Coming Off the Pill

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 the side effects of the contracptive pill they are using
• to try another type 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 a method that is convenient to use, effective, and has 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, before stopping the pill. 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 two to three months of coming off the pill. Visit your nurse or doctor if it does not, as this could be the sign of another underlying health issue.

The hormones within the contraceptive pill should have left your system within a couple of days after stopping the pill. Your cycle will usually take a little longer to return to the state it was before you started the pill, but should be back to normal within two to three months.

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 in order to solve problems like:

• heavy or irregular bleeding
• menstrual cramps
• acne or spots
• usual 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 pill, or a new form of contraception, 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 been having 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 should return to your usual pre-pill state after two to three months.

Compared to taking the pill itself, the likelihood of side effects after stopping the pill is very small. 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 in 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. This is because their body needs some extra time to start making its own hormones again.

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

Theoretically, 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 do so. This way, your midwife or doctor will be able to more easily predict your due date, 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 for 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 you individually-tailored advice for your situation.