Coming Off the Pill

If you’re planning to come off the pill soon, there are a few things you should be aware of. It can take up to 3 months for your periods to return to a normal cycle.

The pill is usually the first form of contraception prescribed to sexually active women. However, it does not suit everyone. Women usually decide to come off the pill for the following reasons:

• to try another pill because of side effects
• to try another form of contraception
• to try to get pregnant

Finding the right method of contraception to suit you at your particular time in life can involve a great deal of trial and error. After having been on the oral contraceptive pill (‘the pill’), many women decide that it is no longer the right option for them, and look to try another type of pill or another method of contraception entirely.

Different pills, and different forms of contraception, will all have different side effects, and each woman will react differently to each method. It is important that you find the right balance between convenience, effectiveness and manageable side effects.

It is completely safe for you to stop taking your contraceptive pills at any point during the pill packet. For the sake of your bleeding pattern, it is usually recommended that you finish your current pack of pills first, though. Some women find that stopping their pills during the middle of a pack can throw their cycle off course, and they can get extra bleeding before their first ‘natural’ period.

Either way, your menstrual cycle should return to its usual, ‘natural’ state after 2-3 months of coming off the pill. Visit your nurse or doctor if it does not, as this could be a sign of another underlying health issue.

The contraceptive pill hormones should leave your system within a couple of days after stopping the pill.

The main thing to expect after coming off the pill is that any hormone-related effects you had before starting the pill are likely to return. If, like many women, you started taking the pill to solve problems like:

• heavy or irregular bleeding
• menstrual cramps
• acne or spots
• monthly mood swings

then it is likely that these will return after you stop taking the pill. If you are concerned about this, it is worth discussing your fears with a doctor or nurse, who may be able to advise alternative treatments for each of these symptoms.

The other very important thing to expect after coming off the pill is that you will be fertile again. If you are sexually active, you can get pregnant within a few days of coming off the pill. If you do not want to get pregnant, make sure you have organised a replacement method of contraception. If you are changing from one pill to another or to a new form of contraception entirely, it is sometimes advised to use an additional barrier method (like condoms) for the first 7 days of your change.

Finally, you can also expect your periods to return to how they used to be before you started taking the pill. Unless you stopped your pill immediately after the last ‘withdrawal’ bleed, your first period will be another ‘withdrawal’ bleed, much as you have had every month while taking the contraceptive pill. The next bleed after this one will be your first ‘natural’ period. This first period could be unusually light or heavy – but after 2-3 months your cycle should return to its usual pre-pill state.

Compared to taking the pill itself, the likelihood of side effects after stopping is minimal. There are very few, and these are unlikely to last very long at all.

The most common side effect of coming off the pill is ‘spotting’, which is minor bleeding between periods. This is usually harmless and should settle within the first few months of coming off the pill.

In some rarer cases, some women have been known to get what is known as ‘post-pill amenorrhea’, which is when they are unable to produce a natural monthly period for some months after stopping the pill. In this situation the body needs some extra time to start making its own hormones again.

Visit your nurse or doctor if you are concerned about side effects you are having after coming off the pill.

You can get pregnant as soon as a couple of days after you come off the pill. If you’re trying to get pregnant, it is usually advised to wait until your first natural period (after the first withdrawal bleed) to get started. This way, your midwife or doctor will be able to predict your due date more easily, and you will have some time to get into good physical shape for the pregnancy (quitting alcohol, smoking, taking folic acid supplements).

A common misconception is that ‘the longer you take the pill, the harder it will be for you to get pregnant’. This is not true! It makes absolutely no difference how long you have been taking the pill, the pill itself will not affect your chances of getting pregnant. However, in some cases it is true that the pill can mask underlying fertility problems (such as irregular periods).

If you are having problems conceiving, discuss your situation with your local nurse or doctor, who will be able to offer individually tailored advice for your situation.

The process of coming off the combined pill is similar to stopping the mini pill. Your period will take a few weeks to return to a regular cycle and you may notice other changes in your weight and mood over time.

If you want to change to another brand of the contraceptive pill, you should first visit your GP or message a ZAVA doctor who can explain how to go about it and what to watch out for.

Ideally, there should be no breaks between pill packs, so you’ll be advised to start the new pill immediately or the day after taking the last pill of your old pack. If the new type of pill takes time to start working, the doctor may recommend to use alternative methods of contraception in the beginning, to avoid getting pregnant.

There are types of contraception other than the pill that have hormones in them and also non-hormonal contraceptives. If you are changing from the oral contraceptive pill to some other type of contraception, particularly a hormonal one, you may have to use a third type of contraception during the changeover period to avoid getting pregnant. This will depend on where in your pill pack you are at the time of changing contraception.

For example, if you are getting the contraceptive implant in what is usually the first week of taking your pill, or during your pill-free week, you will be advised to use condoms for 7 days to give the implant time to start taking effect.