How Long Is Too Long to Be on Birth Control? Ob-Gyns Weigh In
Crucial info if you're on hormonal contraception right now—but plan to get pregnant in the future.
But while you might be happily popping a pill, inserting a ring, or sporting the birth control implant right now to postpone being a mom, it's hard not to wonder what the hormones in these methods are doing to your fertility long-term. When you do want to have a baby and stop taking birth control, will you be able to?
The answer: Being on hormonal contraception has no long-term effect on female fertility. However, it might complicate conception for other reasons.
“With most birth control [methods], as soon as you stop them, you will probably resume ovulation immediately or within the few weeks,” says Nichole Mahnert, MD, ob-gyn and assistant professor of obstetrics and gynecology at the University of Arizona, Phoenix. “You almost immediately return back to your normal hormonal levels.”
What Dr. Mahnert says is backed up by science. A study published in Obstetrics & Gynecology found that previous use of birth control pills had no effect on conception rates, with 21% of the women studied becoming pregnant after one normal cycle and 79% getting pregnant within a year of going off the Pill.
Why will it take just a month off of hormonal contraception for some women to conceive, while for others it takes up to a year or longer?
One explanation has to do with the age at which you decide it's time to toss your pill pack. “The longer we take birth control and we delay childbearing, the older we get, and as a result of that, our eggs get older, and it can become more difficult to get pregnant,” Dr. Mahnert says.
Another potential complication concerns the endometrial lining. One of the benefits of birth control is having a lighter period, but a lesser flow means a thinner lining, says Debra Wickman, MD, ob-gyn and director of female sexual medicine, menopause, and vulvar health at Banner University Medical Center in Arizona. When you’re on the pill, the thin lining makes your uterus an unfavorable environment for an embryo. Go off contraception, however, and it might take some time for the lining to return to the thickness needed for an embryo to implant, she explains.
Still, keep in mind that every woman is different, and some might have an endometrial lining that returns to normal immediately or within a few months, notes Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine. But for others, it could take longer.
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“Some people do get erratic cycling the first couple of cycles off the pill,” Dr. Minkin says, which is why she tells patients to wait two to three months before trying to get pregnant. By waiting, you’re giving your body time to readjust and start cycling regularly.
So is there a time limit for being on birth control, so you can avoid any possible pregnancy setbacks? No. “You can’t say there’s a set amount of months or years that’s too long, but women just need to be tapped into their own experience,” Dr. Wickman says, meaning that whether you're on the pill or not, you should always speak to your doctor if you notice any puzzling changes in your cycle.
Your fertility should return to normal once you ditch your contraception. If you're trying to get pregnant but it doesn't happen, don't panic. “You can have a post-pill disruption of your natural ovulatory cycle; that’s not uncommon. But for most women, that is going to reverse, and once you’re ovulating normally, the pill should have no long-term effect on fertility,” says Jennifer Wider, MD, women’s health specialist.
To coax your body into ovulating normally, Dr. Wider suggests avoiding stress. Worrying about not being able to conceive immediately after stopping the pill can lead to a vicious stress cycle, she explains. If all else seems normal, try to sit back and let your body do its job.