Birth control pills are one of the most effective means of preventing pregnancy, which is why it is such a popular method of contraception. But despite its popularity, there is a common misconception about the pill — namely, that the pill compromises a woman’s fertility potential, even after she stops taking it.
Well, not only does the pill not compromise a woman's fertility, but it may actually help to enhance fertility. Relative fertility potential has been shown to be higher in the first several months after stopping the pill. Here are a few fun facts about the birth control pill and fertility that definitely can help debunk this misconception:
- There is also a known increased incidence in twin gestations in these first several months after stopping the pill.
- There are certain fertility treatments that preferentially use birth control pills to increase the patient’s response to that particular treatment.
- The birth control pill can be used to help women, who do not ovulate naturally, achieve a spontaneous ovulation for one or more months after stopping the pill.
Of course, it is also extremely important for women to consider whether the birth control pill may be offering them long-term health benefits. For instance, there is clear evidence that women who have been on birth control pills for extended periods of time actually have a decreased incidence of both uterine and ovarian cancers. These women also have lower rates of severe pelvic inflammatory disease, benign breast tissue disease, ectopic pregnancy, and iron-deficiency anemia.
Certainly birth control pills also have known side effects, such as blood clots, heart attack, and stroke. However, these complications are rare and the risk of these events is comparatively lower while on the pill than during pregnancy.This is not to say that all or most women should be on the pill, but it is to say that there are many myths about the pill that ought to be reconsidered.
This is true especially around the topic of the pill and fertility. Many women decide to stop taking the birth control pill way in advance as part of their preparation for pregnancy. In fact, the hormones in birth control pills are typically out of the system within 7-10 days, and these hormones DO NOT cause women to permanently lose their periods.
It is important to understand what exactly is happening with the hormones while taking the pill (and after stopping) in order to have more clarity about the connection (or lack thereof) between the pill and fertility potential. To begin, it's essential to know that the hormones that regulate the menstrual cycle are in a state of total dormancy while one is taking birth control pills. So once you stop the pill, these hormones will again be released from the pituitary gland.
For some women, this hormonal cycle resumes almost immediately and, as a result, the menstrual cycle resumes within four weeks of stopping the pill. However, some women do not get their first period until 8-10 weeks after stopping the pill. Both cases are totally normal.
That said, if it has been more than 12 weeks since stopping the pill and you still haven't gotten a period, it's a good idea to contact a medical professional (though less than 2% of women experience a delay of this extent). Most of the causes behind a delayed period after stopping the pill are benign and are context-dependent, different based on every woman's individual body and mind. In the majority of cases, these benign reasons either resolve on their own or can be easily treated.
Overall, there is one universal thing for us all to recognize: the birth control pill is not harmful to a woman’s long-term fertility potential. That doesn't mean it's not important to keep in mind that there may be some variation in when the menstrual period will resume, among other things. It is also important to remember that a woman can immediately get pregnant even before the first menses begins, and that the fertility potential may actually be a bit higher during the first several months after stopping the pill.
Richard Schmidt, M.D., is a Medical Advisor to EmbraceHer, an organization that seeks to mobilize access to reproductive health education. Specializing in fertility and reproductive endocrinology. Richard is also the Medical Director of NOVA IVF in Mountain View, California. He emphasizes the uniqueness of every patient and the importance of individualized treatments for patients to maximize their chances of success.