Is it bad to be on birth control for a long time

Millions of women rely on hormonal birth control: to clear up acne, lessen cramps, and of course, provide peace of mind when it comes to preventing pregnancy.

But while you might be happily popping a pill, inserting a ring, or sporting the birth control implant right now to postpone being a mom, it's hard not to wonder what the hormones in these methods are doing to your fertility long-term. When you do want to have a baby and stop taking birth control, will you be able to?

The answer: Being on hormonal contraception has no long-term effect on female fertility. However, it might complicate conception for other reasons.

“With most birth control [methods], as soon as you stop them, you will probably resume ovulation immediately or within the few weeks,” says Nichole Mahnert, MD, ob-gyn and assistant professor of obstetrics and gynecology at the University of Arizona, Phoenix. “You almost immediately return back to your normal hormonal levels.”

What Dr. Mahnert says is backed up by science. A study published in Obstetrics & Gynecology found that previous use of birth control pills had no effect on conception rates, with 21% of the women studied becoming pregnant after one normal cycle and 79% getting pregnant within a year of going off the Pill.

Why will it take just a month off of hormonal contraception for some women to conceive, while for others it takes up to a year or longer?

One explanation has to do with the age at which you decide it's time to toss your pill pack. “The longer we take birth control and we delay childbearing, the older we get, and as a result of that, our eggs get older, and it can become more difficult to get pregnant,” Dr. Mahnert says.

Another potential complication concerns the endometrial lining. One of the benefits of birth control is having a lighter period, but a lesser flow means a thinner lining, says Debra Wickman, MD, ob-gyn and director of female sexual medicine, menopause, and vulvar health at Banner University Medical Center in Arizona. When you’re on the pill, the thin lining makes your uterus an unfavorable environment for an embryo. Go off contraception, however, and it might take some time for the lining to return to the thickness needed for an embryo to implant, she explains.

Still, keep in mind that every woman is different, and some might have an endometrial lining that returns to normal immediately or within a few months, notes Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine. But for others, it could take longer.

“Some people do get erratic cycling the first couple of cycles off the pill,” Dr. Minkin says, which is why she tells patients to wait two to three months before trying to get pregnant. By waiting, you’re giving your body time to readjust and start cycling regularly.

So is there a time limit for being on birth control, so you can avoid any possible pregnancy setbacks? No. “You can’t say there’s a set amount of months or years that’s too long, but women just need to be tapped into their own experience,” Dr. Wickman says, meaning that whether you're on the pill or not, you should always speak to your doctor if you notice any puzzling changes in your cycle.

Your fertility should return to normal once you ditch your contraception. If you're trying to get pregnant but it doesn't happen, don't panic. “You can have a post-pill disruption of your natural ovulatory cycle; that’s not uncommon. But for most women, that is going to reverse, and once you’re ovulating normally, the pill should have no long-term effect on fertility,” says Jennifer Wider, MD, women’s health specialist.

To coax your body into ovulating normally, Dr. Wider suggests avoiding stress. Worrying about not being able to conceive immediately after stopping the pill can lead to a vicious stress cycle, she explains. If all else seems normal, try to sit back and let your body do its job.

Birth control pills – also known as contraceptive pills – are taken by millions of women around the world. Taking “the pill” is one of the easiest ways to prevent an unwanted pregnancy, which is why it’s so popular.

Benefits of the pill include: 

• There are different types suited to different needs 
• It’s non-invasive and easy to take 
• It’s really effective when taken correctly  
• Serious side effects and risks are rare 

Despite this, lots of women are concerned about the long-term effects of taking contraceptive pills. If you’ve been taking the pill for a while, read on to find out about what side effects can be associated with this type of birth control.

What types of birth control pill are there?

The main types of birth control pill are: 

• Combined – contains artificial versions of oestrogen and progesterone 
• Low-dose – contains both hormones, but a lower dose of oestrogen than the combined pill 
• Progestogen-only or 'mini pill' – contains only artificial progesterone, and no oestrogen 
• Skin patch and vaginal ring – these aren’t pills, but they contain the same hormones as the combined pill, and affect the body in a similar way

The reason there are different types of pill is because some women can’t take oestrogen, or can only take a small amount. Women who can’t have the combined pill are usually able to take the progestogen-only pill.

Remember, if you’ve tried the pill and you didn’t like it, there are other types of contraception out there! Read this guide to your contraception options to find out more.

What risks and side effects are associated with birth control pills? 

Most of the time, people who talk about side effects from the pill are referring to the combined pill. This is the most common type of pill, and it’s also the type that causes the most side effects. 

The main risks associated with the combined pill are: 

• An increase in your blood pressure 
• An increase in your risk of blood clots  
• An increase in your risk of breast cancer and cervical cancer – it’s thought that 10 years after you stop the pill, your risk of these cancers will have returned to normal 

The good news is that these risks are very small for the vast majority of women. If your doctor doesn’t think you’re suitable to take the combined pill, because these risks may be higher for you, they won’t prescribe it.

The low-dose pill are also associated with some health risks, but again, the risk is very low. 

Looking for contraception?

Is it bad to be on birth control pills for a long time?

No. Birth control pills are designed to be taken for a long time. As long as you’ve had yours prescribed by a clinician, and they aren’t causing side effects, you should be safe to keep taking them. 

Just bear in mind that as you get older your body and lifestyle will change, which means your medical needs will probably change too. It’s worth noting that the combined pill, which contains oestrogen and progesterone, is not suitable for women who are: 

• 35 or older and smoke, or stopped smoking less than a year ago 
• Very overweight 
• Taking certain medicines

If your circumstances change, your doctor might prescribe a different type of pill or an alternative form of contraception. 

At what age should I stop taking birth control?

If you’re having sex that could put you at risk of an unwanted pregnancy and you’re of child-bearing age, you should be using birth control.

The pill is not going to be right for all women, but there are plenty of other options, including: 

• The copper coil (IUD) 
• The intrauterine system (IUS) 
• The implant
• The injection 
• Barrier contraception like condoms 

Can birth control weaken my immune system?

There’s no established evidence to suggest that the pill can weaken your immune system.

Will the pill affect my fertility?

There’s no established evidence to suggest that using contraception affects your fertility. The exception is sterilisation. 

However, your body may need some time to return to normal after you stop taking the pill. If you want to get pregnant, the NHS recommendation is that it may take three months for your periods go back to normal. 

Find out more by reading this article written by one of our doctors: Getting pregnant after taking the pill. 

What are the long-term side effects of emergency contraception?

Emergency contraceptive pills, or morning after pills are designed for one-off use in a situation where you haven’t used any other birth control. You can take the morning pill more than once in your menstrual cycle, but it’s a better idea to stay protected with long-term contraception like the combined pill or the IUD.

When used correctly, there are no serious risks associated with the emergency contraceptive pill. Some women find that it causes minor side effects like headaches, pain in the abdomen, and nausea or vomiting, but these are short-lived. You might also notice a difference to your next period, but after that you should be back to normal.

As a note, the NHS advises that you get medical attention if you're sick within two hours of taking Levonorgestrel or three hours of taking ellaOne.

If you need long-term birth control, consider getting the contraceptive coil (IUD) in an emergency situation. This can be left in and used as long-term birth control afterwards. It’s also the most effective form of emergency contraception. 

Is it okay to be on birth control for years?

How many years is too long on birth control?