What to expect when going off birth control

Whether you want to start trying for a baby or you’ve just had enough of any annoying side effects, you’ve decided getting off birth control is the right decision for you. It’s natural to feel uncertain about making the change, especially if you’ve been on birth control for a long time. We’ll explore what to expect and how long it can take for your period to come back, plus tips on how to make the transition as smooth as possible. 

Key takeaways

• You could get pregnant right away after stopping birth control. The only exception is if you’ve been getting the birth control shot, which can take three months or more to clear from your body.
• If you go on birth control to help control skin breakouts or to have shorter and lighter periods, prepare yourself for the fact that you may lose these benefits when you come off it.
• If you have concerns about symptoms like these coming back when going off of birth control, chat with your doctor first. They may be able to give suggestions to help you prepare for any changes to your body. 

Three reasons for getting off birth control

There are no right or wrong reasons for wanting to come off birth control — there’s only what’s right for you. Some of the reasons people decide it’s time for a change can include:

You’re trying to become pregnant

Of course, one of the most common — and exciting — reasons to get off birth control is because you want to start trying for a baby. We’ll explore how long it could take you to get pregnant below (spoiler alert: It could be very soon!).

You’re experiencing negative side effects

From headaches to sore breasts or mood swings, some of the possible side effects of birth control are not ideal. “The most common side effect that causes people to stop their method is an undesired bleeding pattern, like spotting,” says Flo expert Dr. Renita White, obstetrician and gynecologist, Georgia Obstetrics and Gynecology, US. Whatever the side effects, if your birth control isn’t working for you, then you should feel empowered to stop. 

You want to switch to a different kind of birth control

Maybe you’re looking for a form of birth control that’s lower maintenance than taking the pill every day. Or perhaps you simply want to come off hormonal birth control and stick with barrier methods instead. Whether it’s because your relationship status has changed or other factors have shaken up your lifestyle, there are all kinds of reasons why you might want to switch to a different kind of birth control. All are valid, and your doctor can help you to figure out which alternative is best. And remember to use condoms if you don’t immediately switch to a new kind of hormonal birth control.

What to expect when you stop hormonal birth control

You could get pregnant right away

This is vital info to know whether you’re looking to conceive or not. But how long it takes to get pregnant can vary according to the form of birth control you’re on. “Depending on your birth control method, it may be possible to conceive right away,” says Dr. White. “Methods like the pill, birth control patch, or vaginal ring can be out of your system within hours.” 

Not every contraceptive works that way, though. “After [coming off] methods like the Depo-Provera shot, it may take up to three to six months to conceive, as the medication wears out of your system,” adds Dr. White.

The bottom line? If you’re thinking about getting pregnant and you’re planning to have unprotected sex after coming off the pill, patch, or ring, make sure you’re ready for the possibility of becoming pregnant quickly. And if baby-making is not on your agenda, switch immediately to a different kind of contraception — the idea that you need a break between different types is a myth.

That said, if you’re trying for a baby and don’t get pregnant immediately, there’s no need to panic. With frequent unprotected sex, most couples will get pregnant within a year of trying. It’s only after one year (or six months if you’re over 35) that your health care provider would want to check for any fertility issues. 

Your menstrual cycle might change

In a normal menstrual cycle, the hormones estrogen and progesterone rise over the course of the month to prepare your body for a possible pregnancy. If you don’t get pregnant, these hormones drop, and you get your period. Hormonal birth control — which contains synthetic forms of either estrogen and progesterone or progesterone on its own — causes your body to pause these processes. 

Many forms of hormonal birth control are designed to mimic a normal menstrual cycle with a one-week “break” in the hormones where you have a bleed. For example, the pill usually comes in 28-day packs, where only the first three weeks contain active pills (ones with hormones), and the fourth week contains placebo pills. In the fourth week, the pause in the hormones causes your body to have a withdrawal bleed.

Importantly, while it may look like you are menstruating, a withdrawal bleed is not actually the same as a period. Dr. White explains: “The bleeding someone has on birth control pills, for example, is withdrawal bleeding from taking the placebo pills, as opposed to a true menstrual bleed that follows ovulation.”

This means that when you come off birth control, you will get your actual period again. Your period may be heavier, more prolonged, and irregular and cause more lower abdomen pain than withdrawal bleeding. It all depends on what you experienced before going on hormonal contraception. 

“When no longer on a contraception method, you go back to what your body would naturally do,” explains Dr. White. “For example, if you have irregular cycles when not on birth control pills, you will likely go back to irregular bleeding when you are off the method [this is why some women start using the pill to regulate periods]. Similarly, some birth control methods help to stop or lighten menstrual cramps. So you may experience cramps after stopping birth control.”

