Coming Off The Pill: Possible Side Effects & Tips to Manage Them

In this article, we’ll look at how to prepare before stopping the pill, the potential side effects, symptoms and shifts you might experience when you come off the pill and crucially, when to test your hormones depending on which type of contraception you’ve been using. Read on to understand how to support your reproductive and overall health as you manage your post-contraception journey.

Quick facts:

• Coming off the pill can bring on both physical and psychological side effects. 
• You won’t necessarily experience side effects, it’s all dependent on the individual. 
• If you experienced any hormonal symptoms before going on the pill, these may return.
• It generally takes around 3 months for your menstrual cycle to regulate again. 
• Taking a hormone test after you’ve been off the pill for at least 3 months can help you understand more about your reproductive health.

How to prepare before coming off the pill

Coming off the pill doesn’t have to feel like stepping off a cliff. A little preparation in the weeks and months beforehand can make your transition much smoother both physically and emotionally.

Start tracking your cycle now

Even if you’re still on the pill, you can begin noting how your body feels day to day. Use a cycle tracking app like Hertility or even just a notebook, note your cycle length, energy levels, mood, skin and sleep. This gives you a baseline before your natural hormones return, so you can spot patterns more quickly afterwards.

Review your reason for going on the pill in the first place

Many people start the pill to manage symptoms like  irregular cycles, painful periods, acne or conditions like PCOS or endometriosis. If that was the case for you, it’s worth speaking to a healthcare professional before stopping, so you have a plan in place for those symptoms potentially returning.

Consider your contraception timeline

If you’re stopping contraception specifically to try to conceive, it’s worth factoring in the timeline for your hormones to settle before tracking ovulation. In most cases, we recommend waiting at least 3 cycles post-pill before testing your hormones, but this varies depending on the type of contraception you’ve been using (see section below).

Common side effects of coming off the pill

Whilst side effects like mood swings, irregular periods and acne, the experience of coming off the pill (or any hormonal contraception) is totally unique to each individual. This is because each of our hormonal make-ups is unique. 

While coming off the pill may have some side effects, most can be managed or treated and fertility, including a regular menstrual cycle, typically returns to normal within a few months.

Knowing how to manage and prepare for any possible symptoms will make your post-pill journey much easier. Let’s take a look at both the physical and mental side effects of coming off the pill.

What are the physical side effects of coming off the pill?

Stopping the pill may bring on physical side effects including changes in your menstrual cycle, skin issues and weight fluctuations.

Menstrual cycle changes after coming off the pill

Hormonal fluctuations can cause your menstrual cycle to change. While on the pill, your body receives a steady and specific dose of synthetic oestrogen and/ or progestogen to prevent pregnancy.

When you stop taking the pill, the synthetic hormones gradually leave your system, allowing your natural hormones to kick back in. But since your body hasn’t needed them recently, it can take a while for them to find their rhythm. It takes some time for your natural hormones to balance and your menstrual cycle to regulate.

A key sign of hormonal balance is a regular menstrual cycle. After coming off the pill, most people notice cycles return to what was normal within 2-3 months. While we can test some of your hormones while you are on hormonal contraception, if you want to do your hormone blood test without the effect of external hormones, we recommend waiting three months.

If your menstrual cycle doesn’t return after three months, we would recommend reaching out to our in-house fertility experts for guidance. They can provide insights, conduct Advanced At-Home Hormone and Fertility Test and offer personalised advice based on your specific situation.

Your periods may also feel different to how you remember them. Heavier flow, stronger cramps, and a shift in cycle length are all common in the months after stopping, especially if you originally went on the pill to manage those exact symptoms. The pill effectively puts a lid on your natural hormonal fluctuations, so when that lid comes off, it’s like your body is starting all over again.

This doesn’t mean something is wrong. But it does mean it’s worth paying attention. Tracking your cycle from the moment you stop, noting flow, pain levels, mood and energy gives you a detailed picture of what your natural hormones are doing, and makes it much easier to spot anything worth investigating further.

An important thing to remember is that you can get pregnant after getting off birth control. Many women think it takes a long time to conceive after they stop the pill, but you might start ovulating as soon as 1-3 months post stopping.

