Coming off the pill- what to expect?

The contraceptive pill is one of the OG hormonal methods of preventing pregnancy. Introduced in the UK in 1961, it was the first contraception that was solely controlled by the female, allowing a woman to plan when and if she wanted children. The pill was revolutionary and is now used by more than 3.1 million women in England alone.

However, as the effects of the pill are brought higher to the surface and alternative contraceptive methods (such as the implant, coil and condoms) improve in quality and access, more and more women are deciding to stop taking the pill.

How does the pill work?

There are two main types of pill; the combined pill and the progestogen-only pill (otherwise known as the ‘mini pill’). The combined pill has a mix of synthetic oestrogen and progestogen which are both hormones that fluctuate naturally during your menstrual cycle. The oestrogen prevents your body releasing an egg each month, and the progestogen thickens the mucus at your cervix to stop sperm getting through and also thins the lining of the uterus, so that any eggs that do get fertilised will find it hard to implant. The progestogen- only pill works the same, but minus the oestrogen. A newer type of progestogen-only pill which uses desogestrel also inhibits ovulation.

The contraceptive pills essentially take advantage of the female body’s natural hormonal interactions to prevent pregnancy, thus changing the body’s status quo. When a woman comes off the contraceptive pill, the body is bound to be a bit confused initially, which may produce some side effects. So, what should you expect when coming off the pill?

What to expect?

A very (!) important potential side effect to have in mind when coming off the pill is pregnancy! It is very important that unless you are planning to conceive, you use a barrier method of contraception (such as a condom!) as pregnancy is possible shortly after you stop using the pill.

Changes in periods are another common part of coming off the pill. Your cycle could be a bit out of whack for a while, with irregular periods and changes in length, flow and appearance being reported. This all makes perfect sense if you think about how the pill affects the menstrual cycle. For example, if the uterus lining is thinned by a synthetic progestogen, a period will most likely be different to one where the uterine lining is at a normal thickness. If you have abnormally heavy or long (over a week) bleeding and are concerned, you should go to see a doctor. Another point to note is that if you have a menstrual condition such as endometriosis or had problems with your periods such as PMS or bad cramps prior going on the pill, these may come back when you stop taking it. Be prepared to deal with these by having a good supply of hot water bottles, and some painkillers just in case!

Hormones influence the brain and it is thought that taking the contraceptive pill can have adverse effects on mood. This means that coming off the pill could also change your mood. You may feel happier and hornier, but you also may not. Due to women having unique hormones and bodies, it is hard to predict how your mood will change when starting or stopping the contraceptive pill.

Some changes in your appearance may also occur when you come off the pill. The pill does a good job of preventing acne, and you may notice an increase in spots after coming off it. If you do notice a radical difference in your skin, making sure you have a good skincare routine and have a balanced diet can go a long way. If this doesn’t work and your acne is severe, consider seeing a medical professional. You may also notice some changes in your weight and breast size due to changes in water retention, but these are unlikely to be drastic. Vaginal lubrication often increases when women come off the pill, as well as discharge which will most likely change more throughout your cycle than before.

Coming off the pill can be a large step for some. Whether it be because you want to start a family or want to switch to another method of contraception, make sure you learn from reliable information and consult a medical professional if you have any concerns or queries. Alternative methods of contraception are constantly being improved, and being on the pill is by no means the only option for women today!