What to Expect When Going off Birth Control

TEAM KNIX / YOUR BODY

There are many different forms of birth control, but for the purpose of this article, we’re going to focus on what happens when you go off hormonal birth control. This includes:

  • Oral contraceptives, including the birth control pill
  • Vaginal ring 
  • Hormonal IUDs 
  • Birth control injections

Hormonal birth control prevents ovulation, which is the release of an egg for fertilization. Without an egg, pregnancy cannot occur. The birth control pill also thickens the mucus in the cervix, thereby making it more difficult for sperm to reach an egg.

It is worth noting that oral contraceptives, including the birth control pill, focus exclusively on pregnancy prevention. They do not protect you against STIs.

Reasons to Stop Taking the Pill or Hormonal Birth Control

Your body, your choice! There are many reasons women might stop taking the pill. It might be a personal preference, there may be medical reasons or perhaps there’s a desire to become pregnant.

Some of the more common reasons to top taking the pill include:

  • Desire to get pregnant
  • Unwanted side effects of birth control
  • Concerns about health impact of hormonal birth control
  • Curiosity about other birth control methods
  • The cost of birth control
  • Sexual inactivity

Possible Side Effects of Going Off Birth Control Pills / Hormonal Birth Control

Every woman is different. For some of us, hormones rage and for others, they’re calm seas. So the impact of removing birth control, and thereby altering your hormones, will largely vary woman to woman. Therefore, there are no easy “rules” about what to expect. As with many other menstrual cycle symptoms, there’s a spectrum of experiences.

Nevertheless, here are some of the effects that *may* occur when you stop taking birth control pills.


1. Pregnancy

No brainer, right? After all, the point of taking birth control is that you don’t become pregnant. However, you might be surprised by how immediately you can get pregnant after ceasing birth control.

In theory, it’s possible that you ovulate immediately after going off birth control and then become pregnant. This can be shocking for many women, who believe that it’s their period returning that signals their menstrual cycle is “up and running” again, so to speak.

However, it’s ovulation - not menstruation - that is tied to fertility and pregnancy and it is possible to ovulate before you see a period return, even if it takes a few months to see a period.

A 2018 study from Contraception and Reproductive Medicine concluded that:

  • Birth control pills do not affect long-term fertility
  • The duration of use of birth control pills is not a significant predictor of fertility
  • There is no significant delay in the return of fertility after stopping the use of birth control pills

2. Changed Periods

If you expect your period to go back to the way you remember it, you may be surprised. This change may be more noticeable if you’ve been on the pill for many years and you’re comparing your periods in your 20’s with those in your 40’s for example.

Of course, some women experience periods like clockwork with a very predictable flow over the course of their lifetime. But for most of us, there are changes as we develop, age and mature and your period may be heavier, longer and crampier (sorry!) than you remember them.

3. Irregular Cycle

Your cycle may not find its “rhythm” for some time (up to three months) after going off birth control pills. You may experience irregular periods. As long as things settle back down in a few months, there’s usually no cause for concern. But if your cycle is constantly irregular, this may be a symptom of something else.

4. PMS Symptoms

Yep, it will all come back, including the mood swings. It’s important to understand that hormonal contraceptives interrupt your usual cycle not just from a reproductive standpoint, but from a hormonal standpoint to. Those hormones are responsible for instigating each stage of your menstrual cycle. But they have some side effects that most of us are VERY aware of!

With your natural hormones back in play, it may be a surprise just how much of an emotional rollercoaster you go on. Hormonal birth control pills even all that out.

That said, many women feel like those rhythms and cycles help them feel connected with their bodies, so it really depends on the severity of the symptoms and your own personal take on it!

5. Breast Tenderness

Many women experience breast tenderness as a symptom of periods so this may also return. Rising estrogen and progesterone levels (the gonadal hormones) affect how your breasts feel before your period. 

These hormonal changes stimulate the milk ducts (mammary glands) in your breasts. This results in tenderness or lumpy/heavy feeling breasts for some women.  

6. Hair Loss

Hair loss is incredibly complicated and can happen for a number of reasons, including Polycystic Ovary Syndrome (PCOS). 

However, in the context of going off the pill, hair loss can occur. Hair shedding (also known as telogen effluvium) is immediately noticeable, and is caused by a disturbance, imbalance or shock within your body.

