How To Come Off The Pill

What Happens to Your Body While On the Pill?

Women choose to start taking the contraceptive pill for various reasons. The main reason is to stop them from getting pregnant or at least delay it until they feel ready, but some also use it to regulate their menstrual cycle, and manage acne, or premenstrual syndrome (PMS) symptoms.

There are 2 types of contraceptive pill available:

1. Combined oral contraceptive pill (AKA ‘the pill’) – contains synthetic versions of oestrogen and progesterone.

2. Progestogen-only pill (AKA ‘POP’ or ‘mini pill’) – contains only a synthetic version of progesterone.

Although your ovaries produce oestrogen and progesterone naturally, hormonal birth control works to override them and regulates your menstrual cycle to stop you from getting pregnant. The ways the pill can work depends on which type you are taking. The POP works by:

1. Thickening your cervical mucus, making it harder for sperm to enter the womb and reach an egg.

2. Thins the womb lining, so a fertilised egg cannot attach and grow.

The Oestrogen component in the COCP is supposed to stops your ovaries from releasing an egg (ovulation).

What Happens When You Come Off the Pill?

When you come off the pill, your menstrual cycle is no longer being controlled by the synthetic hormones in your pill. So, in time, you will experience natural periods again, just like you did before you started the pill, and your ovaries will release eggs.

When you first stop taking the pill, you’ll likely have a withdrawal bleed as your body adjusts to the changing hormone levels. You may notice it takes a few months for your cycle to regulate and have natural, regular periods. However, your next period is likely to be a natural one.

After coming off the pill, most people notice their cycles return to what was normal for them within 3 months. Although, this can vary between individuals and may take a little longer. That’s because whilst taking the pill, your body was receiving a steady dose of the synthetic hormones, so it can take a little while for your body to find its rhythm again.

Once you come off the pill, some of the symptoms you were experiencing before, such as irregular or painful periods may return. Often, the contraceptive pill can mask conditions such as endometriosis or polycystic ovary syndrome (PCOS).

Side Effects of Coming Off the Pill

There are some potential side effects of stopping the pill as your hormones naturally adjust, such as:

• acne

• mood swings

• irregular periods

• premenstrual syndrome (PMS)

These effects are usually temporary and are a result of the hormonal fluctuations that occur when you are coming off birth control.

What are the physical side effects of stopping the pill?

When you stop taking the pill, there are a number of physical side effects that you may experience including menstrual cycle changes, skin issues, and even weight fluctuations. Although the effects will be unique to you, it’s important to understand what to look out for.

Reasons to Come Off the Pill

Oral hormonal birth control, like the combined or mini pill, is a safe and convenient contraceptive method, but there are several reasons to stop taking the pill.

1. Natural hormone balance

   For some women, their motivation to stop taking the pill is wanting their bodies to naturally control their menstrual cycle.

2. Health risks of the pill

   The combined pill has been linked to an increased risk of blood clots, heart attacks, and strokes as well as breast and cervical cancer^[5]. Although the risks are small, for example, blood clots while taking the combined pill may affect up to 1 in 1000 people, stopping the pill can lower these risks and provide some peace of mind.

3. Wanting to get pregnant

   Perhaps the most obvious reason for coming off birth control is to get pregnant. One of the convenient things about the pill is you can get pregnant straight away after stopping.

4. Switching to another contraceptive method

   The contraceptive pill is not for everyone, and some women experience side effects that are severe enough for them to change birth control methods. When taking the pill it is possible to switch to a different type of pill or method such as an implant, coil, patch, or injection.

5. Lifestyle changes

   If your lifestyle changes, you may decide that you no longer need to take the pill.

6. Health conditions

   If you are diagnosed with any specific health conditions, you may need to stop taking the pill, such as Lupus (a type of autoimmune disease), blood clotting disorders, or a heart problem.

How to Come Off the Pill Safely

If you’re considering stopping the pill, you’re probably wondering how to stop taking the pill safely. Unlike some other medications, there is no right or wrong way to stop taking it and it is safe to just stop taking it.