Skin problems after coming off the pill

Some birth control pills have an anti-androgenic effect, meaning they lower testosterone levels in your body, which can reduce acne, which is a common symptom of PCOS. When you stop, testosterone levels can rise again and your skin may react. Breakouts along the jaw, chin and cheeks are particularly common in the first few months post-pill.

For most people this settles within 3–6 months as hormones find their new equilibrium. If your acne is persistent, severe, or is hitting your confidence, it’s worth speaking to a dermatologist, but it’s also worth looking at the hormonal picture underneath it. Acne can be a signal of elevated androgens, which is a key marker we test for at Hertility

Unwanted hair growth after coming off the pill

If you were taking a pill with an anti-androgen effect, unwanted hair growth may return after you stop taking it. This is because the pill was suppressing testosterone, and when that suppression lifts, androgen levels can rise again. Hair growth on the chin, upper lip, neck or chest, called hirsutism is one of the more noticeable ways this can show up.

While this can happen to anyone stopping an anti-androgenic pill, it’s also one of the hallmark signs of elevated androgens more broadly and a key symptom of conditions like PCOS. Because the pill can mask PCOS for years, coming off it is often the first time these symptoms surface.

💡 If you’re noticing acne and unwanted hair growth after stopping the pill, it’s worth getting your hormones tested to understand what’s driving it. Our Advanced Hormone & Fertility Test can check for up to 10 hormones including testosterone levels, and gives you a personalised care plan based on your results.

Weight fluctuations after coming off the pill

People’s responses to the pill vary. Some report weight gain, while others report weight loss. These changes may be due to increased appetite and the oestrogen content in the pill causing fluid retention, but this is very individual. Your weight can impact your reproductive and overall health. If you need support, consult with a fertility nutritionist who can guide you on diet, exercise, and lifestyle adjustments tailored to your needs.

Sex drive changes after coming off the pill

When you come off the pill, you might find your sex drive (libido) increases and you’re up for sex more often. This is because of a boost in testosterone during ovulation. 

What are the emotional side effects of coming off the pill?

The pill delivers a steady stream of synthetic hormones, and for many people, that consistency has a stabilising effect on mood. When you stop, your body has to start producing and cycling its own hormones again from scratch. That hormonal shift can feel a lot, especially in the first couple of months.

What this looks like varies hugely. Some people notice heightened PMS, more intense irritability, low mood or anxiety in the week before their period than they’d previously experienced. Others feel more emotionally sensitive across the whole cycle or found the opposite, that coming off the pill actually lifts a low mood they hadn’t fully attributed to it.

PMS and PMDD may intensify when you stop the pill, particularly during the luteal phase, the second half of your cycle, between ovulation and your period. If you find yourself feeling anxious, tearful or overwhelmed in a predictable pattern each month, it’s worth tracking it. Symptoms that follow a clear cyclical pattern and disappear when your period arrives are a hallmark of PMS or PMDD, and both are treatable.

In the meantime, be genuinely kind to yourself during this transition. Protect your sleep, reduce stimulants, move your body in ways that feel good, and lean on your support network. If mood changes feel severe or persistent beyond 3 months, speak to your GP or book with one of our Fertility Counsellors, you don’t have to just ride it out.

When should you test your hormones after stopping contraception?

This is one of the most common questions we get  and the answer isn’t one-size-fits-all. How long you should wait before testing depends on which type of contraception you were using, because each type suppresses your hormones differently and for different lengths of time.

As a general starting point, for most hormonal contraception, we recommend waiting around 3 cycles before testing your cycling hormones. The exception is the contraceptive injection (Depo-Provera), which can stay in your system for up to 12 months. The copper IUD is non-hormonal, so you can test at any point.

For the full breakdown by contraception type, including what each method does to your hormones and exactly when to book your test, read our dedicated guide: When to test your hormones after stopping contraception

💡 Not sure which test is right for you? Take our Online Health Assessment, it asks about your contraception history and recommends the right test at the right time.

Long-term effects and fertility considerations

Usually, after a few months of stopping the pill, your ovulation and menstrual cycle will return to normal. If no other underlying health conditions are impacting your fertility, you should be able to conceive. 

At Hertility, we can support you at every stage, whether you’re trying to conceive or planning for future children. 

