Q: How long is too long to be on the contraceptive pill?

We had so many questions sent in to our podcast on the last season that we didn’t get round to answering so will be picking out a few over the coming weeks to answer here.

Q. My question relates to female contraception. I have been on the mini pill for about 9 years. I have largely had a great experience with it – no weight gain, no crazy mood swings, and personally I have not had a period or any spotting during that time. Now, as I approach 30, and although I am personally not, I am starting to hear from friends and colleagues that are trying to conceive, that it is not always as easy as we think it might be, and therefore I am wondering if a female has been on the pill, or another form of hormonal contraception, for a prolonged period of time, is there a benefit in taking a break from that to allow your hormones to reset?

Answer from Dr Nirja:

Thank you so much for this! It’s a very good question and one which is coming up more and more in the GP surgery.

The first thing is, bodies change over time, with or without hormonal contraception, so your periods may change regardless of having had hormonal contraception as you get older. The only way to know how your body is ‘functioning’ is to take a break from hormonal contraception to see what your ‘new normal’ looks like. 

It is possible that women may have lost their regular cycle due to other issues. For example, polycystic ovarian syndrome which would not have shown itself due to the pill, or weight changes and stress may have also impacted how your natural cycle progressed over time.

As per medical advice, it is possible to conceive very soon after coming off any hormonal contraception, so it’s important if you do take this break then you are prepared with barrier contraception or a plan if you would not wish to get pregnant during this break.  In theory, as soon as you come off hormonal contraception, your periods could return to normal the following month. Most women’s cycles should return to normal by 3 months.

I have certainly seen patients come off contraception, and not have a period as they did conceive very soon after coming off contraception – so it’s just a caution depending on what you want. 

In answer to your question, there is no specific benefit in coming off your pill at this point considering you are not in a space of wanting to have children, coming off the pill would not be necessary to allow your hormones to ‘reset’. Particularly, if you were thinking about going back on the pill again. Your body will adjust to coming off contraception when you are ready. The only benefit of coming off the pill, would be to see if your cycles are still regular for your own peace of mind, but again, this may change again with time. 

In reality, I would suggest allowing a 6 month buffer to come off contraception and allow your periods to regulate without hormonal contraception. The difficulty is, as women are having children later in life, it does not allow much time in case things do not return like clockwork. As I said, your periods, your ovaries, your womb, may all be in a different state than when you started contraception several years ago, so if you allow yourself that time, if things don’t go back to your ‘normal’ cycle, and if you do need assistance to conceive eventually, then you have left yourself more time in case you need it. 

Q: How long is too long to be on the contraceptive pill? was last modified: September 22nd, 2022 by Nirja Joshi

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