Millions of people use birth control to prevent pregnancy, manage painful periods, regulate hormones and reduce the risk of some cancers. But if you’ve been considering going off of birth control, whether for family planning purposes or otherwise, you might be wondering how long it will take for your body to adjust ― especially if you’ve been using it for a prolonged period of time.
The good news is that regardless of how long you’ve been on birth control, the adjustment period should pretty much look the same, according to Dr. Kelly Culwell, a board-certified OB-GYN.
“It really doesn’t matter how long you’ve been on it ― one year, five years,” she told HuffPost. “When you come off, the hormones don’t accumulate in your body, they are metabolised the same way when you start taking them as they are a few years later.”
Generally, your period should return to its ‘new normal’ relatively quickly.
For people using the pill, Culwell said things can happen even faster than you might realise.
“The hormones themselves are really pretty much out of your body a week after stopping birth control,” she said, noting that when you get your period can depend on when in the cycle you stop taking it. “If you make it through your cycle, then stop, that’s one thing. If you stop mid-cycle, it can be a bit more difficult to predict when you’re going to bleed next.”
As far as the contraceptive effects of birth control, that can be a relatively quick turnaround process, too.
“We know women can become pregnant even within a few days of stopping their birth control depending on when they stop,” Culwell said, stressing the importance of starting a non-hormonal method of contraception if pregnancy is not your reason for going off of birth control.
If you’ve been using birth control for a long time, there’s also a chance that things may be different now than they were before you started using it. You may remember your period differently, and it’s possible that’s just a matter of being at a different age and stage of life.
“I think that’s where some of the confusion comes in while coming off and not knowing what to expect,” Culwell said.
Overall, when it comes to pills, patches and rings, ovulation can start within a couple of weeks after stopping birth control, she said. “It may take a bit more time, but it’s very common that cycles will resume quickly.”
Other side effects should also shift imminently.
Acne, weight gain, low libido ― these are all side effects anecdotally reported by birth control users. According to the National Library of Medicine, hormonal birth control can have a positive impact on the skin, but if the pill has caused you breakouts, water retention or change in mood, those things should resolve fast, according to Dr. Erica Newlin, a Cleveland Clinic OB-GYN and host of the Ob/Gyn Time podcast.
Newlin added that while the length of time it takes for the body to adjust will vary from person to person, you should start feeling “back to yourself” in between one and three months.
“I often hear from patients experiencing those side effects that it’s even sooner than a month out; very much within the first week or so of stopping something they start to feel better,” she said. Weight, if caused by water retention from birth control, should also shift swiftly, while mood can be even faster.
“Mood is hard to strictly attribute to birth control, but I have patients that say it’s made a big difference,” Newlin said. “Patients who feel like birth control is giving them a significant increase in anxiety and depression felt relief within the first couple of weeks. I’d say give it a month, but expect to improve really quickly.”
But don’t panic if it takes a bit more time than that.
As with most things, adjusting off of birth control can vary from person to person. And the type of birth control you’re on plays a factor, too. With an IUD, for example, it can take two or three months for your period to return. With Depo-Provera, a birth control injection, it could be up to 12 months.
And while Culwell said it’s not out of the ordinary for some people to not return to a regular cycle for up to three months, it’s always better to check in if you have concerns.
“If you find you haven’t had a period within 4-6 weeks after stopping birth control, I would definitely start by taking a pregnancy test to double check, but it might also be a time to go in and get evaluated,” Culwell said. “The main thing to be concerned about if you’re not having a period is to make sure nothing else is going on.”
You might feel inclined to wait it out while your body adjusts, especially if you’re reluctant to go back on the pill. But changes in your period might not just be a side effect of coming off of it ― in fact, it could be something else completely.
“Hormonal birth control can sometimes mask other bleeding problems that might be underlying,” Culwell said. “The main thing to be concerned about is, if you’re not having a period, to make sure nothing else is going on. A main reason someone might not go back to bleeding after birth control is that they’re not ovulating, which has nothing to do with the birth control. They might have Polycystic Ovary Syndrome, or PCOS.”
In patients experiencing PCOS, the lining of the uterus is not cleared out. If left untreated, it can build up to a place where it could cause pre-cancerous changes.
“In that case, we’d recommend having some kind of hormonal withdrawal bleed at least three to four times per month, and birth control pills are one way to accomplish that,” she said. “If you’re not going to have a period on your own, you’re going to need some medical intervention to make sure the lining of your uterus stays healthy.”
Whatever your reasoning for stopping birth control, Newlin said it’s always nice to check in with your doctor, but it’s not always necessary.
“I think people should feel empowered to stop their birth control whenever they want to,” she said.