Coming off the pill: what to expect, week by week
When you stop the pill, you'll usually have a withdrawal bleed within a few days, then your first natural period about 4 to 6 weeks later. Your cycle may be irregular for a few months. Fertility returns quickly, so use other contraception straight away if you don't want to get pregnant. Acne, heavy or painful periods and PMS the pill was masking can return.
Before you stop
You can stop the pill at any time; you don't have to finish the pack. But it's worth a quick plan first, ideally with your doctor, nurse or pharmacist:
- Contraception: if you don't want to get pregnant, start another method the day you stop. Protection from the pill ends quickly.
- Why you take it: if the pill was treating heavy or painful periods, acne, PCOS or endometriosis symptoms, ask what to expect and what you'll use instead.
- Trying to conceive? Start folic acid (400 micrograms a day is the usual advice) ideally before you stop.
- Timing: stopping at the end of a pack makes your first bleed easier to recognize.
What happens, week by week
| When | What usually happens |
|---|---|
| Days 2 to 7 | A withdrawal bleed as the pill's hormones leave your body. This isn't a true period. |
| Weeks 1 to 4 | Your ovaries start their own cycle again. Some people ovulate within a couple of weeks. |
| Weeks 4 to 6 | Your first natural period, about two weeks after your first ovulation. |
| Months 1 to 3 | Cycles may be irregular, longer or shorter, while your rhythm settles. |
| After 3 months | Most cycles have found their pattern. If you've had no period at all, see a doctor. |
Count your first natural period as day 1 of your first real cycle. The withdrawal bleed doesn't count. See period after stopping the pill and what is a withdrawal bleed.
How fast fertility returns
The pill doesn't damage fertility, and it returns quickly. A 2018 systematic review of 22 studies and nearly 15,000 people found that 83% got pregnant within 12 months of stopping contraception, and the rate wasn't significantly different between hormonal methods and IUDs, or by how long the pill had been used. That's close to the usual rate for people who never used contraception. The contraceptive injection is the exception: fertility can take up to a year to return after it.
Things that might come back
The pill smooths out your natural hormone rhythm. When you stop, your own cycle returns, and with it whatever came with that cycle before. People commonly notice:
- Your natural period: possibly heavier, longer or more painful than pill bleeds.
- Acne and oily skin: often flares for a few months, especially along the jaw.
- Mid-cycle signs: stretchy discharge, ovulation twinges, a rise in sex drive around ovulation.
- PMS: breast tenderness, bloating and premenstrual mood changes, which some people haven't felt in years.
- Headaches: some people get fewer; some notice period-related ones return.
Coming off the pill and your mood
Mood after stopping the pill goes both ways. Some people feel brighter and more like themselves, especially if the pill had flattened their mood or libido. Others find premenstrual mood changes return and catch them off guard, because for years their hormones were steady. If you had strong PMS before starting the pill, or the pill was prescribed partly for mood, it's worth watching closely.
A daily mood note for two or three cycles shows quickly whether harder days now cluster before your period. If they're severe, try the PMS self-check and talk to a doctor. More on birth control and mood.
Coming off the pill is a good moment to start tracking. Log your first natural period in Lulu, and it learns your real cycle length and how you usually feel in each phase, which you probably haven't seen in years.
When to see a doctor
See a doctor if you have no period 3 months after stopping (and you're not pregnant), if periods are very heavy or painful, if you bleed between periods or after sex, if acne or hair growth becomes distressing, or if your mood drops in a way that affects your life. If you ever feel unsafe, call your local emergency number, or 988 in the US.
Frequently asked questions
How long after stopping the pill will I get my period?
A withdrawal bleed usually comes within a few days, and your first natural period about 4 to 6 weeks later.
Can I get pregnant right after stopping the pill?
Yes. Ovulation can return within weeks, so use another method straight away if you don't want to conceive.
Will I gain or lose weight after stopping the pill?
Research hasn't shown the pill causes lasting weight change for most people. Some notice small shifts from fluid or appetite as their cycle returns.
Is it normal for my cycle to be irregular after the pill?
Yes, for the first few months. If you have no period at all after 3 months, see a doctor.
Does acne come back after stopping the pill?
It often flares for a few months, especially if the pill was helping it. A doctor can suggest other treatments.
Sources
- Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med (2018)
- ACOG: Combined Hormonal Birth Control: Pill, Patch, and Ring
- NHS: Stopped or missed periods
- NHS: Combined pill
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
Keep reading
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What is a withdrawal bleed?A withdrawal bleed is the bleed you get on the pill break. How it differs from a real period, why it's lighter, why it might not come, and when to test.