Coming off the Contraceptive Pill

There are several reasons why you might have decided to come off the contraceptive pill. You may be:

• trying to get pregnant
• changing your lifestyle
• getting unwanted side effects
• taking a new medication that interacts with the contraceptive pill
• diagnosed with a condition that means the contraceptive pill is no longer suitable

Whatever your reasons, it’s important to understand how to stop taking the pill safely and what to expect.

When you take the pill, the balance of hormones in your body changes which causes changes in your reproductive system which stop you from getting pregnant. Although the exact process is slightly different according to which type of pill you take, the effects are the same as long as you do not miss a pill or have severe vomiting or diarrhoea that lasts longer than 24 hours.

Changes that prevent pregnancy

There are 2 commonly used types of oral contraception pills:

• the combined pill, sometimes referred to as ‘the pill’
• the progestogen-only pill, also known as the ‘mini pill’

They both have similar effects on your body including:

• preventing your ovaries from releasing an egg each month (although the mini pill does not always do this)
• making it difficult for sperm to get to an egg
• thinning your womb’s lining to reduce the chances of an egg attaching to it

Both types of pill are over 99% effective as long as you take it correctly all of the time. But if you miss a pill, it becomes less effective.

Other changes to your body

In the short-term, taking the pill can have effects on your body like:

• regulating your periods
• making your skin clearer
• causing changes in your mood
• getting side effects, such as nausea (feeling sick) and tender breasts
• slight changes in your weight, often due to retaining more water

For people who get mood changes, they can experience depression or mood swings, while others may experience positive changes like greater emotional stability.

Long-term effects of taking the pill can include:

• lowered risk of ovarian and endometrial cancers
• slightly increased risk of breast and cervical cancers
• slightly increased risk of blood clots
• reduction in premenstrual syndrome (PMS) symptoms
• improvement in endometriosis symptoms

Long-term effects of taking the pill will stop straight away or within a few weeks after you stop taking it, however, the risks of breast and cervical cancer will only go back to normal 10 years after you stop taking it.

There may be other side effects associated with the pill that you’re taking. Always read the patient information leaflet that comes with your medication.

When you stop taking the pill, the synthetic hormones which have a contraceptive effect begin to clear out of your system. It can take up to 3 months for your periods to return back to normal. Your regular ovulation and fertility level usually gets back to normal after about 1 month.

Most people will get their first normal period, sometimes called a ‘withdrawal bleed’ within 2 to 4 weeks of stopping the pill. For others, it may take longer for normal period cycles to resume. Ovulation can start quickly after stopping the pill for some people, so if you do not want to get pregnant it’s important to continue to use contraception.

When you stop taking the pill you may get short and long-term side effects as your body gets used to it. Some effects are physical, while others are emotional. However, they often resolve over time.

Physical side effects

Physical side effects after stopping the pill may include:

• acne – if you got acne before taking the pill and it had improved, when you stop the pill it may flare up again in the first few weeks, but this is often temporary and improves over time
• headaches – changes in your hormones when you stop the pill might cause headaches, but this is typically short-term and resolves as your hormones get back to normal
• bloating – you may get bloating because of hormonal changes when you stop taking the pill, but normally resolves itself as your body re-adjusts

Emotional side effects

Changes in your hormone levels as your body gets used to being off the pill may make you feel anxious or depressed, or cause mood swings. This is a normal thing to happen and symptoms should improve over time. If you’re finding things difficult, you can reach out to your GP surgery or call 111 for mental health support.

How long will it take for side effects to stop?

The duration of side effects will vary from person to person. Some side effects might clear up in a couple of weeks whereas others could take longer, but they should clear up within 3 months.

However, if side effects persist for more than 3 months, you should speak to your GP about them as it could be a sign of something else.

You can stop the pill at any time – you do not need to slowly reduce your dose. However, if you’re sexually active and wish to avoid pregnancy, you should not stop without switching to another method of contraception. There are several things you can do to make stopping the pill as smooth as possible.

1. Finish your current pill pack

Although you can stop taking the pill straight away, it is advisable to finish your current pack as this can help your body go back into its regular menstrual cycle afterwards. Sometimes stopping the pill in the middle of your cycle can cause spotting and cramping a few days after your last pill.

2. Choose an appropriate time

Many people stop taking the pill without getting side effects. However, to reduce the potential stress of getting side effects if you have other stressful things happening, you may want to choose a time to stop taking the pill when there are less stressors around you.

If you had difficult side effects when stopping the pill in the past, you might want to consider letting people close to you know when you’re stopping so they can offer support. You should also speak to your doctor about when to stop based on whether you'll be starting a new type of contraception.

3. Monitor how your body responds

It’s worth keeping notes on how your body responds to stopping the pill in case side effects persist beyond 3 months or are serious. That way, when you see your doctor you can give them a full picture of what has happened. Additionally, if you decide to take the same pill again in future it will provide you with a reminder of how your body could respond if you stop taking it.

4. Lead a healthy lifestyle

You may find that trying to lead a healthy lifestyle to support your body’s hormonal adjustment after stopping the pill can make any side effects easier to handle. Consider following a schedule with regular exercise, a sleep hygiene routine, and eating a balanced healthy diet.

5. Speak to your healthcare provider

You may want to consult a healthcare professional such as your GP for reassurance before stopping the pill. They can help you plan when you will stop taking it according to your reasons for stopping and advise on alternatives they can provide if required.

Stopping the mini pill vs the combined pill

If you’re taking the mini pill, you will normally become fertile again faster than if you were taking the combined pill. However, regardless of which pill you take, as soon as you stop taking any contraceptive pill you should use other contraception if you do not want to get pregnant.

➤ See our guide for more information on alternative types of contraception.

If you no longer wish to take an oral contraceptive pill but want to continue being protected from getting pregnant, there are alternatives available. You may find that other methods of contraception are more suited to you, particularly if you get side effects when taking oral contraception or have difficulty taking or remembering your pill.

Examples of alternative contraception include:

• an intrauterine device (IUD) or copper coil, which is fitted to your uterus
• an intrauterine system (IUS) or hormonal coil fitted to your uterus, which releases hormones
• a contraceptive implant inserted into your arm, which releases hormones
• a contraceptive injection of hormones given by a nurse at a sexual health clinic or GP surgery
• a contraceptive patch worn on your skin, which releases hormones
• a vaginal ring, which is put into your vagina and releases hormones
• condoms, worn on the penis to stop sperm entering the vagina and prevent the spread of sexually transmitted infections (STIs)

It is also possible for men to get a vasectomy, a procedure which stops sperm from being ejaculated during sex.

Natural family planning

Other options to try to prevent pregnancy are sometimes called ‘natural family planning’.

The fertility awareness method involves keeping track of your periods, so you know when you’re in the most fertile phase of your cycle. On those days, you can either use condoms or avoid sex. It can be 91 to 99% effective at preventing pregnancy when used correctly. However, if it’s not followed correctly, it is only 76% effective.

Another way to try to avoid pregnancy is called the lactational amenorrhoea method. This is where you breastfeed your baby regularly for 6 months after birth to avoid ovulation. Providing it is consistently followed correctly it is over 99% effective. However, if it’s not followed exactly, it is only 98% effective.

If you keep getting side effects after stopping the pill for more than 3 months you should contact your GP for help. You should also contact a healthcare professional if you:

• do not have a period for 3 to 6 months after stopping
• get severe side effects
• experience intense mood changes
• feel depressed or anxious

You may also wish to consult a healthcare provider if you get irregular menstrual cycles or have concerns about your fertility.