Considering Going Off Birth Control Pills? Here’s What Experts Want You to Know First

Maybe you’re trying to get pregnant, or are having side effects that aren't worth the rewards. Whatever the reason, the decision to stop taking hormonal contraceptives is a really personal one, and there are lots of things to keep in mind before taking the plunge.

For one thing, it’s important to remember that birth control does have its benefits (aside from the whole pregnancy prevention thing). “Non-contraceptive benefits of birth control pills include decreased risk of ovarian and endometrial cancers, while women who are prone to forming ovarian cysts may have a decreased risk of cyst formation while they are on the pill,” notes Rebecca Nelken, MD, an assistant clinical professor of OB/GYN at the University of Southern California who also runs a private urogynecology practice specializing in female pelvic medicine and reconstructive surgery.

Dr. Nelken also notes that if you started taking the pill to address a specific medical concern—like acne, painful periods, or mood swings—you should be prepared for those issues to return in full force once you stop taking it. But if you’ve considered all of these factors and still feel like it’s time to dump your hormonal birth control, read on for expert advice on how to make quitting the pill as pain-free as possible.

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4 things to do before you quit

Taking the step to get off of the pill may require some pre-planning. Here are some things to try:

1. Focus on eating wholesome foods

The experts we consulted all agree that putting the right fuel into your body will help it adapt to the changes it’s bound to face when going off the pill. Nicole Granato, a certified holistic health and wellness coach who specializes in women’s health issues, recommends that you start to prepare three months in advance to ensure that you’re loaded up with all the supportive nutrients you need.

“Routine is key, starting from the first thing you drink in the morning to how you go to sleep at night,” she says. Start by drinking plenty of water to stay hydrated. Granato says trying to eat an easy-to-digest breakfast, like a coconut milk smoothie. “Lunch should be your biggest meal, incorporating healthy fats like avocado, vegetables like Brussels sprouts or sweet potato, and protein,” she adds. “Dinner should be your lightest meal—think soups, brown rice or quinoa, light protein, vegetables, and water.”

2. Consider another method of birth control

Although it can take several months for your fertility to return to its normal levels after quitting the pill, it’s also possible to get pregnant right away. If that’s not in your plan, it's crucial to have another birth control option lined up and ready to go.

Along with barrier methods like condoms and diaphragms, Dr. Nelken says that copper IUDs are a good option for non-hormonal birth control. There’s also growing support among women for the all-natural fertility awareness method of family planning, although most experts recommend using it in tandem with another form of birth control. Discuss all of this with your OB/GYN to help suss out the right choice for you.

3. Prep your skin for hormone changes

The bad news: Hormonal fluctuations (like what can happen after quitting hormonal birth control) often cause breakouts. The good news: You can minimize your risk by doing a few things in advance. Trevor Cates, a naturopathic physician who specializes in skin care, recommends supplementing with evening primrose oil and chaste tree berry in advance, while using “mildly acidic” topical skin-care products to balance the skin’s pH.

4. Prioritize your mental health

We’ll be real with you: For a lot of women, quitting the pill isn’t a bump-free ride. But, says psychiatrist Gail Saltz, MD, just knowing—and accepting—that you will most likely get some acne, you may feel low, and you may have unpredictable periods for a while can help lessen the blow if those blips do occur. “And once the hormones level out, those things tend to dissipate,” she stresses. Prepping in advance by prioritizing your mental health can go a long way.

Side effects of stopping the pill

There are a few potential side effects of stopping the pill after prolonged use. While not everyone will feel these effects, the most common include the following, per UnityPoint Health:

• Weight changes
• Acne
• Mood swings
• Cramping
• Sexual libido changes
• Irregular periods or spotting

How to stop taking birth control pills safely

There are a series of different steps you can take to make your transition off of birth control pills a little easier. We've broken things down into a timeline of month one through three and beyond.

In months 1-3...

Quit cold-turkey
Unlike other long-term medications, Dr. Nelken says there’s generally no need to taper off of hormonal birth control. “The ideal time to discontinue birth control is following a hormone-free interval,” she says. “So after having your period, you can simply stop taking the pills.” (She notes that quitting mid-cycle increases the risk of irregular bleeding.) Again, be sure to let your doctor know that this is your plan so that they're up to speed and can help with the process.

Get moving
This is a good time to amp up your workout schedule; Dr. Saltz says exercise can help make any post-pill mood swings more manageable. “Regular, intense aerobic activity for 30 minutes, several times a week, is good for mood, anxiety, and irritability,” she says. “Combining that with methods of relaxation—whether that’s practicing mindfulness or doing muscle relaxation or visualization techniques—can be very useful.” Need somewhere to start? Try this 15-minute happiness workout for an instant endorphin boost.

