So you want to talk about… coming off the pill

by Sophie King · Aug 24, 2020

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Reviewed by Dr. Melanie Davis-Hall on April 1, 2021

birth control packet on pink background
Despite more research being done than ever, our knowledge of the birth control pill is still lacking. Therefore, it's no surprise that what happens when we come off the pill is even more unknown. Here, The Lowdown does its best to explain what could happen when you decide to come off the pill.

First things first, no body is the same and so everyone will get ‘back to normal’ in their own way after coming off birth control. It will be a slower process for some.

Here we talk about coming off the combined pill and the potential side effects you might face when you stop taking it.

Coming off the pill: side effects and symptoms

How long after stopping taking the pill will I get a period?

The first period you experience after coming off the pill is known as the “withdrawal bleed”. This is not the same as your normal period and normally lasts up to about seven days. Your second bleed will be your normal period. It can take a while for your period to go back to normal – or what is normal for you. The majority of women who leave reviews at The Lowdown find their usual menstrual cycle returns 1-3 months after stopping the combined pill. The NHS advises waiting three months for your menstrual cycle to normalise again.

As one of the benefits of the combined pill is often lighter, less painful periods, you may notice your periods might be more painful and heavier after stopping the pill, but this may subside after a few months.

How will I feel after coming off the birth control pill?

Hormonal contraception can impact on your mood, so logically coming off the birth control may change how you feel. Some women start the pill to help with their mood. The combined pill can help with PMS (pre-menstrual syndrome) and PMDD (pre-menstrual dysphoric disorder) and so coming off the pill may lead to a worsening of these symptoms. On the other hand, some women have reported a negative impact on their mood when using the combined pill that has improved when stopping.

Will coming off birth control affect my skin?

One of the common reasons women like using the combined pill is the beneficial effect it has in improving your skin. In fact, it is often used by doctors as a treatment for acne. Some women find on stopping their combined pill that their acne or spots worsen initially, as their skin is no longer benefitting from the oestrogen effects of the combined pill. Read more about the impact of birth control on acne here.

Coming off the pill to get pregnant? Is my fertility affected?

When you stop using the pill your fertility will return to whatever is normal for you. There is no significant difference in pregnancy rates when compared to women stopping other contraceptive methods or using no contraception. It is important to remember it is possible to get pregnant as soon as you stop taking the combined pill. If getting pregnant isn’t your goal, then you might want to consider switching to another form of contraception before you stop taking your birth control pill.

Your fertility will still depend on your age, genetics and any underlying medical problems. Women who have used contraception for most of their reproductive lives may not be aware of problems affecting their fertility, as contraceptive effects may mask symptoms such as irregular periods. For some women, it is only on stopping contraception, or trying to get pregnant, that they find out there may be an underlying issue. 

According to the NHS it is best to wait until after you’ve had your first natural period before trying for a baby. This gives you time to make sure you’re in the best physical health for carrying a baby. It also helps your GP or midwife predict your due date more accurately.

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Other contraceptive options

If you’re looking to come off the pill and switch to a different method of contraception then we have got you covered. There are many other different types to try, both hormonal and non-hormonal.

If you fancy sticking with a hormonal contraceptive then you could try another pill. Trying a different brand or the progestogen only pill might suit your body better, but if you’re set on coming of the pill for good then your options include; other combined methods such as the contraceptive patch or the vaginal ring, or progestogen only methods such as the hormonal coil, the injection or the implant.

There are non-hormonal options available too. You could try the copper coil, condoms, the female condom, or fertility awareness based methods.

It’s a good idea to talk to your nurse or doctor if you plan to stop taking your birth control pill. They can help you decide which method you want to switch to and help you plan how best to do this.

What do our reviewers say?

No two women will have the same experience but we at The Lowdown try to be as informative as possible. So, here are some experiences from our very own Lowdown team talking about when they came off the pill:

“I had been on Microgynon since the age of 15, decided to come off it after 13 years as I thought it might be causing some anxiety. I went on the copper coil to avoid any hormonal contraception methods and came to realise that I actually have hypothalamic amenorrhea which means my body isn’t producing a period. The bleeds I was having on the pill were not real periods and if I had not come off it I’d still think everything was fine and that my body was functioning properly. I’m very fortunate to have decided to try something new as I can address this issue – otherwise it would still be going on and I’d have no clue!”

“I first started the pill at 17 which was fine. Then, as what can happen, the GP decided to put me on something else but pretty much right away I started to have headaches on the side of my face. After visiting the GP, I was advised immediately to come off it as that was a symptom of a blood clots. Almost immediately, I felt back to normal and the headaches had subsided. I am now on Cerelle and it is great!”

“Since coming off the pill, almost seven years later, I now struggle with adult acne and wish I had been able to deal with it when I was younger. I think the pill can act as a mask for inbuilt issues that will only come out as soon as you’re off it. I still get really awful cramps on occasion but I know how to deal with them. I don’t regret going on the pill – I think it’s almost unavoidable for most women – but I do wish there had been the knowledge and awareness there is now.”

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  1. Faculty of Sexual and Reproductive Health (FSRH)

  2. NHS UK

Sophie is a Cardiff University- trained journalist who is passionate about sharing womens’ contraception stories in the hope that it will connect with others.

You can find her on Twitter.