8 Reasons for a Missed Period After Stopping Birth Control
Birth control pills are widely touted as the answer to a pesky irregular cycle. Once you start taking them, voila—you can expect your period during those placebo pills each month. Doctors sometimes prescribe birth control pills as a way to balance hormones and kick-start your body into a more predictable cycle. What's more, some studies indicate they can actually boost your fertility, partly because they can decrease your odds of fertility-inhibiting conditions like endometriosis.
But while those same studies indicate that normal menstruation can return soon after stopping birth control, what happens when that's not the case? It can be confusing if you have no period after stopping birth control and a negative pregnancy test. However, there are a number of possible explanations, including stress, obesity, or a thyroid imbalance. We asked experts to weigh in on how birth control pills can affect your monthly cycle and explain the reasons why you might miss periods once you stop taking the pill.
How Birth Control Affects Your Cycle
In a healthy person, the menstrual cycle regulates pretty quickly—often within three to six cycles of stopping birth control. (Hormonal side effects may take longer to clear out of the system).
So even if you've been taking birth control pills (or using other forms of hormonal birth control, like injections) for years, it's unlikely that you'll have trouble conceiving once you stop taking them. But it might take a few months for your menstrual cycle to return to normal. The timing depends largely on the reason you went on hormonal birth control, along with any other underlying health issues that were masked by the pills or developed while using them, says Tsao-Lin E. Moy, a fertility specialist who uses natural and integrative forms of medicine.
On the other hand, if you had an underlying medical condition that was causing irregular cycles—like PCOS, hypothyroidism, or endometriosis—you might notice those conditions rearing their ugly heads again as soon as you stop taking birth control.
"Using a hormonal method of birth control to regulate irregular periods doesn't solve an underlying hormonal imbalance," says Camaryn Chrisman Robbins, M.D., an OB-GYN with Washington University Women & Infants Center. "But it can lead to improved quality of life by regulating cycles and promoting endometrial health. When someone stops using hormonal medication, it is likely those original symptoms will resume."
Moy agrees, saying, "the underlying condition, or root cause, is still present, and will express itself when a woman goes off birth control. Many women believe that since they have a period on birth control, that they have achieved a normal cycle, but that is not the case. It is a mock cycle as the natural hormonal process is being suppressed by creating an imbalance."
Sum this up to say that if you're missing your period after getting off birth control, there is a reason behind it—you just have to find it.
Illustration by Sarina Finkelstein; Getty Images (1)
Reasons for Having No Period After Stopping Birth Control
Did you miss your period after stopping birth control? Remember that it can take several months for your cycle to regulate once you stop hormonal contraception, and this is completely normal. In fact, it's common to experience irregular periods immediately after stopping hormonal birth control.
That said, if menstruation is absent for longer than expected, there might be another issue at play. Here are the most common things that might be causing an irregular cycle.
Stress
Small daily stressors like missing the bus or getting the kids to school late shouldn't wreak havoc on your monthly cycle. But if you're experiencing significant stress from major life events, or you're finding yourself stressed out of your mind from your daily grind, your cycles may become less regular over time. That's because stress can affect your hormone balance, which plays a crucial role in maintaining a regular cycle where an egg is produced and the uterine lining is shed if the egg isn't fertilized.
RELATED: Can You Get Pregnant On Your Period?
Low Body Weight
Dramatic weight gain or loss, regardless of your starting BMI, can always impact your cycle. But if your BMI is less than 18, you may experience what's called secondary amenorrhea. That's when your period, which started normally when you were a young teenager, stops altogether. Unless you are a competitive athlete, this is typically a good indicator that it's time to check your diet and lifestyle and ensure you're making healthy choices.
Obesity
On the flip side, having a BMI of 35 or higher is linked to a host of medical issues, including diabetes, heart disease, and of course, menstrual irregularities. Studies have found a high correlation between obesity and missed periods. Similar to being drastically underweight, having a high level of adipose tissue in the body causes disruptions in normal hormone levels like insulin and sex hormone-binding globulin.
Polycystic Ovary Syndrome (PCOS)
One of the most common causes of irregular cycles is polycystic ovary syndrome (PCOS), which is caused by increased levels of the hormone androgen. While PCOS is not a curable condition, there are treatments that can help regulate your menstrual cycle and increase your chance of successfully getting pregnant.
Uterine Polyps and Fibroids
If you're experiencing irregular cycles or spotting along with symptoms like discomfort during intercourse and lower back pain, it's possible the root cause of your missed period is uterine polyps or fibroids. Both sound scary, but they're actually pretty harmless.
Polyps are small overgrowths in the lining of your uterus called the endometrium. Typically symptomless, they can cause disruptions to your monthly cycle and spotting between periods. Fibroids are growths found in or on the uterus that can cause painful, heavy periods.
Why can polyps and fibroids cause you to miss your period? Because both occur in response to fluctuations in hormones that also regulate your cycle.
Thyroid Imbalance
Who knew your thyroid played such a huge role in your menstrual cycle? It seems strange, but it's true. Your thyroid hormones directly impact your periods, and too much or too little (as in the cases of hyperthyroidism and hypothyroidism, respectively) can cause your cycles to become irregular or stop altogether.
Pregnancy
Of course, if you don't experience periods after stopping hormonal contraception, you could be pregnant. Take a pregnancy test to rule out this possibility if you've had unprotected sex. You could conceive even if your menstrual hasn't haven't returned to normal yet.
Breastfeeding
Still waiting for your period to return after birth? Breastfeeding might be a factor. Numerous studies have shown that exclusive breastfeeding leads to a few months of amenorrhea (not having a period) immediately following birth. But there's no definitive guidance on how long that lasts, and often, there aren't any indications that your cycle is gearing up again. This can lead to an unplanned pregnancy if no other method of birth control is used.
To prevent this, many people turn to a "mini pill," which is a progesterone-only birth control pill. According to Dr. Robbins, "A progesterone-only oral contraceptive pill is excellent for parents who are breastfeeding because progesterone pills do not interfere with milk supply. Estrogen has been shown to decrease the volume of milk, especially in early lactation. Many methods of contraception are safe to start any time after giving birth, and women can resume an estrogen-containing contraceptive after they stop lactating."
Once your period does return after giving birth, it's not unusual for it to be a bit irregular if you're still nursing. But if your baby has been weaned for months and your period still hasn't regulated, it's worth a trip to your doctor to have your hormone levels checked.
