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In 2017, the CDC released a report that showed more than half of all people with ovaries in the US between the ages of 15 and 49 were actively using some form of birth control. Of that group, 22.9% were using a hormonal contraceptive. So, it’s understandable that many people might want to know how these synthetic hormones affect the body and how long they linger. Here’s your answer in a nutshell: “Give things three months to return to normal,” explains OB-GYN and Modern Fertility medical advisor Dr. Eva Luo, MD, MBA, FACOG. “Long-acting reversible contraceptives (like the hormonal intrauterine device, or the IUD) generally promise a return of fertility right away, estrogen-containing contraceptives (like the pill) can take about three months, and Depo-Provera (the shot) can take as long as 18 months.” In this article, we’ll go deeper into how long different forms of hormonal birth control stay in the body so you can make informed decisions about your reproductive health. Find the right birth control for you Birth control based on your health, preferences, and goals—delivered to your door Learn moreHow does hormonal birth control work?Before we dive into how long hormonal birth control stays in your system, let’s take a step back and get a refresher on how birth control works to prevent pregnancy. Today’s options for birth control come in many different shapes and sizes, but for the purposes of this article, we’re going to stick with hormonal contraception (as opposed to barrier methods, like condoms, or the non-hormonal IUD). These methods use synthetic hormones to trigger a response in your body that prevents pregnancy — though the responses they trigger vary slightly. The birth control pill (also called the combination pill or combined oral contraceptive), ring, patch, implant, and shot (also called the injection) all work by:
The minipill (aka progestin-only pill) that contains norethindrone (a progestin) doesn’t suppress ovulation for all users because the dose of progestins isn’t high enough — instead, it works by thickening the cervical mucus and preventing the uterine lining from thickening. A newer minipill option that contains another progestin, drospirenone, does work by suppressing ovulation. The hormonal IUD primarily works by thickening the cervical mucus, but also prevents the uterine lining from thickening. Like the minipill, it may suppress ovulation in a smaller percentage (up to 55% depending on the dose of progestins) of people. So, how long does hormonal birth control stay in your system?In order to answer this question as precisely as possible, let’s walk through each form of hormonal contraception separately:
Birth control typeHow long it stays in the systemTime before “normal” cycles returnThe hormonal IUDUntil removalUp to two monthsThe pill and minipillProtective for 48 hours after takingUp to three monthsThe ringProtective for 48 hours after removalUp to three monthsThe patchProtective for 48 hours after removalUp to three monthsThe implantProtective for 7-14 days after removalUp to three monthsThe shotProtective for three months after injectionUp to 18 months Does hormonal birth control have to be cleared from your system before you can get pregnant?So you’re ready to pursue pregnancy after stopping contraceptives. We know that, in many cases, the medication will leave your body within 48 hours. But that doesn’t necessarily mean that your body will be quite ready for pregnancy 48 hours after you stop using birth control. All forms of contraception that contain hormones work by altering your menstrual cycle — and there may be an “adjustment period” of around 90 days as your typical cycles return. But this is not caused by lingering birth control hormones. 90 days is the estimated amount of time it takes for an ovarian follicle (which develops and releases an egg) to go from actively developing (preantral in medical-speak) to ready for ovulation (preovulatory). 90 days gives your body enough time to ovulate an egg that hasn’t been affected by synthetic hormones (cue “normal” ovulation). But, adds Dr. Luo, “there are plenty of patients who stop taking oral contraceptive pills or other forms of hormonal contraception and get pregnant immediately,” she says. That 90 days is the average adjustment period before “normal” menstrual cycles return — you won’t necessarily have that same experience. If your cycle doesn’t start 90 days after stopping birth control, this could be a sign of an underlying issue that birth control was managing (like polycystic ovary syndrome or thyroid conditions). If this happens, seek out medical advice from your healthcare provider so they can help you investigate what’s going on. The only outlier for this 90-day guidance is if you’re transitioning off of the Depo-Provera shot. This is the only type of birth control that’s known to cause a delay, up to 18 months, in the return of ovulation. Regardless of your method of birth control, no — you don’t need to do or take anything to “cleanse” your body of the synthetic hormones from birth control. They’ll leave on their own. How long does it typically take to get pregnant after stopping hormonal birth control?In 2018, researchers conducted a systematic review to understand how likely people were to conceive within 12 months after going off hormonal contraceptives. They found that:
While there’s little data on ex-ring and patch users, you can expect a similar time to pregnancy as oral contraceptives. The bottom lineWhether you’re thinking of changing or discontinuing your birth control method, remember that for most forms of hormonal birth control, the medication will leave your system after about two days. If your body takes longer than three months to get back to its pre-birth control self, check in with your healthcare provider to see if there could be an underlying condition impacting your cycles. The only form of hormonal contraception that may cause your body to take longer than three months to return to your “normal” is the Depo-Provera shot. This article was medically reviewed by Dr. Eva Marie Luo, MD, MBA, FACOG, an OB-GYN at Beth Israel Deaconess Medical Center and Clinical Lead for Value at the Center for Healthcare Delivery Science at Beth Israel Deaconess Medical Center. Can birth control pills balance your hormones?Because birth control pills contain progestin and estrogen, they're able to help balance your hormones and regulate your menstrual cycle. Birth control pills can make your period more predictable, so you always know when it's coming.
How long does it take for the pill to alter hormones?This is because the pill takes 7 days to get in control of your hormones and prevent pregnancy. If you take more than 7 days off the pill, you are at risk of pregnancy again and need 7 days of perfect pill taking before you are protected again.)
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