Coming Off The Contraceptive Pill

When you stop taking the pill, your body stops receiving synthetic versions of oestrogen and/or progesterone, and your natural menstrual cycle can return. Some research has shown that menstrual cycle length is increased in people who have recently taken oral contraception.

For example, people who had recently stopped the pill had an average cycle length of 33.3 days compared to 29.6 days for non-pill users. The same study also found that the first 4 periods after coming off the contraceptive pill were significantly lighter than usual.

As your hormones begin to rebalance themselves naturally, ovulation may return quickly, or it can take a little longer. Everyone is different, and your body will return to its natural cycle at its own pace.

What are some of the benefits of stopping the pill?

The pill is one of the most effective (more than 99%) and popular types of contraception, but coming off the pill has several benefits, including:

Improved mood

Synthetic oestrogen, particularly ethinylestradiol, and progesterone can impact your mood, although not everyone will be affected. Some people find they become more irritable on the pill, or that it can worsen mood disorders like depression. So, some people find that stopping the pill has a positive effect on their mood.

Increased sex drive

Changes in sex drive are commonly reported with the contraceptive pill, with most studies indicating that the contraceptive pill lowers sexual desire and libido. However, not everyone will experience changes, but if you do, coming off the pill may restore your sex drive to what it was before you started taking it.

Natural cycle returns

Once you stop hormonal contraception, your natural menstrual cycle should return, which some people prefer because it can make it easier to notice and track bodily changes (if you have a regular menstrual cycle). This also means you can get pregnant.

While some people feel better as soon as they stop the pill, others may experience temporary side effects as their body adjusts to the new hormone levels. Most of these effects can be managed at home, and any changes in fertility usually return to normal within a few months.

Some of the side effects of coming off the pill are:

Menstrual cycle changes

Hormonal changes can cause your menstrual cycle to change. When you’re on the pill, you are getting a steady and specific dose of artificial oestrogen and progesterone to stop you getting pregnant. However, when you stop taking the pill, your natural hormones restart, but it can take a while for them to get back to normal levels.

A common sign that your hormones are balanced is a regular menstrual cycle. Most people find that their cycle returns to normal within 3 months, but it can take longer. If you are concerned, speak to your doctor for more advice. If you have been taking the mini pill or you have been taking the combined pill without a break, you may not have experienced regular withdrawal bleeds. So, a sign that your menstrual cycle is returning to normal is the onset of your period.

When you come off the pill, it’s common for your cycle to return to how it was before. So, if you started the pill because you had irregular, heavy, or painful periods, it’s likely they will return when you stop. Other medications can help with period pain if you no longer want to use the pill but still need treatment.

Mood swings

When you stop taking the pill, pre-menstrual syndrome (PMS), pre-menstrual dysphoria disorder (PMDD), and mood swings can get worse. These often occur in the later stages of your menstrual cycle, called the luteal phase, and symptoms can include:

• anxiety
• low self-esteem
• mood swings
• tiredness
• irritability
• poor sleep
• food cravings
• suicidal thoughts

Acne or skin changes

Some hormonal birth control methods, particularly the combined pill, can lower your levels of androgens or male hormones, like testosterone, reducing the appearance of acne. So, if you are taking a pill like Microgynon 30, Yasmin, Gedarel, or Rigevidon, you might find that you get more spots or breakouts when you come off of it.

Breast tenderness

Breast tenderness is another common side effect of coming off the pill because the artificial hormones can affect your breast tissue. When you stop taking it, your breasts may temporarily be sore until your body adjusts to the new hormone levels.

For some people, breast tenderness is a side effect of the combined pill, so coming off the pill may improve this once your hormones are back in balance.

Headaches

The hormonal changes that occur after you stop the pill can cause headaches. If you have been taking the combined pill, a drop in oestrogen levels when you stop can trigger headaches in some people. Often, an oestrogen-withdrawal headache will occur within 5 days of stopping the pill and should get better within 3 days.

Weight changes

Some people notice a change in their weight, either gain or loss, when they stop taking the pill, which is often linked to increased appetite, changes in fluid retention, and shifts in metabolism.

It can take up to 3 months or sometimes a bit longer for your periods to return after you stop taking the pill. Most people who come off the pill will get a withdrawal bleed, similar to a period, within 2 to 4 weeks. This can be heavier and last longer than you are used to. A withdrawal bleed happens because your body is no longer getting a steady supply of synthetic hormones, so the drop causes a bleed.

The withdrawal bleed is not a true period, but your next bleed is likely to be your first real period after coming off the pill. If your period does not return within 3 months and you are not pregnant, or you are concerned, speak to your doctor.

What happens if you get no period after coming off the pill?

If you do not get a period after stopping the pill, also known as ‘post-pill amenorrhoea’, you may need to see your doctor for further investigations. It usually improves and you should experience a period within 3 months. However, if it does not, you may need to undergo some tests to rule out conditions like polycystic ovary syndrome (PCOS), thyroid issues, or pregnancy.

Some people may have already had amenorrhea as they started the pill, but because it causes you to have an artificial menstrual cycle, the pill may have masked your symptoms.