We go on birth control because we want it to affect our fertility. We know that birth control stops ovulation from occurring; which means, simply put, no babies. However, at some point most of us will want to go off birth control, whether it’s because of side effects or because we want to try to conceive.
Whether you’ve been controlling your fertility for a few months, a few years, or a decade or more, you’ll have wondered, how might being on birth control affect my future fertility? While you may have heard that you can and will get pregnant right away when you stop taking the birth control pill or have your implant removed, this is not the reality for all women. There are a number of factors to consider when you start this transition to the fertile life.
How your birth control works
The Pill stops you from ovulating, but not all birth control methods do. The hormonal IUD, for example, will allow some women to continue ovulating or to ovulate sporadically. The effects of the hormonal contraceptive shot can last longer than the advertised three months. A birth control method that prevents ovulation has suppressed your body’s own production of the hormones necessary to be fertile and sustain a pregnancy, and when you discontinue that method your body then needs to start making its own hormones again in order to restart ovulation. You may have been told that your birth control would regulate your cycles, but once you’re not using it anymore your cycles will return either to what they were before you started or change according to your current health situation.
The reason you went on birth control
Many women go on birth control for reasons other than preventing pregnancy. You may have been prescribed birth control for a health issue like PCOS, endometriosis, fibroids, ovarian cysts, or irregular periods. Birth control can often be helpful in managing the symptoms of many of these conditions, however, it is not a cure. This means that when you go off your birth control method, it is likely that the symptoms will return and the health issue will still be there, just as it was before you started. This fact often surprises women, who are told that birth control will fix their problem.
Birth control can be a great band aid for months or years, but it does not resolve the root cause. When you go off birth control and want to conceive, you will need to address these health issues first. Not all of them will affect your fertility, but some will make it harder to conceive due to lack of ovulation or hormonal imbalance. Even if you went on birth control for heavy, painful periods or acne, you should be aware that these issues can be indicative of a hormonal imbalance (e.g. progesterone deficiency) that will change your experience of trying to conceive.
Your health when you decide to stop your birth control
Some women will see ovulation and menstruation return quickly after stopping birth control; other women will find themselves waiting months for their cycles to start up again. That first bleed post-birth control is a withdrawal bleed and not actual menstruation. After this, your body need to build up to ovulation by producing the right amount of hormones for itself. Anecdotally, we know that women can wait much longer for this to happen than they may have been told by their healthcare practitioner.
From a medical standpoint, you need to be trying to conceive for a full year before fertility issues are considered a possibility. The speed at which your cycles (ovulation and menstruation) will restart is linked to many factors, including your health prior to going on hormonal birth control (see previous point). Other factors include your age, your diet, and your lifestyle (exercise, self-care). The naturopath Dr. Lara Briden translated her in-clinic experience helping women regain their cycles post-pill into a book, Period Repair Manual. Health coach Nicole Jardim coaches women one-to-one on making their transition off hormonal birth control both smooth and successful with her Birth Control Protocol program.
Your relationship with your body off birth control
Many women go on birth control to disconnect from their bodies—they do not want to worry about pregnancy or handle irregular or difficult periods. Birth control means this can all be controlled and managed. However, in order to make this happen, especially if you’re doing so to conceive, you need to re-engage with your body, cycle, and periods when you go off birth control. Even if you start to ovulate again relatively quickly, it’s really good practice to track your fertility signs to know when this is happening. There are, after all, only six days per cycle on which you can actually become pregnant.
Tracking your fertility signs can be a way of preparing for pregnancy and speeding up the process of conceiving, but it’s also good for keeping tabs of your fertile health month-to-month. Your fertile signs are those factors that change throughout the month to indicate when you are fertile. Signs include cervical fluid changes (that white discharge you might see in your underwear), your basal body temperature (you will get slightly hotter once you ovulate), and the position of your cervix (which changes to allow sperm entry). Femtech like the Daysy fertility tracker or Ava bracelet can make following along with your fertility simple and easy to master.
The impact of birth control on your partner preference
This is kind of the “wildcard” when it comes to transitioning off birth control. Multiple studies have shown that being on birth control can impact who you chose as a partner and the partner that chooses you. This makes common sense—pheromones still play some part in our attraction to another person and these pheromones are changed by birth control. Although as humans we tend to hide the fact we’re fertile well—no reddening butts happening here—females still give off some signs to males when we’re ovulating and one sign is in our pheromones.
Dr. Julie Holland wrote in her book Moody Bitches that she recommends her clients go off their hormonal birth control at least six months prior to considering marriage with their partner to check they still feel the same way about their man when they’re not on synthetic hormones. Some studies have suggested women may be prone to choose a partner who is not as genetically compatible when on birth control. While there’s certainly not enough research to draw solid conclusions, and many women are very happy with the same partner when off the Pill, it’s still worth bearing in mind. On a positive note, you should experience a higher sex drive!