How Long Should You Be Off Birth Control Before Trying for a Baby?
So you’re ready to come off birth control and you’re wondering how long to wait before you start trying to conceive. I’ve got you, girly.
Pretend we’re sitting in our favorite local coffee shop. I’m sipping on an iced oat milk latte and you’ve got your drink of choice. I’m going to walk you through everything you need to know about how long you should be off birth control before trying for a baby.
If you’re new here, hi. My name is Dr. Haley Jackson. I’m a pelvic floor physical therapist and the owner of an in person brick and mortar practice in Texas. My husband is a pharmacist, and together we help women with reproductive issues optimize their fertility with the goal of decreasing time to conception. This is a joint article between the two of us on birth control, what to expect when coming off of it, and things you can do to support your trying to conceive journey.
This is such a common question. A lot of women are placed on birth control and then simply told to stop taking it when they’re ready or have their IUD removed when they’re ready. There’s often very little guidance on whether there should be a gap, how long to wait, or what to expect once you come off.
Being “ready to start trying” looks different for everyone. Some people come off birth control wanting to be pregnant immediately. Others want to stop preventing but aren’t trying super intentionally and just want to see what happens. Take what you want from this article and leave the rest.
Trying to conceive is both an art and a science, and today I’m going to share more of the science with you.
How Long to Be Off Birth Control Before Trying
The first question I want you to ask yourself is why you were put on birth control in the first place.
Was it to regulate your period
Was it to treat acne
Was it purely for contraception
Was it for a gynecologic issue like PCOS, endometriosis, or irregular cycles
That answer matters.
In general, I recommend being off birth control for three to six months before trying to conceive, depending on that reason.
If you were placed on birth control for a gynecologic issue like PCOS, endometriosis, or menstrual cycle irregularities, I usually recommend closer to six months, if not longer. Your body is going to need time to regulate your cycle again.
If you were on birth control for purely contraceptive reasons, I typically recommend closer to the three month mark. Even then, I still believe you need time to regulate your cycles and restore ovulation.
And to be very clear, this is not about the calendar. This is about ovulation.
Your brain has to relearn how to communicate with your ovaries so that optimal ovulation can occur. That signaling takes time.
Another important piece here is education. Most women were never really taught how to understand their bodies or interpret their cycles. This window off birth control is the perfect time to learn how to read your body through cycle tracking and actually understand what it’s telling you.
There’s also the egg quality component. It takes about 100 days for your body to produce the follicle that will eventually become the egg you ovulate. That means the three months prior to conception matter.
I truly believe that, if possible, those 100 days before conception should be spent optimizing egg quality. That includes things like decreasing inflammation, sleeping better, optimizing nutrition, and exercising appropriately.
Using this time to learn your cycle and support egg quality is incredibly valuable.
What to Expect After Stopping Different Types of Birth Control
There are a lot of different types of birth control. This includes IUDs, both copper and progesterone, oral birth control, the NuvaRing, Depo Provera, and more. For this article, I’m focusing primarily on coming off oral birth control.
Some of the most common symptoms women experience after stopping oral birth control include:
Hair loss
Acne
Menstrual cycle changes
More intense cramping
Irregular cycles, especially if this was an issue before starting birth control
Mood swings
Headaches or migraines
Weight changes
Bloating
Fatigue
Many of these symptoms are temporary, but they are still important to pay attention to.
One very important note. If you do not have a period within three months of stopping birth control, you need an evaluation from your medical provider. This is not something that just needs more time.
There are also things you can do during this transition to support your body and restore your cycle.
That includes decreasing inflammation through dietary changes and optimizing blood sugar regularity. Movement matters too, but it should feel good. Choose movement you enjoy and that does not feel punishing. This might look like strength training, walking, Pilates, yoga, or running if that is something you enjoy.
Supplement support can also be helpful. Common supplements used during this phase include zinc, magnesium, and B vitamins. Vitamin C can also be helpful for naturally supporting progesterone levels, which plays a role in ovulation.
Special Considerations for PCOS and Endometriosis
Here’s the deal. Oral birth control or any form of birth control does not treat endometriosis or PCOS. It masks symptoms, but it does not address the root issue.
For endometriosis, treatment is surgical excision of the endometrial like tissue growing outside of the uterus. That surgery needs to be performed by an endometriosis excision specialist. It is not ablation, and it is not oral birth control. That is the treatment.
If that treatment has not been done, coming off birth control can unmask symptoms. Endometriosis symptoms are typically excruciatingly painful periods that disrupt work, school, and daily activities. One of the biggest differentiating factors between painful periods and endometriosis is pain with bowel movements, which is one of the strongest predictors of endometriosis.
If you are on oral birth control for endometriosis and want children in the future, I strongly suggest having an appointment with an endometriosis excision specialist.
Now let’s talk about PCOS.
PCOS stands for polycystic ovarian syndrome. Because it is a syndrome, clinical presentation looks different for everyone. Patients with PCOS typically have difficulty with ovulation. They often experience irregular periods, difficulty losing weight, insulin resistance, and inflammation.
Oral birth control disrupts the communication between the brain and the ovaries. That brain to ovary connection is required for ovulation. When someone is on oral birth control, that communication is shut off. When you come off birth control, your body has to relearn how to communicate again.
If ovulation was already an issue or if birth control was masking symptoms, those same issues are likely to be present once you stop taking it. Similar to endometriosis, oral birth control does not treat PCOS.
Treatment for PCOS focuses on managing insulin resistance, inflammation, and is largely lifestyle based.
If you know you have PCOS, endometriosis, or suspect either one, I recommend working with a provider to create a game plan before stopping birth control.
What’s Next??
Please understand that these recommendations are purely clinical. They represent the science portion of the *art and science* of trying to conceive. They do not account for other life factors like your age, your personal timeline, how many children you want, etc. That part of the equation matters just as much.
The art of trying to conceive is your life. The science is what I’ve shared here. Both are important.
One thing I do want you to know is that egg quality can change within 100 days. Even if you are still on birth control, you can begin optimizing that now through nutrition, exercise, inflammation management, and blood sugar regulation.
I also strongly encourage you to learn how to track your cycle and know whether or not you are ovulating. This information is not only important for trying to conceive, but for your overall health.
Ready to stop guessing and start understanding your cycle?
If this post resonated, you do not have to figure the next steps out on your own. We want to help you! Here are your next steps:
Drop your info below to sign up for The Cycle. When you do, you will be added to our Monday newsletter where we share cycle education, support, and guidance to help you better understand your body.
If you want to work with us, here is how our process works:
Sign up anytime
Complete your intake form by the following Monday
By Thursday of the same week: We review your information and send back a personalized response with insight and next steps
Starting Thursday: You get two full weeks of direct communication with us via Slack for questions, clarity, and support
Check out this page for more information on how to sign up to work with us.
Our mission is simple:
To help women feel supported, validated, hopeful, and empowered by understanding their menstrual cycle and learning how to work with their body instead of against it.
👉 Join the newsletter here
