Period MIA After The Pill? It May Be Post-Pill Amenorrhea

  • Written by

    Leslie Hughes

    Health Researcher and Writer
  • Verified by

    Dr. Aditi Neelakantan

    Medical Practitioner, MBBS

    Dr. Aditi Neelakantan

    Dr. Aditi Neelakantan, a medical practitioner with a strong inclination for compassion-driven research, believes that “knowledge is a commodity to be shared”. She dedicates her time to simplifying complex medical information so that people can better understand their health and make informed choices.

post pill amenorrhea
  • Written by

    Leslie Hughes

    Health Researcher and Writer
  • Verified by

    Dr. Aditi Neelakantan

    Medical Practitioner, MBBS

    Dr. Aditi Neelakantan

    Dr. Aditi Neelakantan, a medical practitioner with a strong inclination for compassion-driven research, believes that “knowledge is a commodity to be shared”. She dedicates her time to simplifying complex medical information so that people can better understand their health and make informed choices.

Have you recently stopped birth control pills? And has your period been MIA? You may be wondering what’s going on, and when you’ll get your period back. We’re here to give you the low-down.

While most experience a return of their menstrual cycle within three to six months, many women may experience a longer delay. This is called post-pill amenorrhea and researchers estimate that 0.2 – 1.3% of women experience it.

How long does it last? What causes it? And what are the potential implications of this lack of a period?

Let’s explore the answers to those questions and more.

Key takeaways

  • Post-pill amenorrhea is the absence of menstruation for six months or more after stopping oral contraceptives.
  • It’s common to experience irregular periods, longer cycles, and delayed ovulation for a few months after stopping birth control. This is you adjusting to natural hormone production.
  • Amenorrhea can be a symptom of underlying health issues in women. While birth control pills can sometimes mask these issues, they aren’t the direct cause of amenorrhea. It’s possible that birth control was preventing you from noticing the underlying condition that’s actually responsible for your lack of period.
  • It can also be due to hypothalamic-pituitary-ovarian axis dysfunction or delayed puberty.
  • Lifestyle factors such as body weight gain, a high body mass index (BMI), stress, and excessive exercise may also be to blame.
  • Hormonal contraceptives do not cause infertility. However, some women may see a temporary reduction in fertility right after stopping the pill. This is due to transient hormonal imbalances.
  • Signs of ovulation after getting off birth control include increased libido, changes in cervical mucus and position, and a rise in basal body temperature.
  • If you haven’t gotten your period within half a year of stopping birth control (three months if you’re aiming for pregnancy), talk to a doctor. There may be some underlying condition that requires treatment.

What is post-pill amenorrhea?

This condition is when your period is absent for six months or more after quitting birth control pills. It can happen because oral contraceptives prevent you from producing the hormones needed for ovulation and menstruation.

Post-pill amenorrhea is a type of secondary amenorrhea, which is when a person has had periods in the past but isn’t getting them now for more than three consecutive cycles.

It’s important to note that absent or irregular periods are normal after stopping combined hormonal contraceptives. It can take time to readjust after the hormonal suppression from birth control. This is especially true if you:

  • Were on the pill for an extended amount of time
  • Had irregular periods before starting birth control pills

So if you’re thinking “I stopped taking birth control and haven’t gotten my period,” don’t panic.

In fact, it’s not uncommon for it to take 3-6 months to return to regular periods. However, if your secondary amenorrhea lasts more than half a year (or three months if you’re TTC), you may want to seek treatment.

What normally happens after stopping birth control?

Menstrual cycles are led by a delicate balance of hormones, mostly estrogen and progesterone. These hormones rise and fall through your cycle, prepping the uterus for a potential pregnancy.

When you’re on combined oral contraceptives, you get a steady supply of these hormones. They suppress your body’s natural production.

how birth control pill works

Once you stop taking the pill, your body slowly starts to resume its natural hormone production. And this means you’ll resume menstruation again. But, it can take a couple of cycles to get things going.

