What causes late periods after stopping birth control?

How does birth control affect your menstrual cycle? 

Most forms of hormonal birth control prevent pregnancy by stopping the process of ovulation, which is when the ovary releases a mature egg cell. If an egg is not present in the fallopian tube, there is nothing for sperm to fertilize. This means that pregnancy is highly unlikely. Some forms of hormonal birth control also thicken cervical mucus, making it even harder for sperm to penetrate and fertilize an egg.

If you’re on the birth control pill, the bleeding you may experience on placebo weeks is called a withdrawal bleed and not an actual period. After stopping birth control, your period would typically come about two weeks after ovulation, shedding the uterine lining and unfertilized egg out of your body and preparing for a new cycle.

Learn more about each phase of your menstrual cycle and remember that everyone’s bodies and cycles are unique (the typical two-week period might be closer to 12 days for you, for example).

What causes irregular periods after stopping birth control?

With those cycle facts in mind, let’s go through a few of the most common causes of irregular, late, or altogether missed periods after stopping birth control:

1. Delayed return to ovulation

Since the body doesn’t ovulate while on most forms of hormonal birth control, it may take a few months for your body to return back to its normal ovulation cycle and for you to get your period back. How long it takes for things to return to normal will depend on the individual. Some people may be able to get pregnant straight away, so it’s important to use a backup form of birth control if you want to.

Remember that whatever was considered normal for you before you began birth control, including factors like cycle length, amount of blood, and any premenstrual syndrome (PMS) symptoms, are likely to return after stopping birth control. [1]

2. Lack of hormones

On that note, your body also needs time to withdraw from the synthetic hormones in the birth control and restabilize your natural hormone levels. Hormones take time to produce and circulate, so this transition can take up to three cycles. As these hormone levels fluctuate during that time, the fluctuations may cause a late or missed period. [1]

3. Stress factors

Stress is a normal (albeit unfortunate) part of life, and small amounts of everyday stress are not likely to affect the menstrual cycle. However, abnormally large amounts of stress in a short time frame, or long-term ongoing stress, can impact your menstrual cycle and cause either irregular periods or missed periods. 

This is because our hormonal systems and pathways are all interconnected, and when stress hormones rise to abnormal levels, it can affect our natural sex hormone levels as well, including those responsible for regulating menstruation. [2]

If you’re experiencing a highly stressful time in your life right now that may be causing a late period, we’re sorry to hear this. The added stress of an irregular menstrual cycle is the last thing you need. 

Here are some suggestions for managing these feelings and controlling what you can:

• Carve out time to explore and relax in nature
• Spend time with loved ones
• Try mindfulness meditation and breathing practices
• Listen to your favorite music
• Explore hobbies that bring you joy
• Elevate your mood with regular, light exercise like yoga, jogging, and dance
• Stick to a daily healthy morning and night routine with minimal exposure to screens [3]

Check out our article about stress and the menstrual cycle for more information.

4. Changes in weight

Extreme and/or sudden weight loss or weight gain can also affect your menstrual cycle. This is because your overall hormone levels are affected by your weight and the amount of fat in your body.

We know that there are endless discussions online about women’s weight and how they should look. Our intention here is to advise on the medical implications of extreme weight fluctuations and offer solutions, not to judge or reprimand women for their choices.

Women typically need to have at least 22% of body fat in order to menstruate regularly, and having less than this can create irregularity in the menstrual cycle. Fast weight loss due to undereating or overexercising can also cause a stress response in the body which can alter all hormone levels in the body and affect normal bodily functions.

Obesity can also affect your menstrual cycle in a slightly different way. Increasing fat tissue in the body can cause the body to produce excess estrogen, which can prevent ovulation and thus lead to missed periods. The systemic inflammation associated with obesity can also cause irregular uterine bleeding and heavy periods, which can lead to anemia. 

Talk to your healthcare professional about a healthy weight range for your age and height, and make sure to reach out any time you notice extreme, unexplained fluctuations in weight. They can test for any underlying conditions that may be causing the changes and advise on the next steps for treatment to get your body back into balance. [4]

5. Thyroid imbalances

Sometimes hormonal birth control treats existing underlying health conditions, like thyroid imbalances, that may not have been previously diagnosed. Coming off of birth control can unmask these conditions and their symptoms. The thyroid is an essential part of your endocrine system (the part of our body that is responsible for hormone production), so an imbalance in this organ can create a hormonal imbalance that affects the length and intensity of your periods. 

