What’s the Difference Between Pregnancy Symptoms vs Stopping Birth Control?

Recently gotten off of birth control and wondering if your symptoms are pregnancy related? Read on to learn the difference between pregnancy symptoms and side effects of stopping birth control.

By OBGYN Dr. Kenosha Gleaton

Pregnancy symptoms and side effects from stopping birth control can be similar, so it’s important to know what differences to look out for. Especially because pregnancy can occur so soon after discontinuing hormonal contraceptives.

Reproductive hormones

Changing hormones are a natural part of the reproductive cycle and are especially common during puberty, menstruation, pregnancy, and menopause. Hormones play an important role in all bodily systems and can cause various symptoms when hormone levels are abnormal or changing. There are four key hormones that regulate the menstrual cycle and are impacted greatly by birth control and pregnancy: luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrogen, and progesterone. [1] The rise and fall of these and other hormones are some of the leading causes of side effects and symptoms associated with pregnancy and hormonal birth control methods.

Hormones and birth control

Most hormonal birth control methods are combination methods, meaning they release both progestins and estrogen into the body. A few common examples include the pill, birth control patch, birth control ring, etc. [2] When progestin and estrogen levels are increased in the body, the amount of LH and FSH decreases, which prevents the growth and release of a mature egg (aka ovulation). [2] To sum it up, most hormonal birth control methods increase estrogen and progestin while decreasing LH and FSH.

Hormones and stopping birth control

When someone discontinues birth control use, hormone levels begin to change and may need a few weeks to restabilize. [2] Coming off of birth control will cause levels of estrogen and progestin to decrease, allowing the production of LH and FSH to continue. The type of contraceptive method previously used will play a role in when earliest ovulation after stopping birth control will occur. For most, ovulation will occur within a few days and the hormone cycle should regulate within a few months. [2] (Learn more about what happens when you stop taking birth control.)

Hormones and pregnancy

Hormones also change dramatically during pregnancy. Once implantation occurs, estrogen levels begin to increase significantly to support the embryo, help transfer nutrients, and form blood vessels. [3] Progesterone levels are also high during pregnancy to support uterine growth and immune system function. [4] There is also the addition of a new hormone known as human chorionic gonadotropin (hCG). HCG is the hormone that pregnancy tests are measuring and is important for supporting the embryo and preventing menstruation. LH and FSH levels remain low throughout pregnancy and for a few weeks after childbirth.

Early pregnancy symptoms

So what symptoms can you expect during early pregnancy? It’s important to note that every pregnancy is different and symptoms can vary from person to person and even from pregnancy to pregnancy. That being said, there are a few common symptoms experienced during early pregnancy, such as: [5]

• Nausea and vomiting: Morning sickness is a common symptom of pregnancy that is defined by feelings of nausea and/or vomiting. Learn how to treat morning sickness.
• Fatigue: Feeling extra sleepy is a very common symptom of pregnancy, occuring in up to 90% of newly pregnant women. [6]
• Breast pain: Tender or painful breasts is a common symptom during PMS, menstruation, and pregnancy.
• Urinary frequency: Many newly pregnant people experience the increased urge to pee. This is likely due to the rise in progesterone and its effects on smooth muscle.
• Bloating: Another common symptom seen prior to and during menstruation, ovulation, and pregnancy. Bloating may occur as a result of pregnancy, but is also caused by many other factors.
• Moodiness: Hormonal changes during pregnancy are known to cause mood swings in some people.
• Food cravings and aversions: Craving a pickle covered in peanut butter, or suddenly nauseous after smelling your favorite food? It’s normal for many newly pregnant people to have intense food cravings or food aversions.
• Spotting: Implantation bleeding is a common cause of spotting during early pregnancy. Some may mistake implantation bleeding from their period, but implantation bleeding is usually much lighter and will only last for a day or two.

Side effects from stopping birth control

When you stop using hormonal birth control, it’s normal to experience a few side effects as your hormone levels return to how they were previously. The kind of birth control you were using can also impact potential symptoms, return to ovulation, menstrual cycle regularity, and more. A few potential side effects from stopping birth control include: [7]

• Spotting or abnormal periods
• Longer or heavier periods
• Return of PMS symptoms
• Changes to skin or hair

Many other symptoms may arise as a result of starting or stopping birth control, and some may be similar to pregnancy symptoms. The best way to rule out or confirm a pregnancy is by taking a pregnancy test. It’s also important to note that if you had irregular periods or specific symptoms tied to your menstrual cycles prior to using hormonal contraceptives, these will likely return after discontinuing use.

How to differentiate between symptoms

Nausea, fatigue, food aversions or cravings, and urinary frequency are more likely to be associated with early pregnancy. [5] A return of PMS symptoms, heavy bleeding, and changes to the skin and hair are more likely to be associated with discontinuing birth control use. [7]

The bottom line is that many pregnancy symptoms and post birth control symptoms can overlap. Symptoms can also vary from person to person. If you’ve recently stopped taking birth control and have had heterosexual sex, it’s possible that you’re pregnant. You should take a pregnancy test and speak to your healthcare provider if you’re concerned about any symptoms you’re experiencing. If you are hoping to prevent pregnancy, you should be using a condom or other form of contraception. If you’re hoping to get pregnant soon, it’s recommended that you begin taking a prenatal vitamin and speak with your healthcare provider about your plans to conceive. Consider adding morning sickness gummies, like our ginger and vitamin B6 gummies for nausea, to your prenatal routine, as they can help ease discomfort during early pregnancy stages.

References:

1. Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/?report=classic
2. Britton LE, Alspaugh A, Greene MZ, McLemore MR. CE: An Evidence-Based Update on Contraception. Am J Nurs. 2020;120(2):22-33. doi:10.1097/01.NAJ.0000654304.29632.a7
3. Kumar P, Magon N. Hormones in pregnancy. Niger Med J. 2012;53(4):179-183. doi:10.4103/0300-1652.107549
4. Cable JK, Grider MH. Physiology, Progesterone. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558960/
5. What are some common signs of pregnancy? National Institutes of Health Office of Communications. Last reviewed 1/31/2017. URL.
6. Behrenz KM, Monga M. Fatigue in pregnancy: a comparative study. Am J Perinatol. 1999;16(4):185-188. doi:10.1055/s-2007-993855
7. Birth Control Pill. Planned Parenthood. Accessed March 2023. URL.