Can Birth Control Pills Cause Infertility?
If you're not actively trying to conceive, you might decide to take hormonal contraception—often in the form of birth control pills. Some women fear that taking the pills will interfere with future attempts to get pregnant, but thankfully, experts say that's not the case. "Birth control pills do not have a negative impact on fertility," says Eric Strand, M.D., a Washington University OB-GYN at the Women & Infants Center in St. Louis.
Here's everything you need to know about how birth control can affect your fertility, including how long it takes to get pregnant once you stop taking the pills.
Birth Control Doesn't Cause Infertility
The Centers for Disease Control and Prevention (CDC) defines infertility as the inability to get pregnant after one year (or longer) of having regular unprotected sex. If you're over the age of 35, the definition changes to six months of unsuccessful attempts at pregnancy. A number of conditions can lead to infertility in women, like hypothyroidism and polycystic ovarian syndrome (PCOS). Birth control isn't listed as a cause. In the vast majority of cases, your cycle will return to normal almost immediately after stopping the pill.
"Birth control pills regulate periods because they suppress the natural cycle (rather than permanently alter it)," says Iris Insogna, M.D., of Columbia University Fertility Center. "The exposure to estrogen and progesterone in the first three weeks, followed by the withdrawal of the hormones in the fourth week, is what causes regular monthly periods when you are on birth control pills."
Dr. Strand agrees, saying, "Any irregularity in menstrual cycles after the use of [the pill] is likely from pre-existing conditions that were masked during the patient's use of the pill."
What's more, scientific research has found no link between oral contraceptives and infertility. Take a 2013 study of 3,727 Danish women between the ages of 18 and 40. "Although OC (oral contraceptive) use was associated with a transient delay in the return of fertility, we found no evidence that long-term OC use deleteriously affects fecundability," or the ability to get pregnant," according the study published in Human Reproduction.
How Stopping Birth Control Affects Your Menstrual Cycle
After you stop taking birth control, the hormones will leave your system, causing your body to take over and revert to a natural menstrual cycle. And this happens relatively fast: "The hormones (associated with oral contraceptives) only stay in your body for a short time, which is why you need to take the pill regularly to avoid a contraceptive failure," says Dr. Strand.
In other words, you should expect your cycle to return to normal soon after stopping birth control. "For some women it can take a little time, typically not more than a few weeks, for the (menstrual cycle) to start functioning again after discontinuing the birth control pill," says Dr. Insogna. "This isn't always the case, however. It's important to remember that some women will ovulate and resume regular periods almost instantly after stopping the birth control pill."
Injectable birth control options, like Depo Provera, can cause things to take a bit longer to get back to normal. "Although the Depo shot is given every three months, it can take six to 12 months (and in rare cases even longer) for a patient's menstrual cycle to return," says Dr. Strand.
Getting Pregnant After Birth Control Pills
When it comes to getting pregnant after stopping the pill, it's possible as soon as your cycle returns. Some women conceive immediately, which is why most OB-GYNs recommend waiting until you're truly ready before stopping contraceptive use. In other cases, things can take a bit longer—and that's often normal.
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"Remember, it can take several months for a patient to achieve a pregnancy under normal circumstances," Dr. Strand says. "In a healthy couple with no known fertility problems, approximately 40 to 50 percent will be pregnant after three months of unprotected intercourse." Always consult your OB-GYN or fertility specialist with any concerns about your fertility.