What You Need To Know About Coming Off Contraception
Your Cycle May Change
If you’ve made the decision to come off contraception – whether it’s the pill, coil or implant – it’s worth understanding that your cycle may be different to what it was pre-contraception. “If you’ve been on contraception, such as the pill, for decades, coming off in your thirties or forties may mean your normal cycle is likely to be different to what it was when you were a teenager or in your twenties,” explains obstetrician and gynaecologist Tara Hughes. “This isn’t a result of a specific contraception, just the normal process of ageing, but because something like the pill delivers a constant hormone level, the ageing process can be masked,” she explains. At the same time, if you struggled with PMS and heavy bleeding in the past, this may come back. “If you have endometriosis, you may also find you have more painful periods and pain at other times in your cycle,” says Tara. She also explains the copper coil is the exception to the rule: “This doesn’t contain any hormones, so there are minimal side effects, and your periods are actually likely to be lighter once removed.”
Be Wary If You Remove Your Coil Early
“When it comes to the Mirena coil, the effects on your period are likely to be similar to coming off the pill,” Tara says, “When it comes to physical and emotional symptoms, the side effects should be minimal.” However, if you do decide to take your coil out earlier than planned, especially within the first year, this can trigger more side-effects. “There are very low levels of progesterone found in the bloodstream of women with the Mirena coil, but they are highest after the first year of insertion, so removal during this time may be more noticeable,” explains Tara.
Your Period May Take A While To Come Back
After having the coil removed, there may be some bleeding for the next week or so, and once finishing the pill, you will experience your regular withdrawal bleed. After that, however, it can take several weeks, or even months, for things to settle down. “The first period you have after stopping the pill will be a withdrawal bleed rather than a genuine period,” says Tara. “A period can start as soon as one month after stopping the pill, and with the Mirena coil and the implant, women should expect their period to return in one to three months.” Tara also says the time it takes for your period to come back shouldn’t be affected by the amount of time you’ve been on contraception: “Other factors like weight, the amount of exercise you do, stress, age and polycystic ovarian syndrome are all much more likely to affect the time it takes for your periods to return.”
You Can Get Pregnant Straight Away
If you want to conceive, you may have heard that you need to stop taking the pill several months before you start trying, as for some women it can take time for your periods to return to normal, but doctors agree this isn’t necessarily the case. In fact, most women will ovulate within two to four weeks after coming off the pill, says Tara. “It’s important to remember you can get pregnant when you come off contraception, even before your period returns. Hormones leave your system very quickly, and this is why there is always a risk of pregnancy with missed contraception.” Many doctors advise you should delay trying to get pregnant until you’ve had a normal period, not the withdrawal bleed, although this is only so they can better tell how many weeks you are when you do become pregnant. The return of your period may also bring ovulation pain, which, if you’ve been on contraception for a while, may seem strange, but is totally normal. This tends to feel like a sharp or dull cramp that happens on the side of the lower abdomen roughly two weeks before your period starts.
Things Can Take Longer If You’ve Had The Injection
If you are hoping to fall pregnant soon after coming off the contraceptive injection, you may need to wait a little longer, but be reassured it won’t affect your ability to conceive, says Tara. “The contraceptive injection is the one exception when it comes to how quickly it takes for hormones to leave your system. The injection is usually administered every 13 weeks and once it’s given, the progesterone-like hormone that’s injected remains in your body until the next injection. It’s the only hormonal contraceptive that’s associated with a delay in return of periods and fertility. It can take up to a year for your period to return after stopping the injections.” If your plan is to conceive immediately after hormonal contraception, the injection may not be the best choice for you.
Your Complexion May Suffer
If you decided to go on the pill to help with acne and blemishes, it’s possible these issues can reappear once hormones return to their natural levels. The combined pill in particular is a very effective acne treatment, as the oestrogen in this pill appears to inhibit acne by reducing the production of androgens (responsible for oil production and pore-blocking) and reducing the amount of active free testosterone in the blood. While it’s likely you’ll grow out of your acne while taking the combined pill, and therefore won’t experience a flare-up when you stop taking it, others may find blemishes appear for the first time, implying the pill was masking your acne for several years. “If this continues in the longer term, see your GP or dermatologist who can recommend non-hormonal treatments for acne, such as topical acids, benzoyl peroxide, and other topical or oral antibiotics and retinoids,” Tara says.
Your Weight May Be Affected
As the body returns to producing hormones naturally, you may notice some physical changes. For example, the reduction in oestrogen may cause a slight change in breast size, while some women say they lose weight, especially after coming off the pill, although it’s believed this isn’t true weight loss, merely loss of water retention caused by progesterone. Tara also explains there is some evidence the contraceptive injection can cause weight gain, so if you come off this, chances are you’ll lose a few pounds.
Your Libido May Increase
One of the biggest complaints a lot of women have about the pill specifically is the effect it has on their sex drive. While this doesn’t affect everyone, hormones may play a role. Some women have lower testosterone levels on the pill, and because they don’t ovulate, this can affect your libido.
It Might Be Time To See Your GP
The experts say it can take up to three cycles to revert back to what’s normal for you, meaning that if you haven’t had a period within three months of stopping the pill or having your coil removed, check in with your GP. And if you’re trying for a baby, don’t be disheartened if you don’t fall pregnant straight away, but remember it could happen. Tara adds knowledge is power when it comes to knowing your cycle if fertility is your goal. “Tracking your periods won’t affect your baseline fertility, but will absolutely maximise your chances of pregnancy each month.”
For more information on contraception, visit NHS.uk and Sexwise.org.uk
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