The shift from synthetic hormones to your natural production of them can lead to some irregularities. So, don’t be surprised if you have a late period after stopping the pill. Or if you’re not getting your period after quitting birth control pills.

Most women experience withdrawal bleeding about two to four weeks after stopping hormonal oral contraceptives. Note that this bleeding is not a true period, but an effect of hormone withdrawal.

Following the withdrawal bleeding, your natural menstrual cycles should gradually start again. However, it’s common to experience:

What causes post-pill amenorrhea?

The exact cause of postpill amenorrhea isn’t clear. But, it’s generally considered harmless and should go away on its own.

Here are the most common causes why you may be experiencing amenorrhea after stopping birth control pills.

Hypothalamic-pituitary-ovarian axis dysfunction

Some research suggests that this type of amenorrhea may be linked to an imbalance in the hypothalamic-pituitary-ovarian axis. This axis is responsible for producing and releasing female reproductive hormones.

Post-pill, you may experience hypothalamic or pituitary gland deficiency. This means low levels of gonadotropins and ovarian hormones. This is because your hypothalamus is a little confused. It’s used to birth control pills producing these hormones, so it may take a while for natural production to resume.

During this time you may also see higher levels of prolactin. You want high levels of this if you’re breastfeeding. But too much of it can suppress the hypothalamus and pituitary gland and throw off your natural production of other hormones.

Think of it like this: When you stop taking oral contraceptives, your body needs time to reboot and get back to its normal hormone production schedule. Sometimes, this reboot can take longer than expected.

Underlying medical conditions

Birth control can be the reason for your amenorrhea once you stop the pill. But it’s not the only potential cause.

There may be underlying issues acting as risk factors. Birth control can mask underlying medical conditions that can contribute to menstrual irregularities. In some cases, losing your period after the pill may actually do you a favor. It can reveal an existing condition that wasn’t apparent before.

Studies show that nearly half of women experiencing amenorrhea following the pill had pre-existing menstrual irregularities before starting birth control.

Delayed puberty

Research has determined that losing your period after the pill is linked to delayed puberty or late-onset menarche (first period).

The shorter the amount of time between menarche and starting the pill, the longer it takes to menstruate post-pill.

Lifestyle factors

Certain lifestyle factors can also lead to menstrual irregularities and amenorrhea. These include:

  • Stress: Chronic stress can seriously impact hormone production.
  • Weight fluctuations: Significant body weight loss or gain can disrupt hormone balance.
  • Over-exercising: Too much exercise can interfere with ovulation.
  • Eating disorders: Conditions like anorexia nervosa or bulimia can negatively affect hormones.

Pregnancy

Remember: ovulation comes before menstruation. So, if you had unprotected sex and haven’t gotten your period, you may be pregnant.

Take a pregnancy test to confirm.

Know more: When to Take a Pregnancy Test After Implantation

Can birth control make you infertile?

No, birth control pills do not cause permanent infertility.

But, there may be a slight reduction in fertility for two to six months once you stop the pill. This is due to your hormones adjusting to production again. But once your hormones get back on track and you get your first period, your fertility should as well. )This is true as long as there are no underlying conditions or issues).

In fact, a meta-analysis found that 83% of women who stopped birth control got pregnant within one year.

Read more: How Soon After Stopping Birth Control Can You Get Pregnant?

Since it can take a while for your hormone changes to balance after the pill, it’s good to look for signs that you’re ovulating again. This will give you a better idea of when you’re most fertile.

What are the signs of ovulation after stopping birth control?

Knowing when you’re ovulating is key to getting pregnant. Here are some common signs:

Increased libido

A boost in your sex drive indicates that your estrogen levels are rising. This is the time to get sexually active if you’re trying to conceive.

Changes in cervical mucus

You may notice your cervical mucus becomes more clear and stretchy. It’s often called egg-white mucus.

Cervical changes

You may notice your cervix feels softer, higher, and more open. This means it’s ready to receive sperm to fertilize the egg.

Increased vaginal discharge

You may notice that your discharge is more than usual.

