Alexandra Paetow MS, RD, CDN

Registered Dietitian and Postpartum Nutritionist

There are many reasons why you might be contemplating the transition off of hormonal birth control. Maybe you have been struggling with symptoms, are hoping to prepare your body for pregnancy, or would like to take a more holistic approach.

The fascinating thing about nutrition is that whether you are on hormonal birth control or not, there is so much value that nourishing foods can provide the body. In the transition away from hormonal birth control some of the considerations we want to be thinking about are repleting your body with nutrients, supporting gut health, and nurturing mood balance. See this article for more details on how and why it’s helpful to dial in on these pieces.

When we think about the menstrual cycle overall and beginning to have a natural cycle, versus one that is hormonally regulated, there are some helpful tips to keep in mind to reduce symptoms and ensure optimal nourishment. So here we are going to focus on ways to support your natural cycle through the power of intentional nutrition.

First let’s talk about the different phases of the menstrual cycle. It can be divided into 4 phases: menstrual, follicular, ovulatory, and luteal.

1. Menstrual phase

The menstrual phase is the time of menstruation, or your period, and is the official start of a new cycle. Nutrition can be a valuable way to support your body during your period.

Focus on the following during the menstrual phase:
Iron: Since blood loss is the hallmark of the menstrual phase, one of the most important nutritional considerations is to eat enough iron to replace losses. This is important because iron-deficiency can lead to a host of unpleasant symptoms such as fatigue, weakness, headaches, brittle nails and hair loss.
Delicious ways to add some iron:

Toss beans into your salad
Mix ground beef into your pasta sauce
Snack on Double Chocolate Chip Cookies made with iron-rich cocoa powder.

Omega 3s: Another common occurrence during the menstrual phase is cramps. The painful cramps are caused by prostaglandins which play a role in inflammation. Some studies have shown that fish oil supplements which provide concentrated sources of omega 3 fatty acids DHA and EPA have been beneficial in reducing painful cramps during the menstrual cycle1.
Delicious ways to add some omega 3s:

Try sardines as a topping for your avocado toast
Enjoy some sushi takeout featuring salmon
Load some seedy crackers with smoked oysters

2. Follicular phase

The follicular phase is the first half of the cycle that leads up to ovulation. As the body prepares to release an egg hormone levels rise.

Focus on the following during the follicular phase:
Magnesium: Blood levels of magnesium are lowest during the follicular phase so it might be helpful to nurture this mineral a bit more at this point in your cycle.2 Magnesium may play a role in symptoms like headaches, constipation, sleep disruptions, muscle aches, and water retention.
Delicious ways to add some magnesium:

Sprinkle some Cinnamon Maca Seasoning in your yogurt
Snack on some salted edamame
Toss some spinach into your lunch wrap

Fiber: Supporting digestion is important throughout the whole cycle but may be particularly helpful in the follicular phase. Fiber helps support regular bowel movements which eliminate excess estrogen. Healthy elimination is an important way for the body to maintain optimal estrogen levels which rise during the follicular phase.3
Delicious ways to add some fiber:

Try out chia pudding with raspberries for a meal prep breakfast
Use wheat bran as a breading for crispy fish
Try eating the skins of fruits and veggies like pears, apples, and potatoes

3. Ovulatory phase

Since the ovulatory phase coincides with the peaking of hormones such as estrogen and testosterone, many experience a similar peak in energy levels and libido. Focus your nutrition on staying fueled especially if you increase intensity or frequency in your physical activity.

Focus on the following during the ovulatory phase:
Fats: Fat-containing foods provide more concentrated energy sources to keep you energized for longer.
Delicious ways to add some fats:

Stir in almond butter to your overnight oats
Drizzle a tahini sauce over your roasted veggies
Dip your chips into some guacamole

Carbohydrates: Carbs are broken down into the body’s primary energy source, glucose. Eating consistent meals throughout the day that contain carbs allow for a stable flow of energy.
Delicious ways to add some carbs:

Eat some berries alongside your scrambled eggs
Munch on some Oatmeal Chocolate Chip Cookies for a sweet side to lunch
Add some potatoes to your meat and veggie sheet pan meal

4. Luteal phase

The luteal phase is marked by the time between ovulation and the menstrual phase and typically lasts about 2 weeks. One of the characteristics of the luteal phase that up to 75% of women may experience is PMS or premenstrual syndrome which includes symptoms such as mood changes, headaches, muscle aches, sleep disturbances, bloating, and fatigue.4

There are some nutrients that have been shown to help with symptoms.
Focus on the following during the luteal phase:
Calcium & Vitamin D: Women who experience PMS symptoms may have lower levels of calcium and vitamin D levels in the blood. Studies have shown that consuming more calcium and vitamin D in the diet can be protective against symptoms.5
Delicious ways to add some calcium & Vitamin D:

Use milk as a liquid base for your smoothies
Sprinkle Sesame Nori Seasoning on tuna salad
Layer in some cheese to your morning omelet

Chasteberry: Herbal supplements are another way to support the body through PMS symptoms. Research has shown chasteberry to be effective in reducing symptoms such as irritability and bloating possibly by promoting more balanced hormone levels.6
Delicious ways to add Chasteberry:
Try a soothing cup of Peppermint Chasteberry Tea with

Some dark chocolate
A relaxing bath
Your morning muesli

Transitioning off of hormonal birth control can be filled with uncertainty, adjustment, and challenges with symptoms. It can also be an empowering way to regain connection and attunement with the body. Integrating your nutrition in a way that supports your natural cycle can be a valuable way to support your body through the transition and beyond.

Sources:

Zafari M, Behmanesh F, Agha Mohammadi A. Comparison of the effect of fish oil and ibuprofen on treatment of severe pain in primary dysmenorrhea. Caspian J Intern Med. 2011;2(3):279-282.
Dullo P, Vedi N. Changes in serum calcium, magnesium and inorganic phosphorus levels during different phases of the menstrual cycle. J Hum Reprod Sci. 2008;1(2):77-80. doi:10.4103/0974-1208.44115
Rose DP, Goldman M, Connolly JM, Strong LE. High-fiber diet reduces serum estrogen concentrations in premenopausal women. Am J Clin Nutr. 1991;54(3):520-525. doi:10.1093/ajcn/54.3.520
Steiner M. Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. J Psychiatry Neurosci. 2000;25(5):459-468.
Bertone-Johnson ER, Hankinson SE, Bendich A, Johnson SR, Willett WC, Manson JE. Calcium and vitamin D intake and risk of incident premenstrual syndrome. Arch Intern Med. 2005;165(11):1246-1252. doi:10.1001/archinte.165.11.1246
Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ. 2001;322(7279):134-137. doi:10.1136/bmj.322.7279.134