It has now been one full year that I’ve been off birth control, and about seven months since my last (and first!) post about it. A lot has happened since, and this ride has been one of my most trying yet. I’ve experienced a lot of ups and downs since I made this decision. I feel that there is so much misinformation out there about the pill and what can happen when you go off it, how it relates to your fertility and body chemistry, and if my experience can help anyone else out there, I want to share that. For a long time, I felt like the only one going through this, and no woman should feel that way about what happens with her body. So, here’s what has been going on with me. The good, the bad, the gross, the exciting and the frustrating. Be warned.
*I am not a doctor, and this is not medical advice. What happened to me may not necessarily happen to you.
As a refresher, ICYMI, I was on the pill for almost 10 years, and in addition to that, I also had been on spironolactone (or “spiro,” an acne pill) for at least five years as well. Last summer, I stopped taking both pills at the same time to prepare my body for TTC and to lead a more natural lifestyle. I was going in pretty blind. I had heard that upon stopping the pill, it might take a few months for your cycle to regulate and your body to adjust, but I figured it’d be a breeze since most women are adjusted within just a few months.
Nope. The first several months, I experienced crazy cycles, cramping and PMS, acne all over my body, really oily skin, weight loss, increased libido, hormone fluctuations that made me an emotional hot mess, becoming obsessive about needing a baby like yesterday and reading everything about fertility. Still, I figured a few more months would solve it all and I’d be good to go in no time. Still wrong. Twelve months later, I am STILL struggling. Some things have gotten better, some have gotten worse and some entirely new things have come up.
I almost don’t even know where to start. There has just been so much since that last post. Let’s start with where I left off, I suppose.
What’s Happened Since
My emotions have leveled out for the most part. I still have typical PMS and regular hormone fluctuations based on my cycle, but nothing extreme and drastic like in those first few months where I was a hot mess most of the time. My libido has also leveled out and seems to ebb and flow with my cycle as well (no pun intended).
My cycle has still been erratic, though for the past four-ish months, it’s been consistent. I started having a full week of spotting followed by a full week period, so it felt like I was essentially having a two-week period, which is no fun at all. In the month of March and April both, I was bleeding more often than I was not bleeding.
Where Have All the Hair Strands Gone?
Around the same time I noticed the new normal (which was not normal at all) with my cycle, I started noticing hair loss. Like, really noticeable. Larger amounts were forming in the shower drain and it seemed I was constantly picking loose hairs off my shirt. Every time I’d brush or comb, a lot would come out. Not in clumps or spots, just all over, a ton of strands were always falling out. Much more than I’ve ever seen before. And then I realized that my hair mass was a lot smaller than it used to be. My ponytail suddenly seemed so teeny, and when my hair was down, it was almost transparent. There was just nothing to it! When I went to my hairstylist for a routine trim, she commented on it as well. In fact, she said that it seemed like my hair was still thick at the base of my head, but the farther out, the less there was. She was perplexed, and together we brainstormed everything that could be causing it. She suggested I eat more protein, do less heat styling, not wear scarves and see my family doctor. Neither of us once ever suspected it could related to that damn birth control pill.
Acne’s Back, All Right!
Meanwhile, my acne and oily skin was getting worse by the month. It was getting so bad that it felt reminiscent of my early teenage days, and I was really self-conscious about it. It was starting to affect my self-esteem big time. I tried a few natural acne solutions, and they were no longer cutting it. I couldn’t take it anymore and decided to go back to the dermatologist and beg for help. I was hoping for another medication that would be less aggressive and harmful for potential babies than spiro was since we were still not preventing (aka playing baby roulette). I tried one topical cream, but it did nothing at all, so finally I just went back on spiro. I agreed to stop taking it immediately if I became pregnant, but I just couldn’t do this acne anymore and was desperate. I was a little sad to be back on prescription pills, but least it wasn’t birth control again. What can you do.
A few months into being back on spiro, I’m thankfully seeing some moderate results. The oilyness is gone again and the random ass zits are gone again. I do have mild breakouts around my period, but it’s far better than it had been when I was off everything. The doc mentioned it probably wouldn’t be as good as before, since the previous combination of both birth control and spiro together is what really did wonders for my skin. Womp womp.
