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We asked a gynaecologist to explain exactly happens to your body when you come off the pill – including any side effects you might experience.

Many people start taking the contraceptive pill in their teenage years or early 20s. This means that by the time you think about coming off it, you might have already been taking the pill every day for the best part of a decade.

This isn’t necessarily a bad thing, as the pill is one of the most effective ways to prevent pregnancy. Although it has been linked to some serious health problems including blood clots and breast cancer, the NHS says that the risk of developing these conditions due to the pill is very low.

However, taking the pill does adjust your body’s natural hormones in order to stop you getting pregnant. Depending on which pill you use, it releases artificial versions of the hormones progesterone and/or oestrogen into your body (the ‘combined’ pill contains two types of hormones, while the ‘mini’ pill contains only one). Some people react very well to these hormones, as they can help clear up acne and stabilise your mood. 

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Others don’t react so well to those extra hormones. “Many people experience side effects when using certain contraceptive pills, such as headaches, breakthrough vaginal bleeding or spotting, a change in libido, weight changes, breast tenderness and more,” explains Dr Sarah Welsh, a gynaecologist and co-founder of sexual wellness brand Hanx.

Even if you haven’t experienced any negative side effects from the pill, you might want to take a break from it anyway – whether that’s to use non-hormonal forms of contraception or try for a baby. And while there’s no reputable evidence that shows being on the pill for a long time is bad for our health, some of us are keen to know what we’d be like without the effects of artificial hormones.

What happens to your body’s hormones when you stop taking the pill?

“When you stop taking the contraceptive pill, whether progesterone only or the combined pill, your body’s natural hormones start kicking in again,” Welsh explains.

Your body’s natural menstrual cycle won’t restart straight away. For most people, it takes a few months (and sometimes years) to get back to your normal rhythm as your body readjusts. “It may be that there are some issues, such as no periods or irregular periods, that reveal themselves when you come off the pill. This is due to the fact that the pill was masking your ‘natural’ hormones,” Welsh says.

The bleed that you have on the pill and the bleed you have when you’re on your period are actually different things. In fact, the bleed you get when you’re on the pill is technically a ‘withdrawal bleed’ rather than a period. It’s the body’s reaction to the withdrawal of hormones when you stop taking the pill for seven days, which causes the lining of your uterus to shed.

During a normal period, the lining of your uterus will also shed, which leads to bleeding but for a different reason. During the menstrual cycle, your body’s natural hormones increase the thickness of your uterus lining to prepare for pregnancy. But if you don’t get pregnant that month, the lining will shed. 

This process should resume as normal within the first few months of coming off the pill. However, you may notice sporadic spotting and bleeding while your body returns to normal.

Are there any side effects of coming off the pill?

Just as with going on the pill, there are a lot of potential side effects of coming off hormonal contraception, but not everyone experiences them. “The change in hormones from synthetic to natural can cause symptoms such as PMS, heavy periods and painful periods,” Welsh says. “Some women notice they have fewer headaches, a change in acne, and a change in libido, too.”

The good news is, if you experienced any negative side effects when taking the pill, these should improve when you stop taking it. But the reverse is also true – so if your skin improved when you went on the pill, there is a chance spotscould return when you come off it. 

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However, none of these side effects are a given. It’s important to remember that your body may have changed a lot naturally, especially if you’ve been taking the pill for a long time. There’s no guarantee that what’s ‘normal’ for you now is the same as what was ‘normal’ for you when you first started taking the pill. This is especially true if you started taking the pill when you were a teenager and your body was potentially still going through (or had just finished going through) puberty.

To help you understand whether or not coming off the pill is a positive thing for you, it’s a good idea to track your menstrual cycle, so you can make a note of any symptoms and patterns (Welsh recommends the apps Clue and Flo). It may also be helpful to chat to your GP so you know exactly what to expect.

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How soon can you get pregnant after you stop taking the pill?

Many people think you have a bit of time after coming off the pill where you’re still protected from pregnancy. But it’s possible to get pregnant if you have unprotected sex as soon as you stop taking the pill.

While most people’s bodies take between one to three months to adjust back to ‘normal’, some people will readjust far quicker. There’s a significant chance you could get pregnant as soon as you stop taking the pill. “Your natural fertility will return to normal when you stop, and therefore if you want to prevent pregnancy you must use other methods of contraception,” Welsh says.

Fortunately, there are lots of non-hormonal contraceptive options you can try. And if you’ve been taking the pill for a long time, you might be pleasantly surprised at just how far barrier methods like condoms have come, with latex-free, chemical-free and eco-friendly options available. 

You can find more information about women’s health, hormones and the menstrual cycle on the Strong Women Instagram page.

Images: Getty

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