Whether you decide to stop the combined oral birth control pill because you want to get pregnant or it's simply no longer working for you, it's essential to know what to expect and how to manage potential side effects.

What happens to your body while on the pill?

The combined oral contraceptive pill is a synthetic form of the female hormones, oestrogen and progesterone

The ovaries produce these hormones naturally, but when you take the pill, the artificial hormones override them to stop the release of an egg (ovulation).

Because there's no egg to shed at the end of your menstrual cycle, the bleeding you get on the pill isn't a natural period. 

The pill also works by thickening the mucus in the neck of your womb, making it harder for sperm to penetrate the womb and reach an egg. 

It can also thin the lining of the womb so that it’s harder for a fertilised egg to implant and grow. 

What happens when you come off the pill? 

When you stop taking your oral contraceptive pill, you’re no longer receiving doses of synthetic hormones. After stopping the pill, the first period you might have will be a "withdrawal bleed". 

After this withdrawal bleed, it might take a while for your periods to regulate, but the next period you'll have is your natural period.

If you had irregular or painful periods before taking the pill, this might be the case again. This is because the contraceptive pill could have masked a condition like PCOS or endometriosis

4 reasons to come off the pill

Oral birth control is a common, safe form of contraception. It's also often prescribed to treat hormonal disorders like PCOS or PMDD and help regulate the menstrual cycle. But there are several reasons why you might choose to stop taking the pill.

Unwanted side-effects

Like any other medication, each version of the pill has side effects. These can include:

  • weight gain*
  • low sex drive
  • headaches and migraine 
  • mood changes 
  • breast tenderness

*Although many women historically believed that the pill leads to weight gain, research has concluded that it doesn’t. Other factors like mental health or lifestyle should also be taken into account if weight gain is experienced during the use of the combined oral contraceptive pill. 

Increased risk of breast cancer

The contraceptive pill can slightly increase the risk of breast cancer, and the risks may outweigh the benefits in women with a history of breast cancer in their families. Your GP can discuss this with you. 

Increased risk of blood clots 

For most, oral contraception is safe. But it may cause an increase in your blood pressure, and you could be more at risk for developing blood clots. Speak to your doctor if you are concerned about blood clots, especially if these run in your family or if you have certain medical conditions. 

You're ready to fall pregnant

You might be ready to come off the pill if you want to try and fall pregnant. Being on the pill for several years won't affect your ability to fall pregnant. The synthetic hormones also work their way out of your system and your fertility should return quickly. 

But for some, it might take a while before your ovulation and menstrual cycle regulates. The pill itself doesn't affect fertility, but it might have masked another condition like PCOS, making it harder for you to get pregnant. 

Find out more about how PCOS affects your fertility.

Side-effects of coming off the pill 

You could experience some side effects as your hormones readjust when you go off the pill. These include:

  • irregular periods
  • missing periods (also known as post-pill amenorrhea)
  • mood swings
  • acne 
  • painful periods 

Coming off the pill safely

There is no right way to go off the pill. You can stop in the middle of the pack or finish your current pack. It might be easier to track your cycle if you complete your pack and have your withdrawal bleed. 

Contraception


If you are planning to try for pregnancy, it’s worth planning before stopping contraception altogether. If you don’t want to conceive, decide on your alternative method of contraception, as it is possible to fall pregnant immediately. Some options include:

  • caps or diaphragms
  • condoms
  • contraceptive injections 
  • IUD (intrauterine device or coil without hormones)
  • IUS (intrauterine system — also a device or coil, but delivers hormones)
  • contraceptive patches
  • vaginal rings
  • the progesterone only pill (also known as the mini pill)

Some of these methods are entirely non-hormonal, while others, like the contraceptive patch or injection, still release synthetic hormones into your system. Speak to your GP about your best options. 

Balancing your hormones again 

While not all people experience side effects, some will find that their bodies take longer to adjust when coming off the pill. 

As your body's natural cycle returns, you might start experiencing unwanted side effects. But there are some things you can do to help you regulate your hormones again. 

When you stop taking the pill, you can ensure that you support your body by eating a balanced diet. You can do a home blood test to check if your nutrient levels are optimal.

You can treat nutrient deficiencies with our range of premium supplements.

Find out exactly what’s going on

You can do a blood test to check your hormones and manage PCOS symptoms.

Hormones don't only affect periods but so many other things in your body. This is why you might experience different side effects. 

Get good sleep


Support your circadian rhythm by getting good-quality sleep. Aim for 7-9 hours of sleep at night. 

See more tips for improving your sleep

Benefits of coming off the pill 

You might see the following benefits when you stop using the contraceptive pill:

  • improved mood 
  • an increased sex drive 

This is more likely if you experienced changes in these areas when you started taking the pill.

When to see a doctor

If you still don't have a regular period after 3 months of stopping the pill, you should see a GP to rule out any underlying conditions the pill might have been masking. 

If you regularly have sex and still haven't conceived in 1 year, you can speak to a GP about fertility treatment if you’re 35 and younger or sooner if you’re 36 and older. This might include:

  • medication that stimulates ovulation like clomifene 
  • injections that stimulate ovulation like gonadophrin 
  • in-vitro fertilisation (IVF)

If you have any bleeding between periods or after sex, it’s also best to discuss this with your GP immediately.

Thriva podcast | S4 E6: Exercise and your cycle
Arrow

References

Barańska, A., Dolar-Szczasny, J., Kanadys, W., Kinik, W., Ceglarska, D., Religioni, U. ve Rejdak, R. (2022). Oral Contraceptive Use and Breast Cancer Risk According to Molecular Subtypes Status: A Systematic Review and Meta-Analysis of Case-Control Studies. Cancers, 14(3), 574. doi:10.3390/cancers14030574

Beksinska ME, Smit JA, Kleinschmidt I, et al. Prospective study of weight change in new adolescent users of DMPA, NET-EN, COCs, nonusers and discontinuers of hormonal contraception. Contraception 2010;81:30–4

Darwish N, Bakillah H, Arun G, Srinivas S, Manaa M, Berliner K, Reddy D. Risk of Venous Thromboembolism: The Prothrombin-G20210A Mutation and Combined Oral Contraceptives. Advances in Clinical Medical Research and Healthcare Delivery. 2022; 2(2). doi: 10.53785/2769-2779.1097.

Fenasse, R., & McEwen, B. (2019). Impact of the oral contraceptive pill on health and nutritional status. Journal of the Australian Traditional-Medicine Society, 25(4), 197–203.