Thinking of Coming off the Pill? This Is What You Need to Know, First
Thinking about coming off the pill? Straight up, this is one topic that does not get enough airtime. Apart from simply not picking up a repeat prescription, most people who do take the hormonal contraceptive feel clueless about what happens to their bodies next.
You might, for example, have heard rumours that choosing to come off the pill will cause you to put weight on, your period acne will return and your flow to be irregular.
But fear not, ditching this form of birth control doesn't have to backfire, if you're up to speed on what really happens. To get the scoop, WH has tapped up gynaecologist Dr Anita Mitra, aka the Gynae Geek and GP Dr Jane Leonard, for their expert opinion.
How to come off the pill, safely
First off, if you're not trying to get pregnant, make sure that you've got a back-up contraceptive figured out.
'With the pill, the main use is for contraception so, if you're going to stop it, make sure you have a back up plan in place,' advises Dr Leonard. 'Many women are on the contraceptive pill for so long, they forget the initial reason why they're taking it'.
Next, you need to know about the side effects of swerving the tablets – and how to mitigate them.
Can you just stop taking the pill?
'When stopping or changing any medication it is always best to consult your doctor, to make sure it is done in a safe way and doesn’t put you at risk of pregnancy,' says Dr Leonard.
Can coming off the pill cause weight gain?
'No, stopping the pill is not directly associated with weight gain. In fact, the opposite has been reported by some – that starting the pill can cause you to gain weight. But when it comes to weight gain or weight loss, this is not completely true, either. Some of the hormones in the pill can make you more hungry, but will not cause you store fat and gain weight without you eating more,' Dr Leonard says.
Can coming off the pill cause nausea?
'Stopping hormonal contraception can cause a variety of symptoms that can affect each woman in a different way. Nausea is a possibility but it is not a direct effect of stopping the pill,' details Dr Leonard.
Coming off the mini pill vs the combined pill: what's the difference?
If you're wondering how coming off the mini pill differs from the combined pill, know that they do contain different ingredients – but that the effects are the same.
'There is no evidence to suggest that there's any difference between the combined and mini pills,' says Dr Mitra. 'There's a myth that the mini pill should cause more bleeding but with oral birth control, the side effects are the same.'
Is it OK to stop the pill suddenly?
'Coming off the pill suddenly shouldn't cause you any issues – but it is something that should be discussed with your doctor, to make sure you're not at risk of unwanted pregnancy.'
What are the side effects of coming off the pill?
There are certain symptoms associated with coming off the pill, although every body is unique and these may differ slightly, from person to person.
Here's what's likely to happen:
1 week after coming off the pill
Coming off the pill will result in a withdrawal bleed, which normally lasts for around a week. Think of it like your pill break.
Often this will be similar to your monthly bleed as most women stop bleeding before the end of their seven day break. However, if you normally begin a new pack of pills before your flow has finished, don't panic.
'It's not really the act of taking the pills again that stops the bleeding,' assures Dr Mitra. 'Normally bleeding isn't any longer [than the usual week], but it's often quite difficult to predict when your next period will come.
'That's because some women have bodies that work like clockwork, however most women don't. And there are many life factors, like stress, that can wreak havoc with periods.'
If your bleeding feels excessive or goes on for much longer than a week, contact your GP.
1 month after coming off the pill
After one month the common symptoms of coming off the pill begin to fade.
'The hormones wash out of the system pretty quickly, so things that you would notice within a month include; a change in vaginal discharge (it'll be less dry), your libido may start to increase and boobs might start to shrink.
'You might actually notice a bit of weight loss, although it's not true weight loss, just loss of water retention that can be caused by progesterone.'
As well as these, any pill-associated headaches should disappear after a month of not taking it, and from now to three months is when you'll likely have bad PMS come back into your life, as the tablets were likely dulling its effects.
'The pill works by stopping ovulation, so you should ovulate within a month or so. 'At the time of ovulation – about seven to ten days after your period stops – you'll tend to see a very clear, stringy and, often, very watery vaginal discharge,' says Dr Mitra.
'This really confuses a lot of women as they won't have had this type of discharge at all while being on the pill! Oh – and if your PMS-y cramps disappeared while taking the pill, stock up on pain relief.
