After coming off the pill your body takes over hormone production again itself, and that takes time. In many women the own cycle returns within one to three months, but sometimes it takes longer. An irregular cycle in the first months after the pill is usually normal.
I notice that women often get a fright after stopping when their cycle returns erratically. That is understandable, because years of a steady pill rhythm give a different picture than a natural cycle.
Below you read what happens after stopping, how long recovery can take, when a check is useful and which hormones then give insight.
What happens when you come off the pill?
The pill suppresses your own hormone production and your ovulation. When you stop, your body has to take that control back, and that does not happen equally fast for everyone. The first period after stopping is a withdrawal bleed, after which your own cycle gradually starts up.
In the first months your cycle can be variable. That is part of the recovery and is usually no cause for concern.
Want to better understand how your natural cycle works? Then read understanding your menstrual cycle and hormones.
How long does it take for your cycle to return?
In most women the own cycle returns within one to three months. In some it takes longer, especially if the cycle was already irregular before the pill. Only if your period still stays away after about three months is it useful to look further.
Factors that can influence recovery:
- How your cycle was before you started the pill
- Your age and how close you are to menopause
- Stress, weight and intensive exercise
- An underlying cause such as PCOS or a thyroid problem
A cycle that was already erratic before the pill sometimes returns erratically. The pill then temporarily masked that pattern.
When is an irregular cycle after the pill a reason for a check?
If your period still stays away after three months, or if your cycle is still very erratic after six months, a check is useful. That applies especially if you want to conceive or if other complaints appear, such as acne or hair growth.
Consider a hormone check if you recognise this:
- Your period still stays away after three months
- Your cycle is still very irregular after six months
- You want to conceive and want to map your cycle
- Complaints appear such as acne, hair growth or a lot of hair loss
Sometimes after stopping an underlying cause comes to the surface that the pill had hidden, such as PCOS. Then read our PCOS pillar on symptoms, causes and diagnosis.
Which hormones give insight after the pill?
To map your own cycle, you mainly look at the hormones that steer your ovulation. FSH and LH show how your brain drives your ovaries, and oestradiol shows how your ovaries respond. Together they give a first picture of your recovery.
- FSH, which drives the ripening of egg follicles
- LH, which triggers ovulation
- Oestradiol, which shows how your ovaries respond
The Hormones Women panel measures these values in one draw. The best time to test is usually in the first days of your cycle, but if you have no period yet, blood can be drawn at any time. You always discuss an abnormal result with your GP.
Coming off the pill with a wish to conceive
If you want to get pregnant, it helps to give your cycle calm time to return. Many women conceive in the first year after stopping. An erratic cycle just makes timing your fertile days harder.
Mapping your hormones can help to see where you stand. See also which blood test is useful when trying to conceive. If the cycle stays away after stopping, discuss that with your GP.
Frequently asked questions
How long does it take for my cycle to be normal after the pill?
In most women the own cycle returns within one to three months. Sometimes it takes longer, especially if the cycle was already irregular before the pill. If your period stays away, a check is useful.
Can I get pregnant straight after the pill?
Yes, you can. Your ovulation can return as early as the first cycle after stopping. An erratic cycle does make predicting your fertile days harder.
Does PCOS return when I stop the pill?
The pill can mask PCOS complaints, so they become visible again after stopping. PCOS itself does not go away from the pill. If you recognise an irregular cycle with acne or hair growth, discuss that with your GP.
References
- NHG. NHG-Standaard Vaginaal bloedverlies. Dutch College of General Practitioners. Available via richtlijnen.nhg.org.
- Thuisarts.nl. I want to stop taking the pill. Dutch College of General Practitioners. Available via thuisarts.nl.
- Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841-2855. PMID: 27664216.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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