Is It Harder For Women To Get Pregnant After Quitting Birth Control Than For Women Who Have Never Been On It?

To some, hearing the term “infertility” may conjure up feelings of despondency. The very notion of physically not being capable of conception – one of the most fundamental aspects of being a woman – could make you feel like your lineage will end with you. Fear of infertility is a very common reason for women to steer clear of hormonal birth control, but while there are many, many health problems associated with contraceptives, the general scientific consensus is that birth control doesn’t cause infertility.

Just because you’ve been taking the pill or perhaps using another option like the patch, implant, or an IUD, you’re statistically not at risk for chemical castration. However, you can’t take existing research for granted. Some women who have been on hormonal birth control do indeed have difficulty getting pregnant compared to those who haven’t been on it – here’s why.

Anovulation: Your Body on (Most) Hormonal Birth Control

Let’s take this step-by-step to fully understand why birth control causes temporary (but sometimes long-lasting) issues with regaining your fertility after quitting. The point of hormonal contraceptives is to prevent pregnancy. They do this by preventing your ovaries from releasing a monthly egg, thinning your uterine lining, or by thickening your cervical mucus to prevent sperm from ever reaching an egg. In other words, hormonal contraceptives place a hard stop on your body’s natural ovulatory cycles, unless you’re using progestin-only methods. When you’re ovulating, you’re most likely fertile. When you’re not ovulating, you’re physically incapable of conceiving a child.

But, when you’re not on hormonal contraceptives, you’re not voluntarily preventing ovulation. If you’re experiencing ovulatory disruptions despite never having been on birth control, there could be other underlying issues, but at the very least, you know you’re not doing it to yourself. You can see how, by virtue of never having introduced your body to contraceptives, logic follows that pregnancy should come a lot easier.

Our bodies are a bit too complicated for black-and-white thinking, however. Imagine this: You’ve been wishing for a positive pregnancy test after getting off the pill and yet you just keep getting negatives. At the same time, your best friend stops taking the pill, and within weeks she’s overjoyed to announce that she’s expecting. You’re not defective – your body is probably just taking longer to recover after you’ve suppressed ovulation for just a couple years, five years, 10 years, or however long you’ve been taking birth control. 

To put your mind at ease, one systematic review of scientific literature found that within one year of discontinuing contraceptives, around 83% of women were able to get pregnant. Furthermore, a return to normal fertility varies based on the type of contraceptive you were on: two menstrual cycles for women using IUDs and implants, three cycles for women taking the pill or using the ring, four cycles for women who had the patch, and up to eight cycles for women using injectable contraceptives.

All this time, you haven’t been ovulating. Instead, you’ve been experiencing anovulation (a.k.a. anything that interrupts your normal ovulation process), which is responsible for 30% of women’s fertility problems. Furthermore, chronic anovulation can increase your risk for low bone density and certain uterine, cervical, and breast cancers. During all of that time suppressing ovulation, your body could have undergone quite a few internal changes.

Researchers found a correlation between being on birth control for over five years and having a thin uterine lining.

First off, your uterine lining – thinned “temporarily” while on birth control to prevent implantation – may take a long time to return to a healthy thickness. When analyzing if long-term oral contraceptives had an effect on endometrial thickness (uterine lining), researchers found that there was in fact a correlation between being on birth control for over five years and having a thin lining. It should be noted that this study was conducted using patients undergoing fertility treatments rather than just women going off birth control in general, but the findings are valuable nevertheless.

Next, consider the fact that your birth control method has probably been serving you up a high dose of artificial estrogen. Many women who have taken oral contraceptives end up with estrogen dominance, which can – among its slew of symptoms – negatively impact your thyroid health. This happens because estrogen dominance elevates your thyroxine-binding globulin (TBG), which binds thyroid hormone. Studies show that long-term usage of hormonal contraceptives can lead you to experience hypothyroidism, or very low thyroid levels.

Is it any wonder why many women trying to detox their bodies after birth control just can’t seem to get pregnant when their uterine lining and thyroid levels have been functionally depleted? Along with those two issues, hormonal contraceptives can also deplete your body’s levels of nutrients essential for maintaining fertility, such as folate, B12, B6, zinc, magnesium, and CoQ10.

Let’s also not forget the fact that hormonal contraceptives effectively mask the symptoms of many feminine health conditions, such as PCOS, endometriosis, or other menstrual cycle irregularities. If a girl goes on birth control early on in her years of menstruating, stays on it for many years to follow, and then gets herself off it when she’s ready to have her first child, she may not even know if she has had menstrual issues all along. That whole time, hormonal birth control was a metaphorical band-aid covering up a gaping wound.

