How does birth control stop you from getting pregnant

When it comes to birth control and fertility, there can be a lot of confusion.

But hormonal contraceptives don’t cause infertility, no matter which method you use or how long you’ve been using it.

What they’re designed to do, however, is temporarily delay your fertility and prevent pregnancy. But when you stop taking them, your normal fertility levels will eventually return.

Infertility usually means when someone is unable to get pregnant after at least 1 year of having sex without a barrier or other contraceptive.

Some doctors may diagnose infertility issues after 6 months of sex without contraception if the person is aged 35 or older.

Around 15 percent of couples experience infertility.

Not being able to become pregnant while on birth control wouldn’t be classified as infertility, because any penis-in-vagina sex during this period would be “protected” by your method of contraception.

Although there can be a delay in fertility once the birth control hormones have left the body, normal levels usually return in a few months at the longest.

“Birth control doesn’t have a rosy history, and concerns are frankly legitimate,” says Dr. Nauf AlBendar, the founder of The Womb Effect.

“Initial studies of birth control were marked by a lack of consent [and] a lack of full disclosure and true informed choice,” AlBendar explains.

Plus, she adds, “reported anecdotal information about side effects were considerably downplayed.”

In 1969, “The Doctor’s Case Against the Pill” by Barbara Seaman “publicly outed the scandal of trials performed without informed consent and hushed side effects,” AlBendar notes, adding that this shook public trust of the medical world.

A few years later, in 1974, the Dalkon Shield intrauterine device (IUD) “was shown to cause risks of permanent infertility and had to be pulled from the market,” AlBendar says.

“As time passed, the use of contraception increased, as well as the introduction of safer and lower-dose medications,” she says. “We also have more of an understanding of the risks and benefits of contraception.”

But, due to the delayed fertility of some modern methods, some people still believe that today’s contraceptives can lead to infertility.

It’s also possible that the artificial (and regular-seeming) menstrual cycle created by some forms of birth control can mask pre-existing irregularities and conditions, like polycystic ovary syndrome (PCOS).

When the birth control is stopped, these conditions reveal themselves, often leading people to think that their contraception caused the problem.

While taking hormonal birth control, you can experience a number of menstrual effects — it all depends on the method of contraception and the individual person.

For example, your period may be lighter or heavier. In many cases, your period will become regular, but in some cases, periods become irregular or disappear entirely.

After stopping hormonal birth control, some people may notice similar irregularities for a few weeks or months.

That’s because the hormones released by the birth control stop ovulation, so it can take a while for the menstrual cycle to return to its usual state.

If your periods are irregular after coming off birth control, you might not be regularly ovulating. So getting pregnant may be difficult.

On the other hand, some people conceive very quickly. So it all depends on your individual situation.

It’s also worth noting that any menstrual irregularities you had before using hormonal birth control can reappear after stopping it.

“There are a number of forms of hormonal contraception, including the birth control pill, the vaginal ring, the contraceptive skin patch, hormone-releasing contraceptive [IUDs], injections, and [implants],” notes AlBendar.

“Although they’re used in different ways, they all have a similar effect: influencing hormone levels and preventing mature eggs from being released by the ovaries (ovulation).”

But some methods can result in longer fertility delays than others.

Statistically, AlBendar says most users “regain hormonal balance within 3 to 6 months of [stopping] contraceptives.”

She highlights a 2020 studythat found the following:

• People who used injectable contraceptives had the longest delay in the return of their normal fertility (five to eight menstrual cycles).
• Patch contraceptive users followed (four cycles).
• Then came users of oral contraceptives and vaginal rings (three cycles).
• Finally, those who used hormonal and copper IUDs and implants had the shortest fertility delay (two cycles).

A 2013 study found similar short-term delays after stopping a variety of hormonal contraceptives.

The shot, however, is known to take up to a year for usual fertility levels to return, so it isn’t recommended for people who want to conceive any time soon.

It’s important to remember that everyone is different.

So, if you don’t want to become pregnant, it’s best to use another form of contraception as soon as you stop taking any of the above.

Since the pill is the most commonly prescribed form of birth control, most discussion centers around it.

“Quitting the pill can be a bumpy ride,” AlBendar says.

You may experience:

• irregular periods
• menstrual cramps
• weight changes
• mood swings

When coming off the pill, AlBendar advises resetting your hormones before trying to conceive. Often, this means making some changes to your diet and overall lifestyle, like getting adequate sleep and balanced nutrition.

Of course, all of this advice also applies to other forms of hormonal birth control.

“It’s also important to tackle nutrition deficiencies (of vitamins) that are depleted from birth control,” AlBendar explains.

This includes:

• vitamins B2, B6, and B12
• vitamin C
• vitamin E
• folate

Alterations in blood glucose levels and insulin resistance should be checked and dealt with, too. AlBendar says they have been linked to hormonal contraceptive use.

Finally, you should pay attention to your gut microbiome, “as it plays a central role in the regulation of estrogen levels within the body.”

To restore it, try limiting artificial sweetener consumption and eating foods rich in prebiotics, probiotics, and polyphenols.

In other words, swap sugary snacks for other options, like whole grains, yogurt, green tea, and asparagus.

A year is the usual suggestion.

A review of more than 20 studies concluded that 83 percent of people who stopped contraception got pregnant within the first 12 months.

Along with other research, it also found that the duration of contraceptive use had no significant effect on conception time. So, if you’ve been a long-term birth control user, you likely don’t have anything extra to worry about.

The obvious one would be the inability to get pregnant after a year of trying. But you may notice other symptoms of potential infertility before that point.

For example, if your menstrual cycle hasn’t returned or is still irregular after a few months of stopping birth control, it’s a sign to connect with a doctor or other healthcare professional.

If you have a uterus, hormone changes may cause:

• skin issues
• weight gain
• lower sex drive

If you have a penis, things to watch out for include:

• libido changes
• difficulty with erection or ejaculation
• pain or swelling in the testicles

Although birth control isn’t a risk factor for infertility, lots of other things are.

The following have all been linked to fertility issues:

• older age
• being overweight or underweight
• history of untreated sexually transmitted infections (STIs)

A person with a uterus will start to see a decline in fertility at the age of 30 that speeds up by their mid-30s.

Aging can have a big impact on sperm profiles , too.

Conditions that affect the reproductive system — PCOS, endometriosis, and blocked fallopian tubes — are also responsible in some cases.

Similarly, anything that can affect sperm production, like diabetes and trauma to the testes, can also result in fertility issues.

According to the NHS, finding the exact cause of infertility isn’t possible in 25 percent of cases.

The treatment depends on the cause (if that cause can be found) along with your age and how long you’ve been experiencing fertility problems.

If difficulty with ovulation is the issue, interestingly, birth control is recommended for people with PCOS, as it can regulate hormones and help with ovulation.

Several medications can help kick-start ovulation, too, including Clomid and injectable versions of human menopausal gonadotropin.

Surgical procedures may help, particularly if fallopian tubes need repairing or endometrial tissue needs removing.

Then, there are assisted conception methods, like in vitro fertilization (IVF) or intrauterine insemination (IUI).

These involve either inserting specially prepared sperm into the uterus or combining a person’s eggs with sperm in a lab and placing the embryos back into the body.

If you’ve been trying to get pregnant for a year after coming off birth control, or if you have any concerns about your fertility, seek advice from a healthcare professional.

They can offer helpful lifestyle and dietary tips or direct you to a specialist if needed.

The main thing to remember is that your contraception can’t cause infertility. So, if you’re experiencing problems, the cause is elsewhere.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.