This article was last updated May 25, 2022. Show
About five years ago, I decided to stop taking the hormonal birth control I’d been on for a decade. I’d taken many different pills — from Ortho Tri-Cyclen to Apri (which I dubbed the “monster pill” for my mood swings) and finally to Tri-Sprintec. I’d done my fair share of experimentation and I wanted to know: What does my body feel like on its own, without the birth control? How’s my mood? My sex drive? What’s my period like? My cramps? I tried to think back to life before the pill — what were my periods like then? But the truth was, I had no idea. I’d been on birth control for about as long as I’d had a period. And that’s true for a lot of us, as the pill is often prescribed for pregnancy prevention, heavy or irregular bleeding, cramps, acne, mood swings, and headaches before we even know our bodies very well. According to the Guttmacher Institute, 4 out of 5 sexually active women have used the pill at some point in their lifetimes. Whatever your reasons are for stopping hormonal birth control — and whether you're on the pill, the hormonal intrauterine device (IUD), ring, patch, shot, or any other hormonal BC — we're here to answer the following questions for you:
What is hormonal birth control, anyway?When we say hormonal birth control, we’re talking about contraceptives that use synthetic hormones to prevent pregnancy. (Other birth control methods like condoms and spermicide don't fall into this category.) Here's how hormonal birth control works to prevent pregnancy:
Why do people quit birth control?Aside from trying to get pregnant, some women stop taking hormonal contraception because of how it makes them feel. It’s not uncommon for people to mention changes in their sex drive and their mood when taking hormonal birth control. It’s difficult to say whether those changes are due to birth control or other external factors that can impact mental health (work, relationships, family, etc.). If you’re experiencing any of these side effects, quitting hormonal birth control might provide you with relief. What happens when you stop taking birth control?When you go off hormonal birth control, you might feel or notice some changes in your body — but those aren’t “side effects” as we typically think of them. Rather, your body and reproductive system are transitioning back to their pre-birth control state. Dr. Jane van Dis, MD, FACOG, OB-GYN and member of our medical advisory board, explains: "If you're going off birth control, expect that some of those experiences and side effects you had before you went on will come back." Some of these changes — like weight gain or weight loss while on birth control — can especially affect your menstrual cycle after stopping. The post-BC changes you’ll experience (if any) vary from person to person, but here’s some of what you might expect after stopping birth control: 1. The “adjustment” period: For most people who quit taking birth control with estrogen and progestin (97%, Dr. van Dis says), your ovaries and menstrual cycle will return to “normal” within 90 days — whatever that looked like for you before starting birth control.
The length of time you’ve spent on birth control will not affect this 90-day time frame, Dr. van Dis explains, since most of the medications clear from your system in 48 hours.
Finally, you don't need to do a cleanse after stopping birth control. 2. Headaches: Some people experience menstrual migraines around day 14 of their menstrual cycles, Dr. van Dis says. “For those people, their brain experiences the downslope of estrogen as a migraine, so if they’ve been on birth control to manage headaches, they might come back.” That’s because some birth control pills have a small amount of estrogen in the “sugar pill week” (aka the week of placebo pills), which helped to keep those headaches at bay. 3. Weight changes: Weight gain or weight loss post-BC isn't likely, unless you're specifically coming off the Depo-Provera shot. "Depo-Provera is the only means of birth control that we know can cause weight gain," Dr. van Dis explained, because the shot is linked to increased appetite. Transitioning off of this specific birth control could result in weight loss. 4. Acne: If hormonal birth control cleared up your acne, then it's likely your skin will break out again after stopping. “Birth control helps to decrease the amount of circulating testosterone in your body,” Dr. van Dis says, which treats acne cysts. So once those synthetic hormones are out of your system, you might expect some skin problems to return. 5. Mood swings and depression: Since birth control pills can be associated with changes in mood for some people, stopping BC can result in mood swings, and increased or decreased feelings of depression. “The chemistry of how birth control affects the brain can increase risk for depression in some people," Dr. van Dis explains. "But for a lot of women, they also experience the anxiety and depression that comes around the potential of having an unintended pregnancy once off birth control.” So, going off BC may increase some people's anxiety and others may feel more positive after quitting (if the hormonal medication had altered their mood). 6. The return of ovulation: Going off and on birth control is not likely to have any impact on your fertility, unless you’re transitioning off of the Depo-Provera shot: “It's the only means of birth control that we know can cause a delay in return to your fertility," Dr. van Dis says. One study suggests ovulation can be delayed for up to 18 months, while another widely cited 1998 study found that ovulation can be delayed for up to 22 months. For every other hormonal BC, Dr. van Dis says that, on average, 83.1% of women will get pregnant within 12 months of stopping. What are the benefits of quitting birth control?The benefits are also different for each person, but going off birth control may help in some of the following ways:
How do you transition off of birth control?You can stop taking the pill safely at any point in your cycle, though it can be helpful to finish a pack so you can predict your next ovulation or period if you’re looking to plan or prevent pregnancy. As for an IUD, it can also be removed at any point by your healthcare provider, though removing it during your period when the cervix is naturally softer could be a bit easier. Your body is really resilient — once you stop taking the pill or remove the patch or an IUD, you’ll likely get back to normal fast. As we mentioned earlier, the majority of former birth control users will resume their pre-BC cycles within three months and conceive within 12 months of trying to get pregnant. As for the conception rates after use of each of the most common hormonal birth control methods, here's a breakdown per one 2018 study:
How can you manage "side effects" of going off birth control?There are a few different ways you can deal with uncomfortable bodily changes after quitting hormonal contraception:
What are some options for non-hormonal contraception?For anyone looking to prevent pregnancy without taking hormonal contraceptives, you’ve got plenty of options:
So, if you’re ditching your pill or removing your patch, know that your body is likely to transition back to its “before” state over your next few cycles. And if you’re not feeling great, enlist your primary care provider (PCP), OB-GYN, some ibuprofen, or a trusty heating pad for support. This article was medically reviewed by Dr. Jane van Dis, MD, FACOG. Dr. van Dis is a practicing OB-GYN, volunteer clinical faculty at USC Keck School of Medicine where she serves on the Gender Equity in Medicine and Science Committee, CEO of Equity Quotient, co-founder of OB Best Practice, and co-founder of TIME'S UP Healthcare. |