Certain Bodily Fluids Could Increase Your Chances of Getting Pregnant

One fascinating theory to explain why some women experience longer fertility delays after getting off the pill is how hormonal contraceptives impact a woman’s cervical mucus. One Swedish researcher and professor, Dr. Erik Odeblad, spent much of his career studying cervical mucus. Dr. Odelblad observed that cervical mucus changes in predictable patterns when a woman is naturally cycling. Cervical mucus is a necessary element for natural fertility, as it enables healthy sperm to navigate through the cervix and into the uterus. He categorized cervical mucus into three different types (G, L, and S) and asserted that each played a different role in a woman’s body.

Dr. Odeblad said that of the types, S is considered to be sperm-conducting, or increases the chances of sperm fertilizing an egg. However, he said that women using hormonal birth control were at risk of diminishing how much S-type cervical mucus they had.

For each year the pill is taken, the cervix ages by an extra year.

“For each year the pill is taken, the cervix ages by an extra year,” he concluded. These findings were later expanded upon in what’s now commonly known as the fertility awareness method, a birth control-free approach to preventing or promoting pregnancy. The bottom line is that if you’re not naturally cycling and instead have disrupted your natural flow of estrogen and progesterone with artificial hormones, you may not have the most fertile cervical mucus to work with. Though cervical atrophy from hormonal birth control is more speculation and a logical extrapolation by doctors like Odelblad, it would appear that messing with Mother Nature’s design can at minimum delay conception.

Could Hormonal Birth Control Be Self-Inflicted Chemical Castration?

No, your Ob-Gyn signing off on your prescription for birth control pills doesn’t equate to him or her signing away your fertility for good, but it could significantly impact the time it will take for you to return to the right hormone levels to allow for, and sustain, a healthy pregnancy.

Women who have never been on hormonal birth control definitely aren’t exempt from an infertility diagnosis. Infertility can be caused by issues unrelated to birth control, like thyroid disease, PCOS, endometriosis, prolactinoma tumors, birth defects, diabetes, certain cancers, sexually-transmitted infections or diseases, age, alcoholism, excessive tobacco use, being underweight, being overweight, chronic overexercise, and more.

Get introspective and really ask yourself: Is it actually worth subjecting yourself to yet another reason why you may struggle to conceive when there are totally natural ways to prevent pregnancy that don’t disrupt your body’s natural processes? I’m not a doctor and can’t provide any firm medical advice, so I’ll leave that one up to you and your trusted healthcare providers to decide.

You can’t predict which side effects of birth control you’ll be affected by.

But speaking from personal experience (which I have detailed in quite a few other articles related to the risks of hormonal birth control), you truly don’t know how your body will react to certain medications, including birth control. Even if you’ve seen that infamously long list of side effects that come packaged with hormonal contraceptives, you can’t predict which ones you’ll be affected by.

The hormonal birth control I was on was the implant Nexplanon. When you poke around on the U.S. Food and Drug Administration’s Adverse Events Reporting System (FAERS) public dashboard, you can search for any drug to see how real-life people have been affected. Sure, not all cases are documented, but it’s still valuable information to have at your fingertips. Nexplanon has 40,449 reported cases of amenorrhoea (the term used when a woman doesn’t have a period), and among those cases, there are roughly 50 women documented as experiencing female infertility or general infertility.

We can’t know if those women are permanently sterile, and the percentage of women experiencing any amount of infertility from Nexplanon compared to the many who had no issue at all is statistically negligible. In any case, it’s quite saddening to reflect on how I went on birth control in 2017, how it only promised three years' worth of contraception, how I got it removed in 2021 (the removal was delayed due to Covid lockdowns), and how in 2023, I still don’t have regular cycles.

I’m the exception to the “rule,” as I have personally known many women who spent years on birth control and could get pregnant right away, but I know there are more women out there like me who just haven’t spoken up. Though there’s hope for me still, I may not have had this very long fertility struggle had I not gone on birth control in the first place.

Closing Thoughts

Most scientific literature out there asserts that hormonal contraception doesn’t have a negative effect on a woman’s ability to conceive. But, as is the case with any medication, you should be cautious about being overly trusting of its promises. Now that more women are opting to start a family later in life when they are past their most fertile years, we should all question whether it’s worth risking an unforseeable delay in functional fertility just for the convenience that hormonal birth control offers. 

Pregnancy is indeed on the table for most women who have been on hormonal birth control, but there will inevitably be some who suffer from longstanding side effects such as hormonal imbalances or thyroid complications. The easiest way to avoid complicated side effects and emotional distress related to fertility is to not intentionally disrupt it in the first place.

Support our cause and help women reclaim their femininity by subscribing today.