No Babies, No No No No No Babies
This whole time, also, no babies happened. I know that weren’t officially “trying” for one yet, but because I was off the pill and had made lots of lifestyle changes to boost my fertility and health in general, I honestly had thought that by now I would have become pregnant anyway. The timing had certainly been right for it a few times. I was perplexed why it hadn’t happened, and then started to become worried. My mom had told me that our family is very fertile and women conceive easily, so what was my problem? I tried to shrug it off since we hadn’t been trying too terribly hard yet, but it still weighed on my mind.
A couple months ago, I suddenly realized I was coming in hot on my 12 months off the pill and realized that by then, things should be remarkably better than they were. Each month should be getting easier, not harder. The combination of all these problems suddenly started to come together in my mind. The weird cycles, more zits, hair loss, weight loss and lack of baby in my belly hit me hard. Until then, I kept thinking they were all separate problems needing separate solutions, but then it dawned on me that I needed a doctor’s help…and my prime suspect as the root problem was that birth control pill. I promptly made an appointment with my ob-gyn and family doctor right away, not sure which would be best to start with.
Doctor, Please Help Me!
The first one was with my ob-gyn. Being the over planner I am, I printed out a calendar of the past year and marked every period, each day of spotting and any other weird symptoms related to my lady bits I could think of that might help the doc help me. After going over my symptoms and concerns with her, she explained that it most likely was all related (including the hair loss, weight loss and acne) to being on the pill for so long then going off. She also explained that spiro is known to cause irregular cycles, especially when used without the pill in conjunction (since the pill regulates cycles), and that it is an adrogen blocker (meaning it messes with my hormones and has something to do with testosterone), so receiving 10 years of synthetic hormones via birth control, combined with spiro, and then going off both at the same time, essentially shocked my body because of the drastic change in hormones. Most women’s bodies are able to start producing natural hormones again shortly after going off the pill, but my body wasn’t able to do it probably because of the length of time I was on both pills together so it was in freak-out mode because it didn’t know what to do.
She also suspected I may have PCOS, which would further explain all my issues. I didn’t fit the typical PCOS profile since I’m not overweight, but it would explain all the other symptoms and would offer some answers at least. At the very least, doc said it could just be a basic hormone imbalance that a few pills could fix. She also suspected thyroid problems (especially since my mom has had hypothyroidism for decades) as another cause. She seemed confident that there was a logical reason and solution and that some blood tests would tell the real story. Once we had those results, she’d call me to tell me what to do from here. I was actually starting to feel excited and hopeful that these tests would provide answers, and that I’d soon be on the road to normality. Even though PCOS was a suspect, and PCOS sucks for fertility, at least we’d know what to do to work around it. I felt like this would be good news, and I expected to find out that was indeed the reason my body wasn’t able to be normal again after so long off the pill.
And so I was sent to the lab for a blood test. Four vials later and a multitude of tests later, the results came in. And they were … 100% normal. Everything was exactly where it should be and from the tests alone, I looked to be normal and the pillar of health. Nothing was wrong with me whatsoever according to the blood.
…But then why was I still so effed up? This didn’t make any sense. I was shocked at these results and my doctor was perplexed. She felt confident from the blood tests that I definitely did not have PCOS, or any kind of hormone or thyroid imbalance. Basically, this meant there was no reason that we could tell was causing my problems besides the basic reason of my body simply could not adjust to not being on birth control. I could go back on it to be “normal” again, but that kind of prevents the ability to make a baby, and with how much this pill has messed me up, it’s the last thing I would ever want to be on again.
So what would we do? Well, she said that even though all the issues are related, we’d have to treat them all individually and just hope and pray that would do the trick. She prescribed me a three-month treatment plan of a pill called prometrium. This would serve to regulate my cycles again and hopefully help me ovulate again since I likely wasn’t before. From what I’ve gathered online, prometrium is a bioidentical form of progesterone only. This means it’s makeup is the same as the progesterone hormone that the body makes itself, as opposed to the synthetic form delivered in combination birth control pills. And even though my natural progesterone levels were fine, the extra boost would essentially kick-start my cycles into regularity. Doc assured me that I could still safely become pregnant while on this pill.