Ovulation pain

Many women experience mild cramping or pain on one side of the lower abdomen during ovulation. The side depends on which ovary is releasing an egg, and you may find the pain switches every cycle.

Basal body temperature (BBT) increase

Your BBT tends to increase by 0.5 to 1 degree Fahrenheit right after egg release due to an increase in progesterone.

Know more: Ovulation Symptoms: How Do You Really Know?

To confirm whether you’ve started ovulating again, use the Inito Fertility Monitor. Inito measures all four fertility hormones – LH, estrogen, PdG, and FSH on one single test strip. LH, estrogen, and FSH help track your fertile window, while PdG is the urine metabolite of progesterone and helps confirm ovulation.

When to see a doctor

If you haven’t gotten your period within half a year of stopping birth control pills (or three months if you’re trying for a pregnancy), consult with your healthcare provider.

Your doctor will carry out a physical exam and conduct blood tests to check your hormone levels including:

  • Follicle-stimulating hormone (FSH)
  • Prolactin
  • Estrogen

Once you stop birth control, depending on the underlying cause of your missing period, treatment may include:

  1. Addressing hormone imbalances: Medication may be prescribed to regulate hormone levels. This can include treatment for menopause, hyperprolactinemia, or low estrogen.
  2. Treating underlying conditions: Your doctor may determine there’s an underlying condition such as PCOS. In that case, he or she will recommend the appropriate treatment for the underlying condition first.

The bottom line

Postpill amenorrhea is common, and in most cases, it resolves on its own within a few months. However, it’s important to remember that postpill amenorrhea is a symptom, not a diagnosis of its own.

If you’re worried about not having a period after stopping birth control, talk with your doctor. They can help determine the underlying cause and find the right treatment options.

faq img

FAQs

For most people, your period will naturally return after stopping birth control. But, it can take up to half a year. Here are some things that can help support your body as it adjusts:

 

Reduce stress: Stress can negatively affect your hormones. Try relaxation techniques like yoga, deep breathing, meditation, and spending quality time in nature to reduce stress levels.

Maintain a healthy lifestyle: Focus on a diet that’s rich in whole foods like vegetables, lean protein, and whole grains. Also, aim for moderate and regular exercise most days of the week. And drink plenty of water throughout the day.

Track your cycle: Use the Inito Fertility Monitor to track and confirm ovulation.

If you haven’t gotten your period back after six months (or three months if you’re TTC), talk to your healthcare provider.

No. In most cases, this type of secondary amenorrhea is temporary while your hormones readjust. However, note that amenorrhea is not a diagnosis, and may actually be a sign of an underlying medical condition.

Not in the long-term, no. Studies show that you may be temporarily less fertile once you stop taking birth control pills. This is simply due to the time it takes for you to adjust to naturally producing hormones again.

But your fertility should return to normal within three months to half a year, unless there is an underlying condition.

There is no single right answer to how long to wait to try for a baby after stopping birth control. You can try right away, if you’d like! Just know that it may take a few months for your menstrual cycle to regulate. If you were taking Depo-Provera, it may take even longer.

The time it takes for you to get a positive pregnancy test post-pill depends on individual factors like:

  • Age
  • Overall health
  • Type of birth control you were using

There aren’t really any scientifically proven ways to induce your period. However, focusing on reducing stress and living a healthy lifestyle can help your hormones stay balanced.

If, after half a year, you’re still waiting for your first period after stopping birth control pills, talk to your doctor.

It can take a few cycles for your period to return to normal. So, if you haven’t gotten your period in three months but still have a negative pregnancy test, don’t worry. It’s likely taking your body some time to balance your hormones naturally.

But if you go more than half a year without a period post-pill, talk to a clinical practice professional.

There is no direct “yes” or “no” answer to this. Pregnancy may be possible if you haven’t had a period in half a year. But it depends on the reason for your lack of a period.

If it’s an underlying women’s health condition, you need to meet with a medical professional. They can aid with treatment. Remember, amenorrhea is a symptom, not a diagnosis.

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