7. Skin Breakouts

Some women notice an acne breakout before or during their period. These hormone-related breakouts are often on the chin or jawline, but can also be on other body parts including the back. 

The severity of premenstrual acne flare-ups can change with age. One study by The Journal of the American Academy of Dermatology found there to be a higher rate of breakouts in women over the age of 33. 

8. Vitamin D Levels

A study published in the Journal of Clinical Endocrinology & Metabolism found that Vitamin D levels may drop when women stop using birth control. 

It noted that this may be especially problematic for women who are going off the pill because they hope to get pregnant, as “during pregnancy, women produce increased amounts of the active form of vitamin D to support formation of the fetal skeleton.”

9. Mid-Cycle Cramping

Mittelschmerz translates literally as “middle pain” and is the name for the slight twinge or cramp that some women experience when the follicle releases the egg on the day of ovulation during your menstrual cycle.

According to the Mayo Clinic “Mittelschmerz pain occurs on the side of the ovary that's releasing an egg (ovulating). The pain may switch sides every other month, or you may feel pain on the same side for several months. Keep track of your menstrual cycle for several months and note when you feel lower abdominal pain. If it occurs midcycle and goes away without treatment, it's most likely mittelschmerz.”

Less Certain Effects of Going Off Birth Control 

10. Weight Loss

Years ago, the pill contained higher levels of estrogen which may have caused weight gain. Birth control pills may cause slight fluid retention, but that effect is usually temporary. But weight gain is not a common side effect of the low dose birth control pills in use today. The one exception to this is with the progestin-only pill, which is tied to weight gain.

Despite this information, some women are very certain that the pill is a cause of weight gain. But it’s likely that this is based on out-of-date information. Many of us experience weight gain and loss over the course of our lifetime as a result of different factors including stress levels, nutrition, exercise and much more. 

The likelihood that you’ll immediately drop pounds after going off the pill is low.

11. Sexual Libido

Many report that their sexual libido took a hit when they went on the pill and expect that to revert when going off the pill. And indeed, there are many articles out there saying that “feeling frisky” is a side effect of going off the pill.

Moreover, increased libido is a symptom of ovulation. Since ovulation has been inhibited, it’s logical to assume that an increased libido will return with a full menstrual cycle.

That said, libido is tied to other factors, like stress levels. And if going off birth control makes you nervous, it’s possible you’ll want and enjoy sex less.

12. Headaches

Many women experience headaches as part of PMS and these may return once you stop taking the pill, resulting in increased headaches.

However, for some women headaches are also a side effect of hormonal birth control. In this case, going off birth control may result in a decrease in headaches.

When to Seek Medical Advice

In general, it’s a good idea to consult with your doctor if you’re thinking about going off birth control. They will help prepare you and have the context of your medical and menstrual history to give you guidance.

They’ll also be able to work with you to determine alternative birth control, if you don’t wish to become pregnant.

If you’re going off birth control because you’re hoping to become pregnant, this is another reason to talk with your doctor. Depending on your age, medical history and other factors, they may offer valuable advice to help you and your partner prepare for pregnancy.

That said, our bodies are remarkably resilient and going off the pill usually isn’t a cause for concern for many women. If you do happen to stop taking birth control without chatting with a doctor, you might want to seek out medical advice if your period doesn’t return two to three months after going off birth control.

More generally, once your cycle settles down, if you experience any of the following, it’s worth seeking medical advice:

  • Heavy periods with a lot of clotting.
  • Irregular periods.
  • Abdominal pain or cramping.
  • Pain or a burning sensation when peeing.
  • Unusual vaginal discharge and/or redness and itchiness.

Alternatives to Hormonal Birth Control

If you wish to stop using hormonal birth control (for whatever reason), but don’t want to become pregnant, there are other contraceptives you can consider. You can learn more about birth control options from Planned Parenthood

Non-hormonal birth control methods include:

  • Condoms
  • Copper IUD
  • Diaphragm
  • Surgical cap
  • Sponge
  • Fertility awareness method (FAM)

Obviously sterilization is a more extreme, and permanent solution. But depending on a woman’s medical situation, it might be an option she and her doctor want to explore.

In general, it’s always a good idea to consult with your healthcare provider to determine your options and what form of birth control would be right for you and your partner.