10 Things You Should Know if You’re Going to Stop Taking Birth Control Pills
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Thinking about going off the pill? You’re not alone. Whether it’s for family planning, health concerns, or other personal reasons, the number of women choosing birth control pills is on the decline.
The percentage of women who take the pill has dropped by about 20 percent since 2002 — from 31 percent to 24 percent.
Whatever your reason for stopping, you’ll need to know about the potential changes that may happen within your body so you can navigate the transition more smoothly — and practice a little compassion for yourself throughout the process.
1. Your Body’s Response to Going Off the Pill May Be Different From Other People’s
When you stop taking the pill, pay attention and record any changes in your body and menstrual cycle so that if you have any concerns, you can discuss specifics with your doctors, recommends Karen Carlson, MD, an obstetrician and gynecologist and an associate professor at the University of Nebraska College of Medicine in Omaha.
“Individual experiences of going off birth control pills may vary — while some women may notice significant changes, others may have a smoother transition,” says Dr. Carlson.
It’s hard to predict each person’s experience — many factors, including your health history and any current health conditions — will likely play a role, Carlson says.
2. You Can Still Get Pregnant — Even Before Your Next Period
Most birth control pills contain synthetic forms of two hormones: estrogen and progestin. These hormones work together to prevent ovulation (the release of an egg from the ovary), thicken cervical mucus to prevent the sperm from reaching the egg, and alter the lining of the uterus to make it less receptive to implantation of a fertilized egg, notes Carlson.
Essentially, birth control pills say to the brain “we already ovulated, no need to release another egg,” explains Erica Cahill, MD, a clinical associate professor and an ob-gyn at Stanford Health in Palo Alto, California.
Though it can take two to six weeks for your period to return, depending on when you stopped taking the pill and how long you’ve used it, you can become pregnant even before your next period, cautions Dr. Cahill. “If that’s not your plan, think about using other methods in the meantime.”
3. Your Menstrual Cycle Will Eventually Come Back
Once you stop taking the pill, your natural menstrual cycle will return, says Carlson. “Some women may experience irregular periods initially (for up to three months), while others may return to a regular cycle soon after they stop the pill,” she says.
“The menstrual flow may also differ, and some women report changes in the duration and intensity of their periods — it’s more common to see an increase in the amount of bleeding with menstrual cycles,” she adds.
4. Some Women May Notice Mood Changes
Hormonal fluctuations can influence mood, and some women may notice a change in their mood after stopping the pill, notes Carlson.
It’s unclear how birth control pills affect mood. Some research suggests that starting on the pill can increase the likelihood of a depression diagnosis. Using data from the UK Biobank, the study included 264,000 women, 80 percent of whom had used birth control pills at some point. Researchers found that the first two years of using birth control pills were associated with a 70 percent higher risk of depression than in women who had never used oral contraceptives. After two years, the risk dropped to a less than 10 percent increased risk.
Although some women may be taking the pill to help with mood swings, recent research has cast doubt on the medication’s mood stabilizing benefits. A study published in September 2023 in JAMA Network Open compared women who had been on oral birth control for at least six months with a control group of naturally cycling women.
Researchers tested hormone levels and mood symptoms during the month at various stages in the cycle, and found that during the pill-free week (the 7 days of hormone free pills that are included in a 21/7 pill pack) the negative mood symptoms of both groups were similar.
5. You Might Experience Breakouts
Acne flare-ups are among the most common symptoms women experience when they stop taking the pill. These are also due to hormonal fluctuations, says Carlson.
Hormonal acne can mean pimples, blackheads, whiteheads, and cysts. If skin issues persist after your period returns to normal, you may want to talk to your doctor or see a dermatologist about treatments.
6. You May or May Not Gain Weight
Weight changes are possible, but that hasn’t been consistently found in studies, says Cahill.
In general, research suggests that birth control pills are not likely to have much impact, if any, on weight. If women do gain weight on the pill, it can be related to water retention.
7. You May Sleep More Soundly
“Hormonal changes may affect sleep and energy levels in some women, although these effects can be subtle and are not universal,” says Carslon. “Individual responses vary, and lifestyle factors also play a role.”
A study published in Sleep Science compared the sleep quality of women who used hormonal contraception (like the pill) to users of nonhormonal contraception. The authors didn’t find a significant difference in sleep quality between the two groups, but they did find that women who used nonhormonal forms of birth control had greater sleep efficiency, which is how much time you actually spend asleep.
8. You May Feel a Little More Frisky
Hormonal fluctuations can influence sexual desire, notes Carlson. “Most commonly, libido is decreased while on birth control pills, so an increase in libido may be seen when you stop taking birth control pills,” she says.
On the other hand, if you’re worried about unintended pregnancy, your libido may be lower because of this factor alone, Carlson adds.
9. Headaches May Change — Especially if You’re Prone to Them
If the pill improved your menstrual migraine headaches, they might return once you stop the pill. For women who experience migraines the week of taking placebos on birth control pills, migraine may worsen when you go off the pill, says Carlson.
If you don’t have a history of hormone-related headaches, stopping the pill probably won’t change that, she says.
10. Talk With Your Healthcare Provider First
It’s a good idea to talk to your doctor before you stop taking the pill, says Carlson.
That being said, there’s no right or wrong way to stop birth control pills. You can stop them in the middle of the pack or finish the pack you’re on without starting a new one, according to Planned Parenthood.
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