Why Am I Getting Irregular Periods After Stopping Birth Control?

Wondering why your periods are irregular after stopping birth control? Discover the factors that can affect your menstrual cycle and how to help regulate ovulation.

By OBGYN Dr. Kenosha Gleaton

If you recently stopped birth control and you’re experiencing irregular periods, you’re not alone. The body may need some time to adjust to your new hormone levels, which may cause some side effects such as irregular menstruation. 

How does birth control impact the menstrual cycle? 

Some birth control works by releasing hormones in the body. Well known examples include birth control pills, patches, vaginal rings, etc. These forms of birth control can prevent the natural hormone cycle that is responsible for menstruation, ovulation, and many of the side effects that coincide with your menstrual cycle. If and when you have periods while on birth control (such as your placebo week), that is what we call “withdrawal bleeding,” and it occurs as a result of a drop in hormones in the body [4]. It’s also common to experience withdrawal bleeding soon after stopping birth control. 

What causes irregular periods after getting off birth control?

When you get off of birth control, the body may need some time to adjust to the drop in hormones before you restart your period. This doesn’t happen to everyone, but it’s considered normal for periods to be irregular for one to three months after stopping birth control [1]. If you were on the depo provera shot, it may take around 10 to 12 months for regular menstruation to occur [2]. It is important to note that you can get pregnant immediately after stopping birth control, so it’s recommended that you take other precautions if you’re wanting to prevent pregnancy. You may also want to take a pregnancy test if your period is late or irregular after stopping birth control.

If you had irregular periods before going on birth control, you may continue having irregular cycles afterward. Irregular cycles may also be the result of weight, exercise, or an underlying condition such as polycystic ovary syndrome (PCOS). You should speak to your healthcare provider about any menstrual irregularities to determine the cause. 

The short answer is that irregular periods after stopping birth control are likely the result of your body adjusting to hormonal changes, but other potential causes could be pregnancy, PCOS, or other health conditions. 

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Hormone adjustment

For those taking hormonal birth control, it’s normal to experience various side effects when first starting and discontinuing use. Most hormonal methods contain a combination of estrogen and progestin, which work simultaneously to inhibit levels of ovulation hormones, thicken cervical mucus, and prevent irregular bleeding [4]. The effects of these hormones may lead to acne, weight fluctuations, headaches, changes in menstrual bleeding, mood swings, etc. If any of these side effects are extreme and interfere with your daily life, or if they don’t resolve within a few weeks of discontinuing your birth control, you should speak to a healthcare provider. 

Other side effects of stopping birth control

If you do notice any side effects or changes to your menstrual cycle after stopping birth control, they may be similar to any effects you were experiencing before starting a hormonal contraceptive. For some, this could be heavier, longer periods, cramping, PMS symptoms, etc. Birth control can impact everyone in different ways. In general, you can probably expect your menstrual cycles and other symptoms to return to how they were before beginning your contraceptive use. 

Return to ovulation

When is the earliest return to ovulation after birth control? As you may know, many birth control methods will prevent ovulation from occurring, but not all. Copper IUDs, sterilization procedures, and barrier methods do not stop ovulation, and hormonal IUDs and the progestin only pill (the mini pill) stop ovulation in only a percentage of users [6-7].

When you do stop taking birth control, ovulation is likely to return within a few weeks [4]. If you were on the birth control shot (depo), you may have to wait up to 10-12 months for ovulation to restart [4].

Birth control and fertility

Fortunately most research suggests that birth control use does not have an impact on fertility long-term [2]. Even if you are on hormonal birth control that prevents ovulation or regular menstrual cycles for years, your cycle should return to its normal state after discontinuing contraceptive use. You should begin ovulating again a few weeks after stopping birth control, unless you were on the birth control shot, in which case you may not ovulate for several months. If you are having trouble conceiving, it’s possible there is an underlying condition responsible, including PCOS, male factor infertility, etc. Speak to a healthcare provider about any concerns you may have regarding your reproductive health. Read more about getting pregnant after stopping birth control. 

What to expect when discontinuing birth control

Birth control methods, specifically hormonal birth control, commonly cause a few side effects when discontinued. These side effects are usually signs of the body adjusting to new hormone levels. Once you stop taking birth control, estrogen and progestin levels drop, and luteinizing hormone (LH) and follicle stimulating hormone (FSH) increase [4]. LH and FSH cause ovulation to occur, meaning you may ovulate a few weeks after stopping birth control and should expect a period within a month or so as well. For some, the body may need more time to adjust and periods may be irregular for up to three months following discontinuation. 

It’s also common to experience the same period and PMS symptoms you were experiencing prior to going on birth control. This can include longer or more painful periods, cramping, mood swings, etc. If you ever have any concerns about your birth control methods, side effects, or irregular periods, you should speak to your healthcare provider. 

References:

1. Your Contraception Guide. National Health Service. Reviewed March 2022. Accessed March 2023. URL. 

2. Mansour D, Gemzell-Danielsson K, Inki P, Jensen JT. Fertility after discontinuation of contraception: a comprehensive review of the literature. Contraception. 2011;84(5):465-477. doi:10.1016/j.contraception.2011.04.002

3. Bansode OM, Sarao MS, Cooper DB. Contraception. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536949/

4. 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

5. Progestin-Only Pills. Centers for disease control and Prevention. Division of Reproductive Health. Reviewed February 2017. Accessed March 2023. URL. 

6. Yoost J. Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States. Patient Prefer Adherence. 2014;8:947-957. Published 2014 Jul 3. doi:10.2147/PPA.S45710