It is common for people to have late, irregular, or absent periods immediately after stopping hormonal birth control. It may take up to 3 months for a person’s menstrual cycle and fertility to return to normal.
This comes from the United Kingdom’s National Health Service (NHS).
However, an absent period is also potential sign of pregnancy. People who are sexually active and who have stopped using their usual method of birth control should take a pregnancy test if their periods do not resume after 4 weeks.
In this article, we will look at the cause of late periods after stopping birth control, other symptoms a person may experience, and how long those symptoms may last.
According to the NHS, it is normal to have late or irregular periods after stopping hormonal birth control. It can take several weeks, or sometimes months, for periods to resume as normal. Some doctors call this postpill amenorrhea.
After a person stops using hormonal birth control, two factors – other than pregnancy – can cause late periods. They are:
Delayed return to ovulation
Hormonal birth control methods, such as pills, implants, intrauterine devices (IUDs), and injections, work to prevent pregnancy in several ways. One of the ways they work is by making ovulation less likely. Ovulation is the release of an egg from the ovaries.
When a person is not using hormonal contraception, ovulation typically happens once per menstrual cycle. If a sperm does not fertilize the egg, shifts in hormone levels trigger a period.
Because people using hormonal birth control typically do not ovulate, it may take time for regular ovulation to return. Until this happens, a person may have no periods at all.
Lack of hormones
Some methods of hormonal birth control, such as the combined pill, can help regulate a person’s periods. This means that, even if a person does not ovulate, they can still experience bleeding at regular times of the month.
Doctors call this a withdrawal bleed, as it typically occurs when a person takes a monthly break from the pill, or takes placebo pills as part of their prescription.
Without the medication, the body’s own hormones must begin to regulate periods on their own. It can take a while for the body to adjust to doing this naturally.
Additionally, people who had irregular periods before they began using hormonal contraception may find irregular bleeding resumes after they stop.
Stopping birth control can affect people in different ways. People may experience:
Temporary side effects
Some people experience side effects after stopping birth control. These typically get better with time, and may include:
- spotting or bleeding between periods
- breast tenderness
- changes to the skin or hair
Some people may find that stopping birth control leads to beneficial effects, particularly if the method or brand of birth control they were using gave them unwanted side effects. For example, people
- increased libido
- fewer headaches
- improved mood
- less nausea
Return of old symptoms
If someone previously used contraceptives to manage the symptoms relating to their period, those symptoms
Similarly, people who used birth control to manage a health condition may find the symptoms return. Examples of conditions this may apply to include:
In some cases, using a hormonal contraceptive can also delay a diagnosis of these conditions, particularly if a person began using the contraceptive as a teenager. This is because some of the symptoms of these conditions, such as irregular periods, are more common in young females.
However, if a person experiences persistent or severe symptoms after they stop birth control, this could indicate an underlying condition.
The length of time it takes for periods to resume varies from person to person based on a number of factors. Stress, exercise, body weight, and overall health can all influence when periods will return and how regular they will be.
In the absence of another health condition, though, normal fertility -– including regular ovulation and periods – usually resumes within 3 months.
A 2018 systematic review and meta-analysis of people who stopped using hormonal contraceptives in order to conceive found that
This suggests that for most people, fertility and periods return to normal within the space of 1 year, and often sooner than this.
Other causes for late periods after stopping birth control include:
- severe or chronic stress
- having a low body weight
- eating disorders, such as anorexia or bulimia
- thyroid conditions, such as hyperthyroidism
- disorders of the pituitary gland or hypothalamus
- premature ovarian insufficiency
- some chronic health conditions, such as inflammatory bowel disease
Even if pregnancy seems unlikely, it is worth getting a pregnancy test. With typical use,
Additionally, spotting is common early in pregnancy, so light or irregular bleeding does not mean a person is not pregnant.
People who miss their periods should consider regularly testing for pregnancy until periods return.
Most people find that their cycle returns to normal soon after stopping birth control, so there is often no need to try any specific techniques to help the body adjust.
However, there are a few things people can do if they want to generally support balanced hormones. They include:
- Managing stress: Long-term or severe stress can sometimes cause amenorrhea, or a lack of periods. If a person often feels stressed or worried, there are many things that could help, depending on the situation. Consider delegating responsibilities to others where possible, learning relaxation techniques, or seeking support from a therapist.
- Eating a balanced, consistent diet: Sudden dietary changes or diet restrictions can disrupt the menstrual cycle. Instead, try to opt for a balanced and moderate diet that remains fairly consistent, and that contains nutrient-dense foods. Avoid foods high in sugar, as over time, this can raise the risk for insulin resistance and type 2 diabetes.
- Maintaining a moderate weight: Both high and low body weight can influence reproductive hormones. A healthy diet and regular exercise may help. However, if a person finds it difficult to reach a moderate weight, they may have an underlying condition, such as PCOS. Similarly, if a person feels that their thoughts about eating, exercising, or losing weight are difficult to control, they may need to seek support for disordered eating.
- Tracking hormone health: People who wish to get pregnant, or who want to keep track of their menstrual cycle for other reasons, can monitor their health using home testing and monitoring devices. For example, people can use ovulation predictor kits, progesterone monitoring, or apps that track a person’s symptoms throughout the cycle.
- Speaking with a doctor: If a person is concerned that their periods are not returning to normal after several months, a healthcare professional should investigate the cause.
It is common for periods to be late, absent, or irregular after stopping birth control. For most people, they will return to normal after a few weeks or months. People may also experience symptoms such as menstrual cramps, changes to the skin, or PMS as their period returns.