Deciding to bid farewell to your regular birth control regimen is a significant choice, with a myriad of reasons driving such decisions – from the desire to start a family to grappling with unwanted side effects like mood swings. While much is discussed about the implications of starting birth control, the journey post-birth control is often overlooked. What exactly should one expect when they decide to quit?
In the United Kingdom, the pill remains the go-to choice for birth control among women, encompassing both the combined pill (containing oestrogen and progestogen) and the progestogen-only pill, often referred to as the “mini pill.”
For those contemplating cessation of the pill, the recommendation is to complete the current packet. Doing so reduces the risk of unintended pregnancy from recent intercourse. In the case of the combined pill, it’s safe to engage in sexual activity during the pill-free break, provided the next packet begins promptly and continues for at least seven days. Stopping midway through a packet heightens the risk of pregnancy.
The most noticeable change upon discontinuation is the resumption of the normal menstrual cycle. If the combined pill has been keeping periods lighter, less painful, and predictable, stopping may lead to heavier and more painful periods. Menstrual patterns, previously irregular for some, will revert to their natural state. Those who experienced mid-cycle pain or pre-menstrual syndrome before using the pill may find these symptoms returning.
Users of the combined pill who enjoyed benefits such as improved skin or management of conditions like polycystic ovary disease may discover these advantages fade post-cessation. On the other hand, users of the mini pill might encounter a different experience. The progestogen-only pill, known for causing irregular bleeding, often light but unpredictable, may result in a more regular and predictable period once discontinued. Stopping both forms of the pill could alleviate side effects like acne, mood changes, or low libido for some women.
Crucially, fertility and menstrual cycles resume rapidly after pill cessation, with the potential for pregnancy within weeks or even days. A backup contraceptive method is imperative for those seeking to avoid immediate conception.
Turning attention to longer-acting contraceptives like the implant, hormonal intrauterine system (IUS), and the injection, similar effects on the menstrual cycle are observed. Periods may become lighter but more unpredictable, or even cease altogether.
Following the removal of an implant or IUS, the menstrual cycle typically returns to its previous pattern within weeks, and fertility normalizes within days or weeks. However, the injection may present a different scenario, potentially delaying the return of periods for several months and fertility for a few months. This delay is attributed to the injection’s high hormone dose and its potent suppression of the natural cycle. Nevertheless, most women resume regular periods within a year of discontinuing the injection.
For users of the copper intrauterine device (IUD), devoid of hormonal content, heavier and longer periods may be experienced. Fertility swiftly returns after IUD removal, emphasizing the need for backup contraception to prevent unintended pregnancies. Women with an IUD are advised against unprotected sex for a week before removal due to the rapid return of fertility.
Concerns about contraception having long-term effects on periods or fertility are largely unfounded. While some may experience a slight delay in the return of periods after ceasing hormonal birth control, especially with the injection, this is typically temporary and not cause for concern unless prolonged.
Ultimately, the decision to halt birth control is deeply personal and influenced by factors such as the desire for a child, relationship dynamics, and individual health considerations. Except for sterilisation, all modern contraceptive methods are designed to be fully reversible, and any effects noticed post-discontinuation are generally attributed to the natural resumption of the menstrual cycle.