If you are planning to stop using birth control, you might be in for some side effects. The most obvious consequence is that your fertility may improve, increasing your chance of pregnancy. Other potential side effects depend on the person -- and the birth control method. If you experienced undesirable side effects when you started using birth control, these may go away when you stop treatment. But if your birth control method countered irregular or heavy periods, or minimized your premenstrual symptoms, these problems may surface again when you stop. If you are concerned about the side effects of stopping birth control, talk with your healthcare provider about your options for managing or preventing these symptoms.
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Not surprisingly, stopping birth control can increase your chance of getting pregnant. Although long-term use of hormonal birth control, such as the pill or oral contraceptives (OC), has been thought to impair fertility, recent research demonstrates otherwise. A research review00049-1/fulltext), published in the March 2009 issue of "Fertility and Sterility," reported that some OC users experienced a brief delay in their return to fertility, but within 12 months, pregnancy rates in OC users were similar to women who did not use birth control. This review also compared a variety of birth control methods, and reported similar pregnancy rates 12 months after stopping contraception.
Menstrual Cycle Changes
One of the benefits of hormonal birth control, which may be delivered by pill, patch, ring, injection or intrauterine device (IUD), is that it can counter heavy periods or irregular cycles. In fact, light or infrequent cycles, or an absence of menstruation, can be a side effect of some hormonal birth control methods. In these women, stopping birth control should bring back their usual menstrual cycles, which may include undesirable symptoms, such as heavy bleeding, cramping or cycle irregularity. This transition to a woman's normal or usual cycle may take a few months, according to a small study published in the February 2011 issue "Journal of Women's Health." On the flip side, the copper IUD, a nonhormonal method of birth control, sometimes leads to more cramping and bleeding, which may resolve in time -- or once the IUD is removed.
PMS and Ovulation Symptoms
Most birth control methods send synthetic hormones, most commonly estrogen and progestin, into the body to suppress ovulation, or the monthly release of eggs from the ovaries. So when hormonal birth control is stopped, the body resumes its normal hormones production, and ovulation often resumes. These hormones, and the resumption of the body's normal cycle, can cause symptoms associated with premenstrual syndrome (PMS), such as mood changes, acne, water retention or breast tenderness. Ovulation symptoms, such as mid-cycle spotting, back pain or cramping, may also resume after birth control is stopped.
Some women link the use of hormonal birth control to weight gain, yet research indicates this is not a universal side effect. A Cochrane review of 49 studies concluded the combination pill, which contains estrogen and progestin, caused no substantial change in weight. Another research review suggests the weight gain that may occur with the progestin-only minipill is small -- less than 5 pounds in one year. But some research has shown the injectable contraceptive, depot medroxyprogesterone acetate, can lead to twice this amount of weight gain. If your birth control method caused weight gain, you may lose some or all of this weight when you stop birth control, particularly if you also increase physical activity, improve food choices and reduce calorie intake. However, limited research is available on weight changes related to stopping birth control.
If you plan to stop using birth control, speak with your doctor or nurse practitioner about the best time in your cycle to stop your pills or remove your device, and so you understand any side effects that may occur. If you are planning a pregnancy, work with your health care team to optimize your health and manage any health conditions prior to conception. If you do not want to get pregnant, be sure to have an alternative plan to prevent pregnancy, as your fertility can improve immediately after you stop using birth control.
Reviewed by Kay Peck, MPH RD