I researched side effects of it and started to become worried. I found a lot of horror stories of what prometrium had done to other women. But I knew I had to do it, and so I took my first dose June 1 and hoped for the best. Thankfully the only side effect I did experience was it made me really tired (which is the most common side effect, which is why it’s always prescribed to be taken just before bedtime). Fifteen minutes after popping my pills, I am out cold, but I still wake up just fine. Phew. The first month on prometrium went by the book. It was a relief. The second month didn’t go as well. It almost was like I wasn’t on it at all because I was back to a week of spotting before my period started, which is what that pill is NOT supposed to let happen. I called my doc in a panic of course, and she said maybe the first month’s dose did the trick and the second dose wasn’t necessary, so as my body was finally started to regulate, it now couldn’t because I was still delivering extra progesterone to it. She said to finish the second course but not proceed with the third one. That brings us to the present.
But, I got ahead of myself. Let’s backtrack to what else happened in between receiving the blood tests results and starting prometrium.
The Other Doctors
When I went the family doctor shortly after the ob-gyn, she agreed 100% that all of these symptoms were pill related. Further, she suspected that the hair loss was my body’s response to the change in hormones and it shed as a way to protect itself (or something like that.) She referred me to another dermatologist to help determine if my hair will ever come back to what it used to be.
She also said she was pretty sure I wasn’t anemic, but that if I was, it could play a role in all this too, so she ordered more blood tests to check my iron, hemoglobin and lipid levels. All came back totally normal. She recommended I start taking a hair, skin & nails supplement to assist in hair regrowth and to eat a ton of fruits and veggies in a wide range of colors to make sure I receive good nutrition to also help. Thank God it’s farmer’s market season now so I can stock up!
At the dermatologist appointment to discuss my hair, that doctor assured me that I have tons of new growth coming in, which is why my hair felt so thick at my roots, but so thin at the ends. This is good news, since now all I have to do is wait for that new growth to come down. In the meantime, I decided to get a haircut (I went with a just-above-the-shoulders bob) to try and hide the drastic difference in thickness as I wait for those roots to catch up with my ends. It’s still visible, though a little bit less so, but I’m still pretty self-conscious about it so I wear my hair up most days, and when it is down, I’m constantly sweeping it all to one side to hide how thin it is.
Oh hey, I got ahead of myself yet again. I need to backtrack again, this time to the meltdown I had right after receiving all my blood test results.
The Emotional Breakdowns & Fear of Infertility
My friends kept telling me that it was a good thing all my tests were normal, since it meant nothing was wrong with me. I know that logically that’s a good thing, but I could not shake that it was a bad thing. To me, it was bad news. I wanted to have a specific problem so we knew how to fix it! How can you fix what you don’t know is broken?! I actually wanted to get a PCOS diagnosis so we would know exactly how to work around it. I felt like now were going to wing it, and I couldn’t hope for the best without knowing the exact problem.
I had the sinking feeling I was falling into the dreaded category of unexplained infertility.
I spiraled. Without conclusive answers from those tests, I started to overanalyze every symptom and fear that because my periods were irregular, it meant that I wasn’t ovulating, which meant I would never be able to have a baby.
For 15 years, I swore I didn’t want kids anyway. But once I was a married lady, everything changed and baby fever hit me like a freight train. It became all I wanted and dreamed of. Now the fear that it could not even be a possibility rocked me. I was devastated and I felt like I was spiraling into despair and panic.
I felt broken. I felt like a failure.
I became bitter and angry and an emotional hot mess. I blamed the pill for effing me up. I blamed my doctors for not being able to fix me and for not telling me how much the pill would mess me up. I blamed myself for not researching more about sooner and for taking that effing pill in the first place 10 years ago.
Thankfully a few days into my spiral, I had an appointment to see my therapist, and I broke down to her. I gave her the rundown of everything that had happened and my fears. She was sympathetic and talked me off the ledge. She explained that getting those results was a trigger moment for me, and my emotional response to it was fight-or-flight. Apparently when the brain experiences a trigger moment, a switch flips into a natural fight-or-flight response as a way to protect itself. I was running purely off of anxiety and stress from the situation. She explained that even though this was a natural response, there was a way to get my brain off of its irrational thinking and turn it into logical thinking.
We walked through every single symptom and emotion around it. Every fear, every event. We broke down, one by one, what it could mean and what I would do about it if it were reality. Slowly, throughout that session, I calmed down. Slowly, I began to see that I could handle this. It was not the end, and I didn’t have to roll over and die. I just had to think through it logically. It felt like a GIANT weight had been lifted off my shoulders, and I broke down again, but this time, in relief.