You might notice some spotting 

The hormonal changes your body goes through after getting off birth control can trigger some spotting, according to Dr. White. “Once off your birth control method (even if only missing a pill or two), your hormone levels begin to rise again, and this can lead to breakthrough bleeding,” she says. “You may experience light bleeding that looks like brown discharge after stopping birth control before a full withdrawal bleed begins.”

Dr. White adds: “The first bleed after stopping a hormonal birth control method is withdrawal bleeding, not the first actual period.”

You might get premenstrual syndrome (PMS) symptoms again 

As birth control helps to control the hormones that cause PMS symptoms — like bloating, nausea, and tender breasts — you may find these reappear after stopping it. PMS symptoms can range from being mildly annoying to completely debilitating. In fact, some people start using hormonal contraceptives for this very reason.

If you’re worried about your PMS symptoms returning after going off birth control, know that there are things you can do to help ease them. These can include lifestyle changes to reduce stress, like yoga, breathing and relaxation techniques, and getting plenty of sleep. You shouldn’t have to just put up with PMS, so speak to your health care provider about any concerns you have. 

Your weight might fluctuate 

If you’ve been on the birth control shot, you might notice your weight change slightly when you stop using the contraception. “The Depo-Provera shot is the only method that has been linked to weight gain due to changes in appetite,” says Dr. White. “Other methods, like the pill, are not linked with weight gain.” 

That said, remember that everybody is different, so there’s no telling whether you’d notice any change in your weight even after stopping the birth control shot. It’s also entirely normal for weight to fluctuate throughout your life, and even from day to day — by as much as five pounds. So try not to focus on any number on the scale as long as you’re feeling healthy and well. 

Your acne might return

Contraception that includes the hormone estrogen, like the vaginal ring and combined oral contraceptives, can improve acne. This is because estrogen cancels out the effects of testosterone, another hormone that causes your skin to produce more oil.

Frustratingly, it can mean that stopping birth control can cause your acne to return. But going off birth control doesn’t have to mean living with breakouts, as there are plenty of other acne treatments you can try. From a regular skincare routine to medications like retinoids or antibiotics that you can apply to your skin, there are many ways to keep acne at bay that don’t involve hormones. Chat with your health care provider or a dermatologist about your concerns to find out the best course of action for you. 

You might notice a higher sex drive 

Some women find they have a lower libido or experience vaginal dryness on hormonal contraception like the pill. This means that after coming off the medication, you may feel more frisky.

When will you get your first period after stopping birth control?

Since the very first bleed you have after stopping hormonal birth control is a withdrawal bleed, when will your actual period start up again? 

To answer this, let’s quickly recap what causes your period. Hormone levels during the menstrual cycle cause your body to release an egg (ovulation) so that it can get fertilized by a sperm and develop into a pregnancy. If, in any given cycle, the egg doesn’t get fertilized, it triggers the lining of your uterus to break down and shed, resulting in your period.

The hormone levels in contraceptives like birth control pills prevent pregnancy by stopping ovulation — and therefore menstruation — from happening. When you no longer get these extra hormones, your body will start to ovulate again, and your periods will resume (unless you become pregnant). In general, this happens in a matter of weeks, with people’s periods returning to normal around a cycle or two after stopping hormonal birth control.

But how quickly ovulation and menstruation return can vary. “It depends on how long you were on your birth control method as well as what type of method,” says Dr. White. “For example, for contraception like the Depo shot, it may take three to six months to get your period.” 

Different people can also react differently to getting off birth control. For example, when it comes to the pill, for many people, ovulation begins again just a few weeks after stopping the contraception. However, for others, it can take several months for the body to start producing the right levels of hormones needed for ovulation. If you don’t have a period within three months of coming off the pill, it’s worth taking an at-home pregnancy test just to make sure you’re not pregnant and speaking with your doctor. 

Tips for getting off birth control

Ultimately, there is no “best way” to get off birth control. It all depends on what’s right for you. “Talk to your health care provider about the reasons you want to come off and determine what the best next step is for you,” says Dr. White. The following tips can also help you to prepare for the change with confidence. 

• If you’re on the pill, the patch, or the ring, you can stop anytime. Just remember that you will have a withdrawal bleed when you stop, so finishing your current cycle will give you the longest break possible from your last withdrawal bleed. 
• Get your health care provider to remove an IUD or a hormonal implant rather than trying to remove the devices yourself. If an IUD becomes dislodged but not fully removed, for example, it can cause cramping and pain.
• Plan to spend some extra time on self-care. From PMS symptoms to heavier periods or acne, the possible consequences of coming off birth control can be tough to deal with. Set aside time to do things that make you feel good, whether that’s exercise, quiet nights in, or cooking healthy meals. 
• Talk to those closest to you about the fact you’re coming off contraception. Having the support of your loved ones can make a big difference in how you feel and can help you adjust to hormonal changes.