for a while — even went a full year without a bleed. But I started having odd cramps and infections. Eventually, I was told to bleed every few months to manage symptoms.

Alayna: Over time, I started feeling really lethargic. I had low libido, recurring yeast infections, low energy — just a bunch of small symptoms that added up. I found Dr. Brighten’s book, your book, and podcasts — and it all made sense. I wondered if the pill could be causing these issues.

Alayna: I decided to come off the pill and see. I was already doing B12 injections, vitamin D, acupuncture, chiropractic — all the things. And nothing was helping. So I figured, why not try this?

Lisa: After coming off, did you notice any improvements?

Alayna: A little. My B12 levels actually started going up, which hadn’t happened even with injections before. But the fatigue and low libido persisted. My vitamin D didn’t move much either. One new symptom was acne — which I hadn’t had since before the pill.

Lisa: You mentioned ongoing itching — did you ever get clarity on that?

Alayna: Yes and no. I was having vaginal itching but no yeast infection, technically. My doctor gave me multiple treatments, but nothing helped. I finally did a microbiome test and it came back with 100% good bacteria. That led me down the rabbit hole of something called cytolytic vaginosis — which is supposedly caused by too much good bacteria. But there’s so little information out there.

Lisa: Did you use soap to clean your vulva?

Alayna: I did — not every day, but occasionally.

Lisa: That might have contributed. Soap can disrupt vaginal flora. The pill also plays a role. I’m glad you’ve since stopped — it’s a small change that can make a big difference.

Alayna: I’ve definitely cut out probiotics too, per the cytolytic vaginosis research, but I’m still eating yogurt and fermented foods. It’s tricky — I get so many mixed messages.

Lisa: It can be helpful to reevaluate and focus on basics. And vaginal steaming is an option some women try with anecdotal success for microbiome balance — if you’re open to it.

Alayna: I haven’t tried that yet, but I’m open. Just haven’t felt it matched my situation.

Lisa: Going back to pain — before the pill, your cramps were intense. Did you notice a difference after coming off?

Alayna: Yes. I think my diet made a big difference. I cleaned up my eating habits over the last two years — less processed food and sugar. And my withdrawal bleeds became lighter even before I stopped the pill. Now, the periods are heavier again, but the pain is more manageable. I rarely take ibuprofen now — maybe once per period.

Lisa: That’s great to hear. Let’s talk about charting. What’s your experience been like learning to chart after coming off?

Alayna: It was slow at first. I had long cycles with barely any cervical mucus. It felt discouraging, but I knew it was normal post-pill. I’ve now seen some mucus and had a more typical cycle, and that boosted my confidence. I’m still using protection for now, but I feel more empowered and motivated.

Lisa: That’s a big step. What was your partner’s reaction?

Alayna: He’s been super supportive. He saw all the side effects I was dealing with and was fully on board. We agreed to use condoms for now, and that it’s temporary. He trusts me to do the research and take it seriously.

Lisa: For those listening who might be nervous about coming off the pill, what would you say?

Alayna: If you’re having symptoms, it’s worth seeing if the pill is part of the issue. Just remember that the transition is temporary. The class helped me stay accountable and confident — and seeing others’ charts and hearing their stories really made a difference.

Lisa: Thank you so much for sharing your journey, Alayna. I think it will resonate with so many women.

Alayna: Thank you — for the class and all the resources. They’ve helped me so much.

Lisa: And that’s a wrap on today’s episode.