At Modern Fertility, we love busting medical myths. (We should probably have our own show, TBH.) And when it comes to hormonal birth control, and going off it, there's a lot of misinformation out there — from birth control's impact on your fertility to post-BC side effects to whether or not it's healthy to skip your periods altogether.
It's absolutely vital to have the latest, most accurate information about reproductive health, so we're recapping our live Q&A about birth control with one of our Medical Advisory Board members, Dr. Jane van Dis, MD, FACOG, an OB-GYN and Medical Director at OB Hospitalist Group, to do just that.
After you’re done reading this article (and watching the video at the end if you’re feeling extra curious), you’ll have the answers to these Q’s:
- Does birth control impact your fertility?
- Is it okay to skip your period using hormonal birth control?
- Do you need a birth control detox?
- Is there really a post-BC "adjustment period"?
- Will you experience side effects after stopping birth control?
- What's important to keep in mind before trying to conceive?
Let’s dive in with the expert herself, Dr. van Dis.
Can birth control impact your fertility?
"Out of all the birth control types, there's actually only one that can cause an impact on fertility, and that's Depo-Provera," says Dr. van Dis. "It's the only means of birth control that we know can cause weight gain and a delay in return to your fertility." (In fact, according to Dr. van Dis, 83.1% of women who stop taking hormonal birth control will get pregnant within 12 months.)
Just as an FYI, you don't “save” any eggs by not ovulating when you're on hormonal BC. "The age of your eggs is your age," says Dr. van Dis. If you start taking the pill when you're 25 and you stop taking it when you're 35, you have 35-year-old eggs — which is important to know, since fertility is impacted by age. But being on birth control for a long time (say, more than 10 years) doesn't negatively affect your fertility. (Read more about birth control and fertility.)
Is it unhealthy to skip your period with the pill?
Nope. We associate periods with normalcy and femininity, "but if you think about it, throughout history, before birth control was made available, women were having fewer menstrual events because they were more often pregnant or nursing," says Dr. van Dis. "Not ovulating is, in a way, more natural."
There are health benefits to skipping periods for many women: It can ease symptoms for those who suffer from endometriosis and menstrual migraines, and it can decrease the risk of endometrial cancer for women with polycystic ovary syndrome (PCOS) and the risk of ovarian and colorectal cancers.
Is there truly an "adjustment period" for your body after you go off birth control?
The science is strong on this one. "97% of women are going to return to a normal period within 90 days of cessation of their birth control," explains Dr. van Dis. If you're one of 3% of people with ovaries whose periods don't return within 90 days, you're going to want to look for other reasons as to why. Dr. van Dis urges women to visit their doctors to consider the possibility of conditions, such as PCOS. "Be proactive," she says.
Having said that, whatever the native state of your period was before birth control, that’s what you’ll return to. If you initially got on birth control to address an issue, like mood swings or cramps, you won't know if things have changed until you stop using the hormones and you return to that native state. If your pre-BC symptoms return, it’s important to visit your doctor to investigate the underlying situation. Severe menstrual cramps, for example, could indicate endometriosis. (Read more about going off birth control.)
Do you need a birth control cleanse?
"It's not a thing," declares Dr. van Dis. To use birth control pills as an example, 13-20 hours after you take a birth control pill, only half the hormones are left in your system. That's why if you miss two birth control pills, you're supposed to use a backup method of birth control. "So this idea of needing a washout [or cleanse] is completely false. Your body is naturally washing those hormones out." (Read more about the birth control cleanse myth.)
What are the side effects of coming off birth control?
While there are no side effects specific to coming off birth control, it’s important to note that you might see some changes after stopping. "If you're going off birth control, expect that some of those experiences and side effects you had before you went on will come back," says Dr. van Dis. "If other things have changed — for example, if you've gained or lost weight since you've been on a birth control method — that can [also] affect your menstrual cycle."
What's important to keep in mind before trying to conceive?
When you're trying to conceive, Dr. van Dis recommends that avoiding alcohol and recreational drugs should be high on your preconception checklist. She also suggests maintaining a healthy lifestyle in other ways, including eating balanced meals, taking prenatal vitamins with folic acid, and exercising. Exercise lowers the risk of gestational diabetes, and women who exercise during pregnancy have shorter and less painful labor. Just make sure you don't overdo it and you're drinking enough water.
If you're over 35 and if you haven't conceived after three cycles, visit your OB-GYN to talk about next steps. If you do have trouble conceiving, Dr. van Dis says to remember this: "It's not just about the physiology of a woman's body — there's a huge portion of infertility that's due to male factor,” she explains.
And there you have it: your biggest questions about going off birth control, answered. Learn even more by watching the full video with Dr. Jane van Dis (below) — and keep your eyes peeled for reproductive health info and live Q&As coming your way.