When you stop taking Myfembree, your period will return and your symptoms will gradually come back. In clinical trials, most women got their first period about 30 to 40 days after their last dose. The medication works by suppressing your body’s reproductive hormones, so once you stop, those hormones ramp back up and the conditions Myfembree was managing (heavy bleeding from fibroids, endometriosis pain, or both) typically resume.
When Your Period Comes Back
The return of menstruation after stopping Myfembree is well documented across multiple clinical trials, and the timeline is fairly consistent. In studies of women with uterine fibroids, 100% of participants in one trial and 93% in another resumed their periods, with an average time of 31 to 36 days from the last dose. Women in endometriosis studies saw similar numbers: roughly 84% resumed menses, with an average wait of 27 to 39 days.
If you took Myfembree for a longer stretch, the gap before your first period may be slightly longer. Women who completed a full 12 months of treatment waited an average of 37 to 41 days. This isn’t a cause for concern. Your body simply needs a bit more time to restart its hormonal cycle after a longer period of suppression.
Keep in mind that your first period back is likely to resemble what your periods looked like before you started treatment. If you were dealing with heavy menstrual bleeding from fibroids, that heavy bleeding will generally return once the medication is fully out of your system. Myfembree manages symptoms while you take it, but it doesn’t cure the underlying condition.
How Your Body Restarts Hormone Production
Myfembree contains a compound that blocks the signal your brain sends to your ovaries telling them to produce estrogen and progesterone. While you’re on the medication, levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), the two key reproductive hormones from the pituitary gland, stay consistently low. That prevents the hormonal surge that normally triggers ovulation each month.
Once you stop taking it, this blockade lifts quickly. In a study tracking ovulation after discontinuation, the average time to return to ovulation was just 23.5 days. Every woman in the study either ovulated or initiated menses after stopping. This rapid recovery is one of the notable features of this class of medication compared to older hormone-suppressing treatments, which could take months to wear off.
Fertility After Stopping Myfembree
If you’re planning to get pregnant, the good news is that Myfembree does not appear to cause any lasting delay in fertility. Ovulation returns in under a month on average, meaning you could conceive within your first cycle off the medication. Because of this fast turnaround, you should use non-hormonal contraception (like condoms) if you stop Myfembree for any reason and don’t want to become pregnant right away.
The clinical trial data is reassuring on this point. Across all the studies, the vast majority of women, between 84% and 100% depending on the trial, resumed normal menstrual cycles. After 12 months of use, 94% to 98% of women got their periods back. The small percentage who hadn’t resumed menses by the time the study ended may simply have needed more time or had other factors at play.
Symptom Return: What to Expect
Myfembree does not shrink fibroids permanently or eliminate endometriosis tissue. It works by lowering the estrogen levels that fuel these conditions. Once your estrogen rises back to its normal premenopausal levels, the conditions pick up where they left off. For most women, this means the heavy bleeding, pelvic pain, or both that prompted treatment in the first place will return within a cycle or two of stopping.
The clinical trials did not track detailed pain scores or bleeding volume in the weeks following discontinuation, so there isn’t precise data on exactly how quickly symptoms ramp back up. But the mechanism is straightforward: as your hormones normalize over those first 30 to 40 days, the hormonal environment that drives fibroid-related bleeding and endometriosis pain is reestablished. Some women notice a gradual return, while others find their symptoms come back in full force with that first post-treatment period.
Bone Density: A Lasting Consideration
This is the part worth paying close attention to. Myfembree can cause a decrease in bone mineral density (BMD) during treatment, and the FDA is clear that this loss “may not be completely reversible after stopping treatment.” Your bone density may improve once you’re off the medication, but full recovery is not guaranteed.
This is the reason the FDA limits Myfembree use to a maximum of 24 months. Bone loss increases the longer you take the medication, and the long-term impact on fracture risk in premenopausal women is still unknown. If you’ve been on Myfembree for close to two years, the bone density question is especially relevant. Women with existing osteoporosis should not take the medication at all.
If bone density is a concern for you, a DEXA scan (a simple, painless bone density test) can give you a baseline and help track any changes. Weight-bearing exercise, adequate calcium, and vitamin D all support bone health during and after treatment.
The 24-Month Limit and What Comes Next
Because of the bone density risk, Myfembree is designed as a time-limited treatment. That means most women will eventually face the question of what to do when they stop. Your options depend on your specific condition and goals.
For women with fibroids, stopping Myfembree often becomes a bridge to another decision: whether to pursue a procedure like uterine fibroid embolization, myomectomy, or hysterectomy, or whether to try a different medical approach. Some women use Myfembree specifically to control symptoms while they plan for surgery or while they’re waiting for menopause to naturally reduce their estrogen levels.
For endometriosis, the picture is similar. The pain relief Myfembree provides typically doesn’t outlast the prescription. Other hormonal options, surgical excision of endometriosis tissue, or a combination of approaches may be part of the next chapter. If you’re approaching the 24-month mark, it’s worth having a conversation about your plan well before your last pill.