I come off the pill?
Whether you’re switching up your contraception or coming off to conceive, here’s what to expect when you stop taking your daily dose of supplementary hormones
01 WAKE UP CALL
Your ovaries are back in business. ‘The combined oral contraceptive pill prevents the release of the hormones that regulate your ovaries, stopping them from releasing eggs,’ says consultant gynaecologist Tania Adib. ‘When you stop taking it, these hormones return, your cycle is re-established and you begin ovulating again.’ NHS advice is that most women will have a period within two to four weeks, with an irregular pattern expected for up to three months. ‘However, the timeframe on this varies from woman to woman – it’s a process that can take up to a year,’ adds Adib. ‘Contact your GP if it gets to six months without your period restarting.’
02 MISSING, PRESUMED RED
If your period continues to be MIA, several issues might be to blame. ‘Most commonly, it’ll be down to polycystic ovary syndrome (PCOS), a thyroid issue or high levels of prolactin – a hormone that increases in pregnancy,’ says Adib. Or you may have hypothalamic amenorrhoea – usually associated with excess exercise, restricted food intake or high stress levels. This occurs when the brain doesn’t produce enough hormones to stimulate the ovaries to produce oestrogen – without which, your periods will be a no-show. Note that this can be masked by the withdrawal bleeds you get monthly on the pill. If this sounds familiar, tell your GP.
03 OH, BABY!
Logic would suggest that once your periods reappear, so does the chance of conceiving a little bundle of joy. And while that’s true, the reverse – absent bleeds indicating you can have unprotected sex minus the risk of conception – is not. ‘Even if you haven’t had a period since you came off the pill, you can still get pregnant,’ says Adib. ‘So make sure you use another form of protection if you aren’t trying for a baby.’ If you are, good news: a 2018 review published in Contraception And Reproductive Medicine found that using – and stopping – the pill had no negative effect on fertility.
04 FOR BETTER, FOR WORSE
Much like an ex messaging you a friendly holiday greeting in the early hours of a December morn, a few undesirables may pop up when you stop popping the pill. ‘If you started taking it for a specific reason, such as to treat acne or manage PMS, unwanted hair growth or weight gain from PCOS, then those issues can all get worse when you stop,’ says Adib. On the flip side, any weight gained as a result of going on the pill will likely drop off. ‘The side effects from synthetic hormones will often disappear when you stop taking them,’ she adds. Discuss alternative ways to address any issues that the pill had been helping you manage with your GP, before they creep back.
05 IT’S A MOOD
If your emotions plummet post-parting ways with your daily tablet, hormonal fluctuations are likely to blame. ‘Most commonly they’ll cause low mood, which can take three to four months to level out,’ says Adib. In happier news, coming off the pill means you’re more likely to get the horn. ‘When you take the pill, it increases sex hormone-binding globulin (SHBG), which binds to a lot of your testosterone, rendering it inactive,’ says Adib. ‘Testosterone is key for libido, so low levels can mean a low sex drive. Coming off the pill corrects that.’ And, since good sex releases feel-good hormones? Alexa, play Barry White.