Your doctor can test for thyroid syndromes and prescribe medications other than birth control to treat them if needed. [5]

6. Polycystic ovary syndrome (PCOS)

PCOS is thought to be a fairly common condition—about one in five women will experience it during their reproductive years as the data currently stands. One of the most common symptoms of PCOS is irregular periods, or no periods at all. This is because PCOS has been linked to abnormally high levels of the hormones insulin and testosterone, and high testosterone can prevent ovulation. As we know, when ovulation doesn’t occur, this leads to irregular or missed periods.

If you have other symptoms of PCOS including excessive hair growth, weight gain, and oily skin or acne, reach out to your healthcare provider for further testing, diagnosis, and treatment.

7. Pregnancy

If you are sexually active, a missed period can also be a sign of pregnancy. Other early signs of pregnancy include swollen or tender breasts, nausea, frequent urination, cravings, and fatigue. You may even have bleeding during early pregnancy, which can be easily mistaken for a resumed period. 

If you’re experiencing any of these symptoms and your period has not resumed within four weeks after stopping your hormonal birth control method, it’s best to take a pregnancy test. [5]

8. Breastfeeding

It’s common to experience a missed or irregular period while breastfeeding, although this is unlikely to be caused by coming off of birth control. Breastfeeding releases the hormone prolactin into your system, which assists with the breastfeeding process but may also prevent menstruation. Some women’s periods do not resume until they wean their baby, which may take months or years. They may still be irregular for a few cycles after weaning while the prolactin levels stabilize. [6]

Did you know that breastfeeding can actually be used as a form of birth control for up to six months when done exclusively? That means no formula feeding or pumping. Learn more about preventing pregnancy while breastfeeding.

What else can you expect when discontinuing birth control?

Aside from missing or late periods after stopping birth control, there are a few more common side effects you may experience that can be a difficult part of this transition. The good news is that these aren’t likely to last, and should stabilize once your hormones return to normal levels. They include:

• Headaches
• Breast tenderness
• Changes to the texture of skin and hair (more dry or more oily)
• Increased acne

On the flip side, there are plenty of benefits to coming off of hormonal birth control that many people experience as well, including:

• Increased libido
• Improved mood
• Less nausea [5]

Like many things in life, there are tradeoffs either way. In the process of stopping birth control, your hormonal system is undergoing a huge transition. Try to be patient as your body works to support you and transition back to your natural cycle. Learn more about what to expect when stopping birth control.

When will your regular periods start again? 

While there is no one-size-fits-all answer to this question (your hormone levels depend on your unique health, stress, and other environmental factors) most people have seen regular ovulation and periods resume within three months after stopping their hormonal birth control. Remember that your cycle may still be irregular for a time, even if it has resumed.

What can you do to prevent pregnancy after stopping the pill?

If you’ve stopped using the pill or another form of hormonal birth control and you’d still like to prevent pregnancy while sexually active, there are plenty of non-hormonal birth control options available to you. Using male condoms is one of the most common methods. It’s important to note that no birth control is 100% effective, and condoms have a typical use effectiveness of 87%. This means over the course of one year of use, on average 13 out of 100 women will get pregnant.

Another non-hormonal option is Natural Cycles. This temperature-based birth control method learns the pattern of your cycle so you know when you’re fertile, and when you don’t need to use protection. Natural Cycles has a typical use effectiveness of 93% at preventing pregnancy without any hormonal side effects.

When should you see a doctor?

As we mention throughout this article, if you are experiencing sudden overall health changes that may be affecting your menstrual cycle (i.e. high stress, sudden weight gain or loss, anxiety, thyroid imbalance symptoms, etc.), talk to your doctor about testing and methods of treatment for these conditions. Hopefully, addressing these concerns can also bring your menstrual cycle back to normal.

If you don’t seem to have these extreme symptoms but you’re still late or missing your periods after stopping birth control, it’s likely that your body is taking time to restabilize your natural hormone levels. Give it about 3 months to see if your normal cycle comes back, and if not, talk to your doctor to discuss any potential underlying causes and get advicee on next steps.

We always recommend speaking to your healthcare professional before making any big medical decisions, including coming off of birth control. They can help prepare you for what to expect when coming off of the contraception based on your unique medical history.

Take control of your health journey with Natural Cycles

Natural Cycles can assist you in preventing pregnancy by helping you take control of your fertility. We’re here to support your health by providing technology-based tools and educational resources like this to help you get a full understanding of your journey. If you haven’t already, check out Natural Cycles today.