It’s good to know your goals
“Coming off birth control is a big life change for women,” says Sarah Yamaguchi, MD, ob-gyn at Good Samaritan Hospital in Los Angeles, California. Some women go off birth control because of the side effects, because they want to get pregnant, or because they’ve lost access to it, often due to insurance. If you fall in the last category, then know that even without insurance, there are many clinics such as Planned Parenthood that will provide you with contraception at low or no cost. “Your financial situation should not have to dictate your decision to use contraception,” Dr. Yamaguchi says. If it’s the side effects influencing your decision, there is usually another contraceptive option that will work for you—just ask your doctor. If your aim is to get pregnant, Dr. Yamaguchi recommends starting a prenatal vitamin immediately.
You shouldn’t fall for this medical myth
“The best reason to go off your current birth control method is in hopes of getting pregnant,” says Sherry Ross, MD, an ob-gyn in Santa Monica, California. “I know some women like to go off their current birth control method to ‘give their body a break.’ It’s a medical myth that you need to go off the pill to give your body a break.”
You don’t want to quit mid-pack
“I recommend not stopping the pill in the middle of a pack, but finishing the current pack,” Dr. Ross says. This can keep from drastically dropping your hormone levels unnecessarily, which could lead to mood swings, headaches, and breakouts. There is no prep needed before going off the pill other than taking the pill every day as prescribed until the pack runs out, according to Dr. Ross. The pill contains hormones that normally allow for a period, and that’s the time to end it.
You may be in for a rude awakening
“I recommend trying to remember how you felt before you started on birth control so you will be prepared for what to expect,” Dr. Yamaguchi says. For women who’ve only been on the pill for a few months or a year, it’s easy to remember what their cycles were like—with cramps and cravings, for example. “A lot of my patients get more discomfort with ovulation and heavier menses as they get older, so if it’s been 10 years of their being on the pill, they can be surprised at how bad their symptoms can be when they are naturally cycling,” Dr. Yamaguchi says. Check out the secrets your period really wants to tell you.
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You may bleed more—or less
The most common side effect of going off the pill is a heavier period, but that’s not the fault of the pill. “Birth control pills help make your period more predictable and also lighter,” Dr. Yamaguchi says. “It’s a common misconception that the birth control pill causes heavier, more painful periods when you stop—it’s just that your body has been getting treated for these symptoms but you didn't know.” Stopping any form of hormonal birth control, including the Nuva Ring, the Patch, or a hormonal IUD, such as Mirena, will likely also cause heavier bleeding. With the removal of the copper IUD, however, which doesn’t have hormones, you will likely return to a lighter period, as the copper IUD tends to cause heavier bleeding. Stopping use of the implants Nexplanon or Depo-Provera may cause your menses return to normal if they changed when you started birth control. These are period problems to never ignore.
You could get ovulation pain
If you suffered from PMS, cramps, or painful twinges during ovulation, expect that those will come back if you’ve been on the pill or another form of hormonal birth control. “It is also common to get more cramps when you’re off the pill,” Dr. Yamaguchi says. “Some women will experience more PMS symptoms or more symptoms of ovulation.” Try these novel treatments for period pain relief—no ibuprofen needed.
You could get pregnant immediately
It seems like a no-brainer but some women think they’re protected for a period of time after going off the pill or having an IUD removed, but don’t fool yourself. Dr. Yamaguchi warns her patients that there is very little "washout" period, so they should definitely use some method of birth control if they’re not looking to start a family. The moment you stop using birth control, you can get pregnant, so plan accordingly.
You might need more vitamin D
A recent study from the National Institutes of Health links pill use with higher levels of vitamin D. “Women taking oral contraception have higher levels of vitamin D compared to women not taking the pill,” Dr. Ross explains. “There is a positive association between women taking the birth control pill and having higher levels of vitamin D, which is important in your overall health and well-being.” Dr. Yamaguchi recommends making sure that if you’re aiming to conceive, that you choose a prenatal vitamin that contains vitamin D. The news could also have implications for postmenopausal women who are at greater risk for osteoporosis, as estrogen and low vitamin D can both contribute to bone loss. Check the silent symptoms you may have osteoporosis.
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Even stopping condoms has an impact
“If you are stopping condoms, you may experience more vaginal infections, as semen can cause changes in the vaginal flora and raise your risk of either yeast infections or bacterial vaginitis,” Dr. Yamaguchi says. “If you are stopping the diaphragm, however, there is not much change.” Don’t miss the important things your vagina wishes you knew.
You might need a post-pill checkup
Dr. Yamaguchi recommends that you see your doctor if you have very heavy periods or severe cramping, if you don’t get your period in three months after stopping your birth control, or if anything else seems off. “The pill is the treatment for myriad problems in women, so many women don't realize they have things like severe PMS, polycystic ovarian syndrome, dysmenorrhea, endometriosis, or mittelschmerz [pain associated with ovulation] until they come off the pill,” she says. “Some of these things are benign but can still cause a lot of stress and anxiety if you don't know what they are.”