What to expect after you stop taking birth control

What happens when you stop hormonal birth control after multi-year use?

In the U.S. nearly two-thirds of women of reproductive age regularly use birth control to prevent pregnancy. Oral contraceptives are the most commmon method of birth control aside from sterilization. On any given day, roughly 10 million American women use birth control pills. Many women start taking the pill as teenagers and continue for years or even decades.

After using hormonal birth control for an extended time period, some women wonder what might happen to their bodies once they stop. When initiating birth control, it can take 3-6 months for the body to adapt and for homone levles to recalibrate. It is fair to ask then, if going off the pill results in a similarly long adjustment period?

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Birth control hormones leave the body quickly

It takes only 3-6 days for the hormones in birth control pills, patches or rings to clear out of the body. The only exception is birth control injections, which are intended to last up to three months. This saves you the trouble of having to take a pill every day, but it also means that after your last shot, it will take at least three to six months to clear the injected hormones out of your system.

Is it possible to get pregnant right away after you stop birth control?

Indeed, unprotected intercourse may lead to pregnancy only a day or two after you stop using birth control. Statistically, the risk is low, but probably not one you want to take. You should definitely be aware that without the protection of birth control, hormones levels will quickly return to baseline, as will your fertility. Therefore, If you are not planning on becoming pregnant, consider using another form of protection, such as condoms.

Some women will find that their bodies will take longer to get back into a natural cycle, and may take several months to return to baseline. It is not possible to know exactly when you resume ovulation, without serial bloodwork to monitor hormone levels. Be patient, but also be aware that it could happen after a few days or a few months.

How will my period be affected?

The effect of discontinuing birth control on your menstrual cycle is similar to the effect on fertility and ovulation. It differs from woman to woman. It may take a few weeks or several months for your period to return to a predictable pattern. This is because your body’s hormone levels need time to adjust. During this adjustment period, spotting and irregularities (such light or heavy menstrual periods) can happen, and timing can be irregular.

After about 3-4 months, your menstrual cycle should normalize. If you continue to experience irregularities, or do not menstruate for over 3-4 months after stopping birth control pills, it’s best to schedule an appointment with your gynecologist or primary MD. There could be other factors impacting your menstrual cycle.

Keep in mind that after using birth control for several years, your period may be different from how you remember it when you were younger. Even without use of birth control, menstrual timing, blood volume, and any side effects you recall (migraines, aches, nausea, etc.) can change with age.

Will stopping the pill affect the way I look?

This is a popular topic among women, who after taking birth control for several years, are thinking about stopping. While there can be some visible effects, most often, there will not be any changes that people other than yourself will notice. The most common effect of stopping birth control is gradual weight loss for the first few months. When first starting birth control, you may gain a few pounds. Therefore, when discontinuing birth control you may lose a few. Changes in weight can however, be offset by modifying eating habits.

Accompanying weight loss, your breast size may decrease. Some women also will notice changes in their hair volume. Thinning or thickening can occur, although hair loss is more common. Birth control can increase hair generation, so once you stop taking it, your hair growth goes back to its natural pace.

Vitamin D levels will also be affected

One positive side effect of hormonal birth control is that it improves Vitamin D absorption and retention. Therefore, after you stop taking birth control pills, your Vitamin D levels may decrease. Your doctor can measure this with a simple blood test and may advise you to take Vitamin D supplements. Low levels of vitamin D can lead to osteoporosis and weaken your immune system. Also, adequate levels of vitamin D are especially important for a healthy pregnancy. If you plan on getting pregnant (one of the main reasons to stop birth control), it’s worth getting your Vitamin D levels checked out.

References:

Wright, Kristen Page, and Julia V Johnson. “Evaluation of Extended and Continuous Use Oral Contraceptives.” Therapeutics and Clinical Risk Management, vol. 4, no. 5, 2008, pp. 905–11, www.ncbi.nlm.nih.gov/pmc/articles/PMC2621397/. Accessed 16 Jun. 2020.
Frost, Jennifer J., and Laura D. Lindberg. “Trends in Receipt of Contraceptive Services: Young Women in the U.S., 2002–2015.” American Journal of Preventive Medicine, vol. 56, no. 3, Mar. 2019, pp. 343–351, 10.1016/j.amepre.2018.10.018. Accessed 16 Jun. 2020.
Westhoff, Carolyn L., et al. “Oral Contraceptive Discontinuation: Do Side Effects Matter?” American Journal of Obstetrics and Gynecology, vol. 196, no. 4, Apr. 2007, pp. 412.e1-412.e7, www.ncbi.nlm.nih.gov/pmc/articles/PMC1903378/, 10.1016/j.ajog.2006.12.015. Accessed 16 Jun. 2020.
Wright, Kristen Page, and Julia V Johnson. “Evaluation of Extended and Continuous Use Oral Contraceptives.” Therapeutics and Clinical Risk Management, vol. 4, no. 5, pp. 905–11, www.ncbi.nlm.nih.gov/pmc/articles/PMC2621397/. Accessed 16 Jun. 2020.