Everything you need to know about coming off the pill to conceive

So, you’ve decided to grow your family…and not with a fur baby, but an actual baby. How exciting! 

Where to begin? One of the first steps is generally to stop using contraception – whether that’s the pill, an IUD or good old condoms. 

We sat down with Naturopath Jacintha Gunasekera to ask everything you need to know about coming off one of the most common forms of contraception – the pill. 

Who…should you chat to about coming off the pill?

Depending on your individual circumstances and any underlying health issues, you may want to speak to your GP, gynaecologist, naturopath or nutritionist about coming off the pill. Let them know you’re looking to conceive and work with them to tailor a plan. 

Jacintha explained, “Many women go on the pill for contraceptive purposes. But some women might also go on the pill to assist with managing polycystic ovarian syndrome (PCOS), irregular periods, heavy or unpredictable bleeding or spotting, hormonal migraines, period pain, endometriosis, acne or premenstrual syndrome (PMS).” 

If you are in the latter group, it’s important to make a plan to cope with any symptoms that may return (the things women have to deal with, honestly). Jacintha added, “Once you stop the pill those original underlying conditions or symptoms will likely rear up again. I commonly see women coming off the pill needing assistance to manage this.”

When…should you stop taking the pill when trying to conceive?

The short answer? At least three months. This is for a few reasons…

Firstly, Jacintha explained that while the hormones from the pill start to clear immediately, the pill creates deficiencies in nutrients like folate and zinc in our bodies, which play an important role in pregnancy. “Folate helps prevent neural tube defects, anaemia and miscarriage, and zinc assists with maintaining a regular ovulatory pattern, fertilisation, hormone production and balance and more. Their baseline levels return within three months of stopping the pill, so this should be considered the minimum time to give your body before conception,” she said. 

Secondly, it’s important your body re-establishes its menstrual cycle, not only so you can track and predict ovulation, but eventually a potential date of conception! The time it takes for your body to do this varies from woman to woman – some women will see their cycle return immediately, while others might be waiting for three months or more (thanks, mother nature…). If you haven’t had a period after three months of stopping the pill, Jacintha recommends seeing your GP.

Lastly, allowing time between coming off the pill and trying to conceive also gives you the chance to review your overall health. “Assessing things like your iron levels, any thyroid issues, weight concerns, previous hormonal imbalances, or what medications you’re taking will ultimately improve your fertility,” said Jacintha. 

What…symptoms might you experience when coming off the pill?

The mechanics work like this: when you stop taking the pill, you should first have a ‘withdrawal’ bleed, then you’ll be waiting for your natural menstrual cycle to re-establish itself.

At this point, Jacintha noted that you might experience more pronounced period and PMS symptoms than when you were on the pill. “Your period might be heavier and last longer. Changes to your cervical mucus throughout your cycle may be more evident. You might also see an increase in some PMS symptoms like breast tenderness, fluid retention, mood changes, and changes to appetite and food cravings.” Know that it’s ok, and that it’s normal for your body to take time to recalibrate after the pill.

How…do you help yourself to feel your best after coming off the pill?

Certain symptoms will require specific and tailored treatment, but in Jacintha’s books you can’t go wrong with nourishing your body and staying relaxed. “A balanced diet can help you feel good and energised, as well as help to balance your hormones and manage any PMS or PCOS symptoms you might experience during the transition of coming off the pill,” said Jacintha. She recommended loading your plate with protein, fibre, fatty acids, veggies, fruit and whole grains.

She added that regular exercise may help you maintain a healthy body weight, build bone density and reduce cardiovascular and diabetic risks…as well as give you a lovely hit of feel-good endorphins! “Plus, studies have shown regular exercise can help reduce the incidence of endometriosis and the severity of PMS,” she said.

Staying relaxed and stress-free can not only help you manage any symptoms but also give you a better chance of conception. “In addition to increased PMS symptoms and period pain, stress can contribute to irregular cycles and can in fact cause menstruation to cease,” said Jacintha. Hitting the gym or trying a home workout is a great way to keep your stress levels down. 

Jacintha does warn that too much exercise can sometimes cause more harm than good though, with overexercising potentially leading to added stress on the body and ultimately the loss of your period in some cases. You could also try strategies like meditation, yoga, colouring-in and journaling. Say it with us – ”ommmmm!” 

Where…do you go for help if things aren’t working?

While we come off the pill with the best intentions to conceive, sometimes things don’t happen as quickly as expected. Know you’re not alone, friend. “One in six couples have difficulties. This could be due to female factors, male factors, a combination of the two or simply – and frustratingly – unexplained infertility,” said Jacintha.

She pointed out that if intercourse is timed with ovulation, most women under 35 should conceive within 12 months; but to head to your GP if it’s taking longer. For women over 35, she recommended speaking to your GP if you haven’t conceived within six months. “Don’t panic if you aren’t conceiving as quickly as you’d expected. Getting help will ensure nothing is being missed. There are plenty of practitioners out there ready to be on your team. Look for someone with experience and, most importantly, who listens to you,” she concluded.

Read next: When to have sex to get pregnant

Expert contributor: Jacintha Gunasekera

Jacintha is a University qualified naturopath, with over 15 years experience, specialising in the full range of women’s reproductive wellness.

Combined Oral Contraceptives, 2016, RANZCOG

Nguyen, AT. 2016, Post-pill amenorrhoea, Pearls of exxcellence, SASGOG

Palmery, M, Saraceno, A, Vaiarelli, A, Carlomagno, G. 2013, Oral contraceptives and changes in nutritional requirements, Eur Rev Med Pharmacol Sci, 17(13) 1804-1813

Stewart, M & Black, K. 2015, Choosing a combined oral contraceptive pill, Australian Prescriber, DOI: 10.18773/austprescr.2015.002

Trickey, R. 2011, Women, hormones & the menstrual cycle, Trickey Enterprises

Make motherhood easier, with Mumli.

Discover, share, and save everything you need in one place.