What to Expect When You Go On or Off the Pill

By Tanya Edwards


Since getting approved by the FDA in 1962, the hormonal birth control pill has been one of the most popular methods of birth control. Currently, four out of five women in the U.S. who are sexually active have used the Pill or currently do; and thanks to new advances, you might be surprised (in a good way!) by some of the effects that tiny little thing can have on our bodies.

We got the scoop from Dr. Evelyn Minaya, board-certified ob-gyn, expert at Sharecare, and cohost of The Juice.

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Going on the Pill

  • Overview: “The hormonal birth control tells the brain that it is getting enough hormones (meaning estrogen and progesterone) from the Pill,” explains Dr. Minaya. “The brain, in response, will not signal the ovary to produce hormones or to ovulate. That is how it prevents a pregnancy.”

  • Weight Gain: One of the biggest rumors I heard from my friends in college was that the Pill would add pounds. Whether or not you agree, relying only on your girlfriends isn’t the best source of info. “No, not true!” says Dr. Minaya, “And I’m going to tell you where that came from. The commonly prescribed patient population years ago was just going into college, and what do you do in college? You deviate from your normal diet, you’re not eating regular meals, and most importantly…alcohol.” Normal college weight gain influenced early studies, leading to the belief that the Pill causes weight gain. If you maintain your diet and work out, you shouldn’t gain weight on the Pill.

  • Sore or Swollen Breasts: Think you’re going to go up a cup size from the Pill? That would have more to do with gaining weight than the Pill itself. While you may experience temporary swelling, it won’t be permanent. The lower the hormonal dose your pill has (most pills now have a relatively low 0.02 mg to 0.035 mg of estrogen), the less likely you are to see or feel anything, says Dr. Minaya. “Any swelling will dissipate by the third month.”

  • Lighter Periods: This is a bonus side effect (in our humble opinion) of the Pill for many women. “I prescribe more birth control for cramps and heavy periods [than just for birth control alone]. It’s an amazing little pill, with so many more uses than you’d think. Especially for teenage girls or women with conditions that give them heavy periods.”

  • Cancer Risk Reduction: Some types of cancer risks can be lowered by taking the Pill. “When you take the Pill, you reduce your risk of endometrial and ovarian cancer,” says Dr. Minaya.

  • Nausea: “The first versions of the Pill had much higher doses of estrogen (as high as 50 micrograms!), and that’s a lot of estrogen! A lot of women experienced a lot of nausea with it,” explains Dr. Minaya. “Nowadays, the more popular ones are usually 30 micrograms or below, and the most popular is 20. Most women have very little nausea.” And the doctor’s advice? “Always take it with a meal.”

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Going Off the Pill

  • Breakouts: “If you start using the birth control pill, you will [generally] see a decrease in breakouts,” says Dr. Minaya. “However, it is a daily-dose pill, and if you stop taking it, you’ll see the effect go away in [as little as] 24 hours.”

  • Mood Changes: You may find yourself a little…grumpy. “For some women,” says Dr. Minaya, “[the Pill] does stabilize their mood. Every month our hormones fluctuate, and the Pill is very beneficial to those women who are sensitive to that.”

  • Heavier Flow: Bad news. If you experienced much lighter flow while on the Pill (“it really reduces the flow and curbs cramps significantly,” says Dr. Minaya), you’re likely return to a heavier flow when you stop the Pill.

  • Increased Libido: I’d always heard going off the Pill could heat things up in the bedroom, assuming that the steady hormones somehow decreased fluctuations in your libido, but Dr. Minaya disagrees. “I’ve only had a handful of people complain about [lowered sex drive on the Pill], and only one person where we actually proved it. Ninety-five percent of your libido is in your head.”

  • Pregnancy: This is the most important one—don’t assume that the hormones stick around for a while to protect you. “We’re more likely to get pregnant right after we stop taking the Pill,” Dr. Minaya cautions. Great news if you’re ready, but be careful (and use another method of protection) if you aren’t!

Of course, every woman’s body is different, and millions of women take birth control pills for health reasons as well, so talk to your doctor about any concerns you might have and to get a full exam before starting any prescription contraceptive.

Let us know in the comments what your experiences have been like going on or off the Pill.

photo: CN Archive

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