What to expect when you stop hormonal birth control

Are you planning on going off the pill or another hormonal contraceptive method? There are plenty of reasons to do so. Maybe you want to get pregnant. Or you’d like a break from taking a pill every day. Or condoms just seem like a better fit for your romantic life right now.

It’s good to be prepared for a few normal changes to your body after you stop taking hormonal birth control. Read on for what to expect.

What exactly is hormonal birth control?

Hormonal birth control methods all work in the same basic way. They contain medication that prevents your ovaries from releasing an egg. If there is no egg, you can’t get pregnant.

The pill is the most commonly used hormonal method, according to the Centers for Disease Control and Prevention. But there are many options. Hormonal contraceptives contain either progestin or a combination of progestin and estrogen. Options include:

• The pill (aka oral contraceptives). These are tablets you take daily.
• Implant. A thin flexible rod that a doctor inserts into your upper arm.
• The shot. An injection given by a doctor in your arm or butt every 3 months.
• The patch. A skin patch you wear on your abdomen, butt or upper body (but not on your breasts).
• Vaginal ring. A flexible ring you place inside your vagina and change monthly.
• Hormonal intrauterine device (IUD). A small T-shaped device placed in your uterus by a doctor.

(Learn more about your birth control options and how to choose the best one for you.)

How your body adjusts when you go off birth control

Your body might be a little confused when you first stop taking hormonal birth control. That’s because you’ll start ovulating again. You may notice some changes as your body returns to its baseline, says Meghan Klavans, MD. She’s an OB-GYN at Rush River North, Rush University Medical Group, in Chicago, Illinois. 

• Your periods may be heavier. Why? “The hormones released into your body from the contraceptive work to suppress the lining of your uterus,” says Lindsay Sillas, MD. She’s an OB-GYN at the Woman’s Hospital of Texas in Houston. “When you end the hormones, you allow heavier menstrual bleeding and cramping.” You could also experience spotting or bleeding in between periods.
• You might get PMS. Cramps and migraines may be more frequent than before. Try an over-the-counter pain reliever such as ibuprofen (Advil® or Motrin®) for pain relief. Heating pads can also help.
• Your sex drive could improve. Some hormonal birth control methods cause vaginal dryness. More natural lubrication could give your libido a lift. That’s a nice perk.
• You could get a few pimples. A benefit of hormonal birth control for many women is that their acne clears up. When you stop the hormones, you might see some pimples popping up again. (Learn more about treating adult acne.)

And by the way, your fertility may come back quickly. “Many women get pregnant within the first 6 months after stopping birth control,” says Dr. Sillas.

If you’re trying to conceive, that’s probably welcome news. But use another form of contraception if you don’t want to get pregnant.

The Optum Store carries a variety of family planning products to fit your needs.

What’s the best time of the month to stop hormonal birth control?

This is an important conversation to have with your OB-GYN. If you’re using a method such as the pill, patch or vaginal ring, for example, you can safely stop it on your own. It’s best to stop at the end of your cycle.

If you have a longer-term form of birth control such as an IUD or implant, your doctor will need to remove it.

“But there are no age or length-of-time guidelines for when to stop hormonal birth control,” says Dr. Klavans. “I have had women on it for a few months, a few years, and some longer.”

Trying for a baby? Dr. Sillas recommends taking prenatal vitamins right away. “They will build up your folic acid to reduce the risk of birth defects,” she says. Ask your doctor what kind is right for you.

You should also make an appointment with your doctor if you don’t start getting a period within 3 months, according to the Mayo Clinic. Consider taking a pregnancy test, too.

Getting pregnant may take a bit of time. So don’t worry if it doesn’t happen right away. “It may take a while to return to a normal menstrual and ovulation cycle after stopping hormonal birth control,” says Dr. Sillas.

Need birth control? The Optum Store can help, no insurance needed.

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Additional sources
Pill popularity: Centers for Disease Control and Prevention (2018). “Current Contraceptive Status Among Women Age 15-49"
Pill facts: Planned Parenthood (n.d.). “Birth Control Pills”
Getting your period after stopping: Mayo Clinic (2021). “Birth Control FAQs”