People start taking hormonal birth control for a variety of reasons, not only to prevent pregnancy. Birth control can help with painful period symptoms, acne, and more. For people who have used hormonal contraceptive methods and are considering coming off birth control, here are some frequently asked questions and answers.

Why might someone consider going off birth control?

There are plenty of reasons why someone may want to go off birth control or try a different method! Some of these reasons include:

  • Wanting a break from hormones
  • Wanting to prepare for pregnancy and establish a regular menstrual cycle and ovulation pattern
  • Needing to stop due to bothersome side effects

What are some side effects of stopping birth control?

Side effects will likely occur once a person stops using birth control as their body shifts from an external source of hormones, such as progesterone and estrogen, to rebalancing those naturally. Some side effects of getting off birth control include:

  • Changes in your menstrual cycle, or even a delay if you have an intrauterine device (IUD)
  • Heavier periods with more painful cramping or pain during ovulation
  • Changes in mood or more noticeable PMS symptoms
  • Changes in weight
  • Headaches
  • Changes to your sex drive

Less common side effects may include changes to your skin, breast tenderness, and unwanted hair growth.

Immediately after the removal of an IUD, a patient may experience cramps, light bleeding, or bloody discharge. These symptoms should subside within 24 hours of removal of IUD. A heating pad, ibuprofen, and rest may help ease any uncomfortable cramping sensation.

After stopping birth control, your body will be adjusting to its new rhythm of hormonal levels and cycles. Some people report feeling "more themselves" right away, while others may take a little while longer to adjust to these new changes in hormone levels.

Can you stop taking birth control at any time?

You can stop taking birth control at any time, though it may be helpful or more natural for your body to stop when you are already on your period or at the end of a pack of birth control pills. It is also important to think through the timing of stopping birth control. Pregnancy is a possibility immediately after stopping birth control, so if pregnancy is not an intended outcome at the time, be prepared to practice another form of contraceptive use, such as condoms, as your menstrual cycle returns to normal.

What do you need to do to prepare to stop birth control?

For individuals with an implant or IUD, stopping birth control will require a minor medical procedure and an office visit with your gynecological healthcare provider, which could be your OBGYN/midwife or your primary care provider. For individuals using birth control pills or an inserted device, such as a Nuvaring, you can stop taking the pills when you have finished the pack or remove the device on your own.

Is it healthier to go off birth control?

Balancing your medical needs and health goals can involve constant fine-tuning. With birth control, preventing unwanted pregnancy or regulating your menstrual cycle may be the goal, but finding the right method may require some effort and involve getting off birth control.

Hormonal birth control doesn’t work for everyone. For individuals with migraines with aura or risk of blood clots or cardiovascular disease, for example, it is very important to avoid birth control with estrogen. For those who need to avoid estrogen, your provider can offer options such as certain IUDs, progestin-only pills, or Nexplanon. Some non-estrogen birth control methods, such as the Copper IUD, do not involve hormones but do often make your period or menstrual flow heavier with more intense cramping. 

Some birth control options are not intended for long term use and may require surveillance. Depo Provera, for example, is a contraceptive injection that contains the hormone progestin. Using Depo Provera continuously for more than two years may increase the risk of osteoporosis, which could increase your risk of weak, porous bones.

What if I want to avoid using birth control?

There may be no need for birth control if you’re not currently sexually active and if your period symptoms are manageable without the support of hormonal birth control.

If you are sexually active but want to avoid hormonal birth control while also preventing pregnancy, your sexual partner should be involved in this plan as well. Preventing pregnancy by using condoms or a permanent method of sterilization are options for men. Condoms are also the only method that would help protect against sexually transmitted infections.

How long does birth control stay in your system?

The length of time that birth control stays in your system will vary based on the method of birth control, but most hormonal birth control methods clear out of your system within a few days. After stopping the birth control pill, for example, it may only take 36 hours for the level of hormone to drop dramatically in your system and for you to become fertile. With IUDs, your body returns to its normal hormonal level almost immediately.

For those people who have used Depo-provera shots, this medication will last in the system longer as it is designed to suppress ovulation for three months at a time between injections. It may take up to seven to nine months for the Depo-Provera to be fully out of your system and for ovulation to resume. This matters most when families want to try to conceive right away and may be something to consider when evaluating the different types of birth control before starting or changing methods.

What are some signs of ovulation after getting off birth control?

Ovulation generally occurs halfway through a person’s menstrual cycle, meaning that if you have 30 days between the first day of your period and the start of your next period, you likely ovulate around the 15th day. There are many apps that can help you track your cycle and detect ovulation. When looking for signs of ovulation, you can keep an eye out for changes to cervical mucous, check for ovulation using an ovulation predictor test, or check your basal body temperature every morning to watch for changes in temperature.

Basal body temperature is simply taking your temperature with a digital thermometer at your most resting states (“basal body” means resting, such as sitting comfortably or laying down). By checking your temperature daily, you can notice a trend in your body’s temperature throughout your cycle. During the first half of the menstrual cycle, from menstruation to ovulation, your body temperature is lower than after ovulation occurs. After ovulation and as progesterone levels rise, body temperature increases slightly and remains elevated until progesterone levels drop and your period begins, or stays elevated in early pregnancy. It’s important to buy a thermometer that reads out to the hundredth decimal point (98.67º not just 98.6º) to appreciate the differences in your basal body temperature.

When should I see a doctor after stopping birth control?

If your period has not returned after three months since the date of your last birth control pill or device removal, reach out to your gynecologist, certified nurse midwife, or primary care provider. 

If you’re considering starting or ending a birth control medication or have other obstetric or gynecological concerns, the group of physicians and certified nurse midwives at Newport Women’s Health Services are here to help.  Visit us online or call 401-848-5556.