When it comes to birth control and fertility, there can be a lot of confusion. But hormonal contraceptives don’t cause infertility, no matter which method you use or how long you’ve been using it.
Hormonal birth control delays your fertility and prevents pregnancy temporarily. But your fertility levels will eventually return to previous levels when you discontinue the contraceptive.
Infertility usually means someone is unable to get pregnant after at least 1 year of having sex without a barrier or other contraceptive.
Some doctors may diagnose infertility after 6 months of sex without contraception if you’re age 35 or older.
Doctors would not classify an inability to become pregnant while on birth control as infertility because your method of contraception has prevented pregnancy.
Although some people may experience a delay in fertility once the birth control hormones have left their body, it usually returns in a few months to a year.
“Birth control doesn’t have a rosy history, and concerns are frankly legitimate,” says Dr. Nauf AlBendar, the founder of The Womb Effect.
“Initial studies of birth control were marked by a lack of consent [and] a lack of full disclosure and true informed choice,” AlBendar explains.
She adds, “reported anecdotal information about side effects were considerably downplayed.”
In 1969, “The Doctor’s Case Against the Pill” by Barbara Seaman “publicly outed the scandal of trials performed without informed consent and hushed side effects,” AlBendar notes, adding that this shook public trust in the medical world.
A few years later, in 1974, the Dalkon Shield intrauterine device (IUD) “was shown to cause risks of permanent infertility and had to be pulled from the market,” AlBendar says.
“As time passed, the use of contraception increased, as well as the introduction of safer and lower-dose medications,” she says. “We also have more of an understanding of the risks and benefits of contraception.”
But, due to the delayed fertility of some modern methods, some people still believe that today’s contraceptives can lead to infertility.
It’s also possible that the artificial (and regular-seeming) menstrual cycle created by some forms of birth control can mask pre-existing irregularities and conditions like polycystic ovary syndrome (PCOS).
When a person stops using birth control, these conditions reveal themselves, often leading people to think that their contraception caused the problem.
You can experience some menstrual effects while taking hormonal birth control, but it depends on the method of contraception and the individual.
For example, your period may be lighter or heavier. In many cases, your period will become regular, but sometimes, periods become irregular or disappear entirely.
After stopping hormonal birth control, some people may notice similar irregularities for a few weeks or months.
That’s because the hormones released by birth control stop ovulation, so it can take a while for the menstrual cycle to return to its usual state.
If your periods are irregular after coming off birth control, you might not be ovulating regularly. So, you might find it difficult to get pregnant.
On the other hand, you might conceive very quickly. So it all depends on your individual situation.
It’s also worth noting that any menstrual irregularities you had before using hormonal birth control can reappear after stopping it.
“There are a number of forms of hormonal contraception, including the birth control pill, the vaginal ring, the contraceptive skin patch, hormone-releasing contraceptive [IUDs], injections, and [implants],” notes AlBendar.
“Although they’re used in different ways, they all have a similar effect: influencing hormone levels and preventing mature eggs from being released by the ovaries (ovulation).”
However, some methods can result in longer fertility delays than others.
Statistically, AlBendar says most users “regain hormonal balance within 3 to 6 months of [stopping] contraceptives.”
She highlights a
- People who used injectable contraceptives had the longest delay in the return of their expected fertility (five to eight menstrual cycles).
- Patch contraceptive users followed (four cycles).
- Then came users of oral contraceptives and vaginal rings (three cycles).
- Finally, those who used hormonal and copper IUDs and implants had the shortest fertility delay (two cycles).
A 2013 study found similar short-term delays after stopping a variety of hormonal contraceptives.
The shot, however, is known to take up to a year for usual fertility levels to return, so healthcare professionals do not recommend it for people who want to conceive any time soon.
It’s important to remember that everyone is different.
So, if you don’t want to become pregnant, it’s best to use another form of contraception as soon as you stop taking any of the above.
Since the pill is the
“Quitting the pill can be a bumpy ride,” AlBendar says.
You may experience:
- irregular periods
- menstrual cramps
- weight changes
- mood swings
When coming off the pill, AlBendar advises resetting your hormones before trying to conceive. Often, this means changing your diet and overall lifestyle, like getting adequate sleep and balanced nutrition.
Of course, all of this advice also applies to other forms of hormonal birth control.
“It’s also important to tackle nutrition deficiencies (of vitamins) that are depleted from birth control,” AlBendar explains.
This includes:
It is also important to check and treat any alterations in blood glucose levels and insulin resistance. AlBendar says they
Finally, you should pay attention to your gut microbiome, “as it plays a central role in the regulation of estrogen levels within the body.”
To restore it, try limiting artificial sweetener consumption and eating foods rich in prebiotics, probiotics, and polyphenols.
In other words, swap sugary snacks for alternatives, like whole grains, yogurt, green tea, and asparagus.
A year is the usual suggestion.
A 2018 review of more than 20 studies concluded that
Along with older research, it also found that the duration of contraceptive use had no significant effect on conception time.
So, if you’ve been a long-term birth control user, you likely don’t have anything extra to worry about.
The obvious sign would be the inability to get pregnant after a year of trying. But you may notice other symptoms of potential infertility before that point.
For example, if your menstrual cycle hasn’t returned or is still irregular after a few months of stopping birth control, it’s a sign to connect with a doctor or another healthcare professional.
If you have a uterus, hormone changes may cause:
- skin issues
- weight gain
- lower sex drive
If you have a penis, things to watch out for include:
- libido changes
- difficulty with erection or ejaculation
- pain or swelling in the testicles
Although birth control isn’t a risk factor for infertility, lots of other things are.
The following all have links to infertility:
- older age
- having overweight or underweight
- history of untreated sexually transmitted infections (STIs)
A person with a uterus will start to see a decline in fertility at the age of 30 that speeds up by their mid-30s.
Aging can have a
Other conditions that can affect the reproductive system include PCOS, endometriosis, and blocked fallopian tubes.
Similarly, anything that can affect sperm production, like diabetes and trauma to the testes, can lead to fertility issues.
According to the National Health Service (NHS) in the United Kingdom, finding the exact cause of infertility isn’t possible in 25% of cases.
The treatment depends on the cause (if known) along with your age and how long you’ve been experiencing fertility problems.
If you have ovulation difficulties, birth control might help. Doctors often recommend hormonal birth control for people with PCOS, as it can regulate hormones and help with ovulation.
Several medications can help kick-start ovulation, too, including Clomid and injectable versions of human menopausal gonadotropin.
Surgical procedures may help, particularly if fallopian tubes need repairing or endometrial tissue needs removing.
Then, there are assisted conception methods, like in vitro fertilization (IVF) or intrauterine insemination (IUI).
These involve either inserting specially prepared sperm into the uterus or combining a person’s eggs with sperm in a lab and placing the embryos back into the body.
If you’ve been trying to get pregnant for a year after coming off hormonal birth control, or if you have any concerns about your fertility, seek advice from a healthcare professional.
They can offer helpful lifestyle and dietary tips or direct you to a specialist.
The main thing to remember is that your contraception can’t cause infertility. So, if you’re experiencing difficulty, the cause is elsewhere.
Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.