'Around the same time you can also get a bit of cramping pain. This can be a sign of ovulation and is totally normal, but you won't have experienced it while on the pill,' Dr Mitra adds.
3 months after coming off the pill
When coming off the pill, do bear in mind that you might experience changes in mood. This is likely to differ from person to person. Some women report an increased libido, for example.
For others, moods drop and they only level out around the three-month mark. Keeping a daily diary of what you're doing, the stress you're under and ultimately how you're feeling can help you see patterns in your moods. More often than not, you might not be feeling like you because of other reasons than coming off the pill.
In one Danish study on the link between the pill and low moods, scientists concluded that women on the pill are 23% more likely to be prescribed an antidepressant than those not on hormonal contraception. However, a cull of female contraception for this reason alone was met with hostility by UK medical experts, and it's important to remember that other variables could have been at play.
During this time do seek help from your GP if you're worried about your mental health.
Coming off the pill to get pregnant: what you need to know
The experience will vary from woman to woman. 'The main thing to remember is that when you're on the pill, the purpose is to stop you ovulating. To get back to ovulating, it can either happen straight away or it can take up to six months,' says Dr Leonard.
If you're coming off the pill to get pregnant, it's about letting your natural hormones give you periods again.
'The synthetic hormones in your pill stop you from getting pregnant, but it's just a matter of observing how your body reacts post-pill.' Dr Leonard recommends seeing a doctor if your period hasn't come back after six months.
Dr Mitra suggests a couple of lifestyle changes you should adopt to help you conceive after you stop taking the pill.
Start taking folic acid immediately – because you really can get pregnant straight away
Focus on your sleep hygiene
Move every day
How long will it take for my fertility to go back to normal, after coming off the pill?
A common myth is that it takes up to three months for your fertility to return to normal after being on the pill. However, this isn't strictly true.
'Everyone has heard of that person who got pregnant after forgetting to take their pill, right? That's because if you miss a pill at the right time – or wrong time, whichever way you think about it! – you can ovulate and get pregnant,' says Dr Mitra.
But even if your period doesn't return straight away, you can still get pregnant.
'If you're not taking the pill anymore and don't want to get pregnant, you need to use an alternative form of contraception straight away,' she adds.
The effects of going on and off birth control, frequently
Dr Leonard explains that coming off the pill and on again won't affect your fertility but this will have side effects, just like when you began the pill.
'Your body may take time to settle into a pattern as stopping and starting the pill is never great as your body doesn't have time to adapt to the contraceptive pill.'
And just because you had side effects before doesn't mean they will be identical again, it's also very much dependent on what else is going on in your body at the time, such as your stress levels and your diet.
Will my fertility decrease if I take the pill for 'too long'?
The most frequently asked question about coming off the pill are the side effects of staying on it for years and years. Despite a lot of people thinking that taking the pill long-term reduces your fertility, this isn't the case.
Unfortunately, some people have trouble conceiving, pill or no pill, and there isn't a library of research to confirm that the pill reduces fertility in the long term. A review of studies examining fertility after cessation of the pill, published on the NCBI website, found that women who take the pill shouldn't see a decrease in their fertility.
Although results indicated there may be a slight delay in getting pregnant, there wasn't a significant difference between women who had taken the pill and those who hadn't.
'The pill doesn't decrease your chances of getting pregnant, getting older does. The longer you are on the pill and your body is on synthetic hormones, it may potentially take longer to get back to regular and natural periods but this is not the rule for everyone,' says Dr Leonard.
The best thing to do? Concentrate on leading a healthy life. If you're trying to get pregnant with a male partner: 'Focus on making sure your partner is healthy too, as 30% of fertility problems are related to the man,' Dr Mitra advises.
'There has been increased media coverage of decreasing sperm counts and most of this is directly related to poor lifestyle choices.' Her advice? Live a healthy lifestyle together and enjoy regular sex, rather than viewing it as a baby-making task.
Are there benefits of coming off the pill?
'While the pill is a great contraception option, some people do suffer from unfavourable symptoms from taking certain pills,' explains Dr Leonard.
'These can include anything from bloating, acne, headaches, low libido or mood. Coming off the pill (or discussing your pill with your doctor and changing the one you are on) can help to reverse these symptoms and could therefore benefit you.'
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