Reduce alcohol intake
This would be a really good time to do that "no-alcohol challenge" you’ve been meaning to take on. “Skipping alcohol throughout the first few months of getting off the pill is essential,” says Granato. “Alcohol [may have] the ability to knock our hormones off balance and create inflammation in the body.” This means that it can intensify many of the symptoms you might already be having in that first month, including acne and bloating. Instead, try making virgin versions of these avocado cocktails—trust us, you won't miss the booze.

Consider adding vitamins and supplements to your routine
Everyone's body reacts differently after quitting birth control. One potential reaction is becoming deficient in certain essential vitamins and minerals. Of course, ask your doctor for recommendations to see what's right for you.

And while research on this is limited, some studies suggest that birth control reduces your levels of vitamin B12 and B2 (riboflavin), per Colorado State University Extension. In this case, starting a B-complex supplement may be helpful (if your doctor gives the "okay").

Lastly, some women go on birth control to help relieve heavy periods that contributed to iron-deficiency anemia. If this was your case, adding an iron supplement to your routine may be helpful while transitioning off the pill. Magnesium supplements may also help with the cramping and aches you may feel as your periods start to return. "I often find that my clients are deficient in these two essential minerals," says Granato.

If you don't want to try supplements, getting these nutrients through food is the best approach. Try magnesium-rich foods, like spinach or dark chocolate, or foods rich in iron, like beef or beans.

Beyond month 3...

Take stress reduction seriously

The side effects from hormonal changes should balance out by around three months. To help facilitate this transition, it's important to prioritize reducing stress, says Yoga Medicine founder Tiffany Cruikshank. “The hormones are really affected by stress levels,” she says. Try to find relaxation methods that you enjoy during this time, whether that be walking, meditation, or yoga.

“From the yoga side of it, the simplest way to address stress is by doing restorative postures.” The exact poses you choose don’t really matter, she says. “It’s more about being able to relax and breathe.”

Don’t hesitate to get professional help
If you’re still getting unusual symptoms after three months, all of our experts wholeheartedly agree that you should go back to see your doctor. For example, if your period hasn't come back, you might want to see an OB/GYN, and if you're dealing with symptoms of depression, anxiety, or mood swings, consider reaching out to a mental health professional to explore therapy or medication treatment options.

Even acupuncture and some traditional Chinese medicine practices may help with hormonal rebalance, says Cruikshank. “There are a plethora of "interesting" things that can happen when going off the pill—weight fluctuations, digestive changes, irregular bleeding,” she notes. “When needed, an acupuncturist who’s trained in herbs can make a very specific, individualized formula, which can be really helpful.”

When to see a doctor

If you're thinking about getting off birth control pills, talk with your doctor about what to expect and other possible birth control methods to choose from. If you've been off your birth control for three months and are still dealing with unpleasant symptoms, reach back out to your doctor to make sure that you're not dealing with an underlying hormonal imbalance (like PCOS) or health condition, or take a pregnancy test if you period has not come back.

FAQ

How long does birth control withdrawal last?

The symptoms you feel with contraception discontinuation can last days to weeks, often depending on the type of birth control you used. Things like headaches, mood changes, breast tenderness, or bloating from birth control can fade fairly quickly once the medication is completely out of your system. However, withdrawal symptoms like bleeding can last for weeks to three months after stopping the pill. By three months, things should start to return to your "normal," per the University of Rochester Medical Center.

How long should you be off birth control before trying to have a baby?

Because the hormones from birth control pills leave your body fairly quickly, your fertility after birth control can return quickly, too. For example, if you took a combination pill (with estrogen and progestin), your cycle will likely return to its normal within one to three months. Most women are able to get pregnant within a year of stopping this type of pill. If you took the mini pill (progestin only), it's possible to get pregnant within weeks or even days of stopping, because this form of birth control does not stop your ovulation, per Penn Medicine Lancaster General Health.

That said, you may still want to give your body time to adjust before trying to conceive. In that case, you can use barrier methods like condoms to prevent pregnancy.

How do you get your sex drive back after stopping the pill?

Because your libido is determined by the very hormones that wax and wane while stopping the pill, it makes sense that you might be feeling less interested in sex. Learning how to get your sex drive back after stopping the pill may require some trial and error. Continue to eat a balanced diet with wholesome foods, exercise regularly, get plenty of sleep, and try implementing stress-management techniques. Take things slow and dip back into a sexual health routine that feels right for you—whether with a partner or solo. And keep in mind: Many people experience low libido while on the pill, so you may just find that your sex drive revs up once you stop taking it, per the Cleveland Clinic.

—reviewed by Andrea Braden, MD, OB/GYN