Peanut Butter, Baby Time?
Ironically, not long after that therapy appointment, new bizarre things started happening to my body. Like, pregnancy symptom things. At first I just thought it was more stuff related to all these other problems, and it was my body still adjusting off of the pill. But these symptoms were different than before, and they kept morphing. I knew this was different. For the first time in many months, I did not have the typical spotting before my period, which was due like now. My boobs were tender. My lady bits felt weird. I was emotional, but not in the hot mess way like before. Like in the crying at random commercials on TV kind of way. I was starving but no food was appealing and I couldn’t keep more than a few bites of anything down. I wanted to eat but everything made me gag. I peed a lot. My cat was snuggling me at every possible second like she never had before.
I had the gut feeling a baby was forming in there. I took a test. Negative. Damn. I took to the Internet and Googled everything under the sun. I spent hours upon hours learning everything there was to know about the earliest pregnancy symptoms and process. I realized that if I was (and the timing was right this month), it would still be too early for my hcg levels to register on a test, so these could be false negatives. I became hopeful, and then I became obsessive. Literally, every single thing that happened in my body I Googled if it was a pregnancy symptom. Multiple times a day. I hiccuped, but only once? Pregnancy. Obviously.
I started thinking of baby names and how we could decorate a nursery. I planned out exactly how I would announce the news to Cal and then to everyone else. I figured out my due date. All I had to do first was wait for that positive. So I waited. And waited. And waited. And tested and tested and tested, Negative, negative, negative. By this point, I was 14 days post ovulation, and I should have been showing on a test.
I started worrying that I could have lost it early on. I did take a hot bath earlier in the week. Could that have done it in? What about the deep clean I gave the bathroom days prior? Or changing the cat litter? Surely cleaning materials and kitty pee would be bad for a forming baby. More Googling told me that it’s entirely possible for an egg to be fertilized, travel to the uterine lining and take several days to implant before actual pregnancy has occurred, and that you can experience symptoms that early too. That fertilized egg can try to implant for like a week before it gives up, and if it doesn’t take, then it’s over. It’s not technically a pregnancy yet until implantation has occurred, therefore it also is not technically a miscarriage either. It’s just something that could have been but wasn’t. It wasn’t viable, and the body knows that early enough to prevent implantation. Fascinating, right?!
Also, it could have been nothing at all. But in my heart I don’t think it was. My new symptoms started slowly fading away, I never did get a positive, and eventually bitchy Aunt Flo came to visit. Damn.
Turns out, this probably happens to tons of women all the time, but most of the time, they don’t even know it. The very earliest pregnancy symptoms can be mistaken for PMS, and sometimes they go unrecognized completely, especially for busy women that just aren’t paying attention. Because I had become so finely tuned in to my body for the sake of tracking related to my medical concerns, I noticed the smallest variations in my body right away.
I’ll never know for sure what happened during those two weeks, and even though my heart become set on being pregnant, I actually felt a peace about realizing I wasn’t. I was surprised I wasn’t more crushed about it. I was, a little bit, at first, but then I came to accept it. In fact, I viewed this as a good thing. If it was that implantation failed, that means I do indeed ovulate, and that it IS possible to become pregnant, which is actually a giant victory. Even though this one could have failed, future ones may not. And when I told Cal what had transpired, it was one of the best things for our marriage yet because it made us closer and made us both realize that maybe we were more ready for a baby than we first thought we were. I was happy. It was good.
Where am I now? Well, I recently finished the second round of prometrium and will not be starting a third. We are hoping that my cycle is fixed from the dose already. I feel much more level-headed after the roller coaster highs and lows of the past couple months and feel like I can talk myself logically through anything else that might come my way. I am trusting in my doctors, in fate and the plan and hoping for the best. It helped that I had my high school reunion to pull off, which served as a distraction from all of this. Now that that’s over, I also have a new job to focus on and a house to save for.
As for a baby, we’re still not trying yet, but not preventing, and I’m trying to not become obsessive again about one. I’m trying to trust that it will happen when it’s meant to, as well as that my medical issues will sort themselves out as they need to.
Here’s to hoping that the second year of being off the pill goes better than the first. I got this. I hope.