Deciding to stop using birth control is often prompted by changing life circumstances, health considerations, or future family planning goals. Navigating this transition requires understanding the logistics of cessation and anticipating the physiological changes that will occur as the body adjusts. Consulting with a healthcare provider is an important first step to ensure a smooth and informed process, whether the goal is pregnancy or simply a change in contraceptive method.
Primary Reasons for Cessation
The decision to discontinue hormonal contraception typically falls into two major categories: family planning and quality-of-life concerns. The most frequent reason for stopping is the desire to attempt conception. Many people choose to stop their birth control a few months before actively attempting pregnancy to allow their natural cycle to re-establish itself, although fertility can return almost immediately for most methods.
A significant number of users also discontinue hormonal contraception due to adverse effects. These side effects can include persistent mood changes, such as increased anxiety or depression, or a decreased libido. Persistent breakthrough bleeding is another common complaint. For some, the return to a non-hormonal state prompts them to switch to barrier methods or non-hormonal Long-Acting Reversible Contraceptives (LARCs).
Timing the Process of Stopping
For those taking combined oral contraceptives (the Pill), the question often arises whether to stop mid-pack or finish the current cycle. While one can stop taking the pill at any time, finishing the active pills is often suggested because it offers a clearer starting point for tracking the return of a natural menstrual cycle. Stopping mid-cycle may cause unscheduled bleeding and make it harder to predict the first true period.
Methods like the contraceptive injection, such as Depo-Provera, require a different approach. Depo-Provera is slowly released and can suppress ovulation for up to seven to nine months after the scheduled injection date, significantly delaying the return of fertility compared to other methods. Long-Acting Reversible Contraceptives (LARCs), including hormonal implants and intrauterine devices (IUDs), require removal by a clinician. Once removed, the hormonal effect ceases almost immediately, and fertility can return very quickly.
Physiological Changes After Discontinuation
The body begins a process of readjustment as it takes over hormone production again. This transition is marked by the return of the natural menstrual cycle, which can sometimes be irregular for the first few months. Some individuals may experience post-pill amenorrhea—the absence of a period for three to six months—though this is usually temporary.
Fertility often returns quickly for most methods, including the pill, patch, ring, and IUDs, with many individuals ovulating within weeks of cessation. The primary change is the re-emergence of conditions the birth control was managing, such as acne or heavy, painful periods. Conversely, side effects experienced while on the contraceptive, such as headaches or decreased libido, often resolve as the body adapts to its natural hormone levels.
Age, Health Risks, and Long-Term Use
The decision to stop birth control can be driven by a change in health status or age-related risks. Combined hormonal contraceptives carry an increased risk of venous thromboembolism (VTE), especially in users over the age of 35 who smoke. A healthcare provider may recommend switching to a progestin-only method or a non-hormonal option to mitigate this risk.
The approach of perimenopause also prompts a conversation about cessation, as fertility naturally declines but does not disappear until after menopause, which is defined as 12 consecutive months without a period. Continuing contraception is generally recommended until age 50 to 55 to prevent unintended pregnancy, but new medical conditions can become contraindications. The development of uncontrolled hypertension or certain types of migraines may necessitate stopping estrogen-containing contraceptives due to the increased risk of stroke and heart attack.