Birth Control’s Effect on Fertility

What is The Grapevine? A weekly newsletter that shares clinician-approved fertility insights in an easy-to-understand way.

Today’s topic is birth control’s effect on fertility. Did you go on birth control and lose your period? Wondering about the rumored “fake period on the pill?” Concerned your fertility may be impacted by which type of contraceptive you choose? If so, read on.

First things first, let’s be clear on what we mean by birth control.

While many different types of contraceptives exist—from barrier methods like condoms to complete abstinence—the focus of this conversation is on hormonal methods. This includes pills, vaginal rings, patches, injections, and some types of IUDs. Because these products release hormones into the body over time, we were curious about the long and short-term impact of these hormones on fertility.

Wait, how does hormonal birth control work again?

When used properly, hormonal contraception works in one of two ways. With progestin-only formulas, it will only thicken your cervical mucus as a defense to keep the sperm from reaching an egg. With combination estrogen-progestin contraceptives, it thickens cervical mucus while also preventing monthly ovulation to decrease odds of pregnancy.

How does hormonal birth control impact fertility?

Scientific studies have proven that hormonal birth control does not negatively impact fertility - phew! It’s designed to work as a temporary pause on your fertility. Preventing monthly ovulation does not impact the number of eggs in your reserve or reduce egg quality. Most women return to their natural fertility within one or two monthly cycles. However, because hormonal birth control can mask any irregularity in your menstrual cycle, once you go off birth control, those irregularities may resume and impact your fertility. As always, if you have health concerns, see your doctor! 

If I don’t get my period on birth control, am I harming my future fertility?

Nope! Not getting your period while on birth control can be perfectly normal and safe. As mentioned, hormonal birth control prevents ovulation and stops your uterine lining from thickening in the first place, so there’s no need for a true menstrual cycle to come clean up aisle three. Some women experience a small “fake” period at the end of a pill pack cycle, but for other women, the bleeding stops completely. When you stop taking the contraceptive completely, your period should return to normal within a few weeks or months.

Hold on… tell me more about this “fake period.” 

For those on the combined estrogen-progestin pill or using a vaginal ring, many experience “fake” periods. Medically known as “withdrawal bleeding,” this occurs during the seven days of placebo pills at the end of a pill pack or before replacing a new vaginal ring. The drop in hormones can trigger a smaller shedding of your uterine lining, causing a “fake” period (compared to a normal period due to the hormone drop after ovulation.) Withdrawal bleedings don’t have a medical necessity and were designed to give women peace of mind that they aren’t pregnant. Some women choose to skip the bleed week, but you should talk to your doctor before trying it to determine if it's a good and safe option for you and your birth control.

If I stop taking hormonal birth control, how quickly does my fertility return?

Like everything, it depends on the gal and the birth control. On average, it takes 1-3 months for ovulation to return after stopping the pill, but can take up to 6 months for women using injectable contraception. If you are trying to have a baby with a specific horoscope, make sure to factor the wait time into the equation. Because IUDs only thicken cervical mucus and don’t prevent ovulation, when you remove an IUD (AKA sperm fighter) you can get pregnant right away. IUDs can be a great option for those who want to get pregnant soon after coming off a birth control method.

So will my fertility stay the same over time?

While hormonal birth control can prevent ovulation and impact your period, it doesn't have a direct impact on the number of eggs your ovaries release or the natural process of egg loss. So, even if you're not experiencing ovulation, your body's still doing its thing behind the scenes and bidding farewell to 500-1000 follicles per month. This means that your chances of getting pregnant in the future still declines naturally over time with or without birth control. Read our What Happens to Your Fertility Over Time? edition for more details.

So what’s the TL:DR?

While your chances of getting pregnant right after stopping birth control may vary, your fertility is not impacted by your choice of birth control in the long-run. Whether or not you get a “fake period” or your period returns to normal within 1 month or 4, each birth control method and each person’s body responds just a bit differently. 

Editor’s Pick:

Regardless of your birth control type, if you're still struggling through periods like we are, try our fave heating pain relief products. Just stick them on and let the gentle heat soothe your cramps. We love these brands because they are designed by women for women <3  

• Rael Herbal Heating Patches: We love these ones because they are infused with 3 herbal ingredients, rose, lemon, and jasmine oil. Additionally, they are super thin and discreet under clothing.

  

• LILAS Menstrual Natural Relief Patch: Best part of Lilas is they work for 12 hours! They will last from your 8am class through your small group dinner. It was specially designed for PMS, menstrual cramps, and PCOS.

  

Upcoming Newsletter Editions:

• “How Fertility Testing Works”

• “Egg Freezing 101”

• “5 Things to Ask Your Gynecologist”

Quick note: We acknowledge that not everyone assigned female at birth or born with ovaries identifies as a woman, so in this newsletter the terms “woman/women” include all persons born with ovaries. This newsletter was written with those assigned female at birth and those born with ovaries in mind, but we also think this is important reading for those who identify with any gender, especially partners and friends. If you have questions or suggestions on how we can be more inclusive, we would love to hear them.

*The information provided is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or any other qualified healthcare provider with questions you may have regarding a medical condition or treatment.