For your skin, you can take spironolactone— it’s a much lower dose estrogen, so it won’t have as many symptoms (at least in my experience).
But also, your menstrual cycle, and your skin, will have changed over the past five years— if you want to go off birth control, you may find being off it feels better on your body.
I went off birth control 3 years ago, and my periods are more regulated now, and my body feels better. Some practical tips:
Keep a journal/track your cycle as you go off it, and remember it will take a few months for your body to regulate its own cycles again.
Be generous with yourself— you and your body are on the same team, and if you get crampy or cranky or period anxious, that’s your body communicating with you.
For the first few cycles, really plan your week around your period: I use my period as a week of rest, and now I look forward to it. I skip exercise classes, I eat iron rich foods, I go to bed early and I hang out with my girlfriends.
Think of your period as your body “wintering”; a season of rest and dormancy so that you’re reenergised for the rest of your cycle.
If you notice a change in your skin, you can start by using clindamycin topically— it’s a low dose antibiotic, and it will help stop breakouts from spreading. You can also try a retinol and a good moisturise.