Although there are no medical requirements to wean yourself off the pill or to stop taking it at a specific time, it is recommended that you finish your current strip. This will make it easier for you to track your menstrual cycle and give you a better understanding of when your period is likely to occur.

How to stop taking the pill

• Choose a time that suits you to come off the pill – for example, if you’re worried about side effects and you have an occasion, it may be best to wait until after the event to stop taking your pill.

• Book a check-up with your doctor or nurse to discuss coming off the pill and any steps you need to take especially if you’re looking to get pregnant or want to change contraceptive methods.

• Continue exercising regularly and eating healthily to promote hormonal balance and help your body deal with side effects.

• Ideally, finish your current strip of pills. You will then have your usual withdrawal bleed, then your next bleed should be your first proper period after coming off the pill.

Balancing Your Hormones Again

There are no guarantees about whether or not you will experience side effects when you come off the pill, but some people will notice that it takes their body a little while to adjust and find its natural rhythm again. Although the transition after stopping the pill will vary from person to person, there are natural ways you can support hormone balance through diet, exercise, and lifestyle changes.

Nourish your body with a Hormone-Balancing Diet

Eating a healthy, balanced diet which is rich in whole foods, that are nutrient-dense and contain healthy fats, fibre, and protein can positively benefit your hormone levels.

• Healthy fats

  Omega-3 fatty acids like those found in oily fish can balance hormones like follicle-stimulating hormone (FSH) and testosterone and manage conditions like polycystic ovary syndrome (PCOS)^[6].

• High-fibre foods

  Foods like vegetables, fruits, and wholegrains can help to balance oestrogen levels in the body^[7].

• Protein

  Protein is an important macronutrient required for the production of hormones, appetite regulation, and metabolism – all of which are important when coming off the pill. Choose healthy protein sources like lean meat, eggs, nuts, and seeds.

Exercise regularly to support hormonal health

Exercise is a powerful and underrated tool for managing hormone fluctuations after the pill. Low to moderate intensity activities can regulate oestrogen levels, and even manage side effects like mood changes and promote better health. Some good examples include:

• yoga

• walking

• swimming

• dancing

• jogging

• pilates

• gardening

Supplements for hormones

Some supplements can help restore natural hormonal balance after stopping birth control, such as:

• magnesium

• vitamins B6 and B12

• zinc

• folic acid (vitamin B9)

Prioritise stress management

Cortisol is a major stress hormone which can directly influence other hormone levels, including sex hormones. So, managing stress is vitally important as you transition off the pill. For example, women with high cortisol levels can have reduced sexual functioning including lower levels of arousal, sexual desire, and satisfaction.

Activities like mindfulness, meditation, breathing exercises, and prioritising good sleep can reduce cortisol levels and create a more balanced hormonal environment.

Benefits of Coming Off the Pill

For many people, coming off the pill can bring about many positive changes as the body gets back to its natural hormonal rhythms. There are several benefits of stopping the pill, including:

• Improved libido after stopping the pill is common because some pills can suppress testosterone levels, directly affecting your sexual desire and arousal.

• Returning to a natural cycle after the pill gives you a better sense of your natural menstrual cycle and is beneficial for recognising potential imbalances and tracking fertility.

• Enhanced mental clarity has been reported as a benefit of stopping the contraceptive pill as well as feeling more emotionally balanced.

• Mood improvements can be another benefit of stopping the pill because your body will adjust to its natural oestrogen and progesterone levels which have key roles in mood regulation.

• Further benefits include reduced number of headaches, less bloating, and better skin.

The benefits you can experience when you come off the pill will be unique to you, so you may experience some that aren’t listed here.

When to See a Doctor

If your periods have not returned after 3 months of stopping the pill or you’re experiencing side effects that you’re finding difficult to manage, you should speak to a doctor for advice.

If you’ve stopped taking the pill to get pregnant and have not conceived within one year, or if you’re aged 36 or over then sooner, you should speak to your GP. They may be able to prescribe medication to promote ovulation or discuss fertility treatments with you, if needed.