Keep in mind that your fertility timeline after coming off the pill depends on many different factors. Age plays a role (females are generally more fertile in their 20s and early 30s), along with lifestyle, overall health, and potential underlying fertility issues.

While the pill itself hasn’t been found to impact long-term fertility, it might mask health conditions like PCOS or endometriosis that could affect conception. Coming off the pill is often the first time these conditions make themselves known, which is exactly why testing at the right point matters.

💡 Ready to understand your hormones? Our Advanced Hormone & Fertility Test  checks for up to 10 hormones and screens for up to 18 conditions including PCOS, and gives you a personalised care plan, so you know exactly where you stand.

What do you need to do to prepare to stop birth control?

For those with an implant or IUD, stopping birth control will require a minor medical procedure and an office visit with your gynecological healthcare provider, which could be your GP, OBGYN or midwife. For those using birth control pills or an inserted device, such as a Nuvaring, you can stop taking the pills when you have finished the pack or remove the device on your own, but always speak to your doctor before deciding to stop.

Consider taking a hormone and fertility test

Taking a hormone and fertility test around 3 cycles after stopping the pill can be a great way of understanding more about your reproductive health. Whether you’re planning a pregnancy, curious about your hormones or getting a treatment plan for any symptoms that have cropped up our Advanced At-Home Hormone and Fertility Test has got you covered.

Coming off the pill FAQs

How long do side effects last after coming off the pill?

Give it at least 3  cycles for your hormones to settle. Usually, any significant side effects should settle around the three-month mark as your menstrual cycle becomes more regular. If you’re experiencing any symptoms that are impacting your quality of life, don’t put up with them! You can take a Hertility  Advanced At-Home Hormone and Fertility Test or speak to one of our gynaecologist  to explore symptom management or treatment.

How long after coming off the pill can I get pregnant?

You can technically get pregnant as soon as you stop taking the pill, as ovulation can return quickly,  sometimes within the first month.. If you have been on the pill for several years, it may take a few months for your cycle to regulate before you notice clear signs of ovulation.

How long does it take for hormones to regulate after stopping the pill?

For most people, it takes around 2–3 months for cycling hormones to return to their natural baseline after stopping the combined pill. Some people find their cycle returns almost immediately; for others, it can take up to 6 months. If you haven’t had a period within 3 months of stopping, you can consider taking  a Hertility  Advanced At-Home Hormone and Fertility Test  this is known as post-pill amenorrhoea and is worth investigating, as it can sometimes indicate an underlying condition that the pill was masking, such as PCOS.

Can coming off the pill affect my mental health?

For some people, stopping the pill is associated with increased anxiety, mood swings and emotional sensitivity. This is thought to be linked to the shift in synthetic hormones the body has been receiving. The combined pill contains synthetic oestrogen and progestogen, which can have a mood-stabilising effect for some people; when those hormones are removed, the sudden change can trigger heightened emotional responses. These symptoms are usually temporary and tend to settle as your natural hormonal cycle re-establishes itself,  typically within 2–3 months. If anxiety feels severe or persistent, speak to your GP or book with one of our Fertility Counsellors.

What are the signs that I should consult a healthcare provider after stopping the pill?

Trust your instincts. Allow three months for your body to adapt to hormonal changes. If, after this time, you haven’t had a period or the symptoms are disrupting your daily life, reach out to a private gynaecologist to figure out the next steps for you.

Resources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1903378/
2. https://onlinedoctor.lloydspharmacy.com/uk/contraception-advice/coming-off-the-pill
3. https://www.webmd.com/sex/birth-control/stopping-pill-10-ways-body-changes
4. What Happens When You Stop Using The Combined Pill?
5. https://www.health.com/condition/menstruation/period-going-off-birth-control-pills
6. https://www.drfelix.co.uk/health-center/coming-off-the-pill/
7. https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
8. https://www.medicalnewstoday.com/articles/post-pill-pcos#:~:text=Stopping%20hormonal%20birth%20control%20cannot,with%20PCOS%20in%20some%20people
9. https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/treatment/
10. https://patient.info/sexual-health/hormone-pills-patches-and-rings/combined-oral-contraceptive-coc-pill
11. https://www.nhs.uk/conditions/loss-of-libido/
12. https://www.nhs.uk/conditions/contraception/when-periods-after-stopping-pill/