What to expect if you decide to go off birth control

The conversation

Young hispanic hand holding birth control pills on isolated pink background.

Considering abandoning your birth control method? Here’s what you need to know (Image: Getty Images/iStockphoto)

Deciding to stop using your regular birth control method is a big decision.

There are a number of reasons you might be considering this, either to have a baby or because of negative side effects you might be experiencing (such as mood swings).

But while there’s a lot of discussion about what to expect when starting birth control, there’s less information about what to expect when you decide to quit.

One of the most important things to consider if you stop using your regular birth control method is the possibility of getting pregnant. If you are trying to avoid this, it is important to use a backup method of birth control.

But some women may also experience changes in their periods, skin, or mood when they come off the pill and return to their natural cycle. This is because most birth control methods contain hormones, usually estrogen and progesterone, that suppress the body’s normal hormonal changes. Not only does this prevent pregnancy, but it can also have other effects, such as reducing menstrual pain or affecting your mood.

the pill

The most common contraceptive method used by women in the UK is the pill. This includes both the combined pill (which contains both estrogen and progestin) and the progestin-only pill (often called the “mini-pill”).

If you decide you want to stop using the pill, it’s usually best to wait until the end of a pack. This will reduce the risk of getting pregnant from having sex just before you stop taking the pill. When using a combination pill, it’s safe to have pill-free intercourse, but only if you start the next pack on the right day and take pills for at least the next seven days. This is why stopping in the middle of a pack is risky in terms of pregnancy.

The biggest change you’ll experience when you quit smoking is the return of your normal menstrual cycle. Since the combination pill generally makes periods lighter, less painful, and more predictable, it’s possible that your periods will be heavier and more painful than when you stop taking the pill. Your periods will also return to their regular pattern (which for some may have been irregular).

People who experienced mid-cycle pain (during ovulation) or PMS before starting the pill may also experience these symptoms again.

If you were using the combination pill to improve acne or control certain conditions (such as polycystic ovary disease), these benefits will likely be lost once you stop taking it.

But if you were someone who took the mini-pill, your experience may be slightly different when you stop taking it. The progestin-only pill doesn’t provide the regularity of periods that the combined pill usually does, and many women often have irregular bleeding (usually light but unpredictable) while taking it.

So when you stop taking the mini-pill, your period is likely to return to its natural pattern, which may be more regular and predictable.

Since progestin has a number of side effects for some women, such as causing acne, mood swings, or decreased libido, stopping both the combined pill and the mini-pill can improve all of these.

It is also important to note that your periods and fertility return very quickly after stopping the pill and you could become pregnant within a few weeks or even days of stopping the pill. So use a backup method immediately after stopping the pill if this is something you want to avoid.

IUD.Hormonal contraception concept on a pink background

Make sure you’re using a backup method of birth control if you’re not trying to get pregnant (Image: Getty Images)

Long-acting contraceptives

Long-acting hormonal contraceptive methods, such as the implant, the hormonal intrauterine system (IUS), and the injection, have similar effects on the menstrual cycle as the pill. This can include making periods lighter but more unpredictable, or even no periods at all.

If your implant or IUS is removed, your menstrual cycle will return to its previous pattern in a few weeks. Your fertility will also return to normal within days or weeks.

But with the injection, you may not have a period for several months after stopping it, and the return of fertility may also be delayed for a few months. This is most likely due to the high dose of hormone in the injection and how well it suppresses the natural cycle. However, most women usually get their periods again within a year of stopping the injection, and these periods are just as regular and heavy (or light) as before.

If you use the copper intrauterine device (IUD), it does not contain hormones. Although it is long-acting and extremely effective against pregnancy, some women experience heavier and longer periods when using this method.

Fertility returns immediately after the IUD is removed, so it’s important for women who don’t want to get pregnant to use backup methods of birth control. It is also recommended that women with an IUD not have unprotected sex for a week before removal because fertility returns very quickly.

You may be worried that contraception will have a long-term effect on your periods or your fertility, but happily all the evidence points to this not being the case. Some women may find that they experience a slight delay in the return of their periods after stopping any form of hormonal birth control (although this is more common with the injection). This is because the body’s natural hormonal cycle can take a few weeks to reset. This is not a cause for concern unless it continues for many months.

The decision to stop using birth control is extremely personal and will be influenced by whether you want to have a baby, your relationship, and many other factors. Aside from sterilization, all modern contraceptive methods are designed to be completely reversible. While you may notice some effects after you stop taking them, they are usually due to the return of the natural rhythms of the menstrual cycle.

Susan Walker, Professor of Contraception, Sexual and Reproductive Health, Anglia Ruskin University

Click here to read the original article on The Conversation.

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