Transitioning off hormonal birth control: What to expect, how to prepare, and fertility FAQs

As a Functional Diagnostic Nutrition Practitioner, I’m constantly asked questions like: Can I get pregnant after being on birth control for decades? Is it hard to get pregnant after stopping birth control? What are healthier alternatives to hormonal birth control? And can I just stop taking birth control cold turkey?

Whether you're thinking about transitioning off birth control due to health concerns, fertility goals, or curiosity about your natural cycle, you're not alone. While every woman’s experience is different, practitioners frequently note that it’s common for menstrual cycles to resume within 1 to 3 months of going off birth control. However, a small cohort study indicates that it can be 9 months or more before cycles are regulated. If you were using hormonal birth control to regulate your cycle, this could indicate it may take longer for your cycle to regulate.

Leaving behind the pill or any form of hormonal contraception can feel daunting. This blog will guide you through the process of stopping hormonal birth control with empathy, science-backed advice, and a whole lot of support.

First up: What does hormonal birth control do?

Hormonal birth control prevents ovulation and pregnancy. It contains synthetic versions of the hormones estrogen and progesterone, which override your natural hormonal rhythms and suppress your body’s own production of estrogen, progesterone, FSH, and LH—the key players in your menstrual cycle, altering the ovulation process to prevent pregnancy. 

When taken as directed for pregnancy prevention, hormonal birth control such as the pill or a hormone-based IUD can be very effective. But birth control is also sometimes used to correct period issues: Many women are told going on birth control helps "balance hormones," but in reality, hormonal birth control turns off your natural hormone production. Think of it like a Band-aid—it may mask symptoms like acne or irregular cycles, but doesn’t address the root cause. When you stop taking it, symptoms often return.

Risks of long-term hormonal birth control use

Like any medication, especially one used for a long period of time, there can be side effects. Here's what you might see after long-term use of HBC: 

• Nutrient depletion (especially B vitamins, magnesium, vitamin D)

• Increased risk of stroke and blood clots

• Mood changes, including anxiety and depression

• Potentially increased risk of certain cancers (especially breast and cervical)

What to expect when stopping birth control

When stopping hormonal birth control, your body essentially has to "reboot" its hormonal system—and this transition is what can lead to withdrawal symptoms.

Every woman’s experience is different, but most people will resume their cycle within 1–3 months after stopping hormonal birth control. If the pill was prescribed to “regulate” your cycle, it might take longer to see your natural rhythm return.

Common post-birth control symptoms include:

• Acne or skin flare-ups

• Heavier periods or intense cramping

• PMS, mood swings, anxiety or depression

• Hair growth in new places (like the chin or jawline)

• Irregular or missing periods
  
  

This “post-birth control syndrome” isn’t your body failing—it’s a temporary adjustment as your natural hormones recalibrate.

Related: Could nutrient deficiencies be impacting your fertility?

How to prepare for stopping hormonal birth control

Many ask, “Can I just stop taking the pill cold turkey?” Technically, yes. But I strongly recommend preparing your body for at least 3 months before stopping hormonal birth control. Think of it like training for a marathon—you want your body in top shape before making the shift.

Here are my top tips:

Talk to a supportive doctor

Talk to your doctor before stopping hormonal birth control. Make sure it’s the right step for your body and health history. A supportive provider will help guide you when starting fertility conversations or if looking to explore hormone-free alternatives.

Find a provider who respects your decision to transition off hormonal birth control and can walk you through alternative options. If your doctor isn’t supportive, it’s time to find one who is.

Balance blood sugar through diet

Prioritize healthy eating by consuming a colorful, nutrient-rich diet that’s high in protein, which can help prevent big blood sugar swings. Blood sugar regulation is so important to help your body recover from the pill because of how HBC affects your hormones. 

Frequent blood sugar fluctuations increase insulin levels, which can lead to insulin resistance, chronic inflammation, weight changes, period problems, and more. When you have a lot of blood sugar spikes during the day from food, insulin will rise, telling your ovaries to make more testosterone, which can lead to hormonal acne or things like hirsutism (male pattern hair growth in women). 

Blood sugar swings also affect our cortisol levels (and cortisol levels affect blood sugar, a vicious cycle) which will contribute to more stress in/on the body, which will only make symptoms worse. 

Blood sugar swings impact cortisol, insulin, and even ovulation. Focus on:

• Whole foods with plenty of fiber

• High-quality protein at every meal

• Healthy fats like avocado, olive oil, nuts, and seeds

• Low sugar, low refined-carb intake

This combo supports balanced hormones and reduces common post-pill symptoms.

Replenish nutrient deficiencies

Long-term use of hormonal birth control also may deplete your body of key nutrients. A high-quality prenatal is one of the best tools in your toolbox. As a practitioner, I recommend WeNatal for Her, Egg Quality+ and Omega DHA+ with bioavailable nutrients that support hormone health, egg quality, and your body’s return to balance. WeNatal contains optimal forms of the following nutrients that can be helpful in your transition: 

• B vitamins (especially B6, B12, folate)

• Magnesium

• Vitamin C and D

• Zinc, selenium, and CoQ10

Support your liver

Your liver is responsible for running your body's detoxification process, and  supporting your liver function can help your body clear out the last of the synthetic hormones and encourage a smooth transition back to baseline. Help it do its job by:

• Drinking lots of water

• Eating fiber-rich foods,  leafy greens, and cruciferous veggies

• Reducing alcohol and processed foods

• Considering liver-supportive herbs like milk thistle, dandelion root, N-acetyl cysteine (NAC) and Alpha-lipoic acid (ALA)

I highly recommend speaking with a Functional Medicine Practitioner to help with an individualized protocol before taking any new supplements or herbs.

Heal your gut

Hormonal birth control can negatively impact gut flora and increase intestinal permeability (leaky gut), which can affect immunity, mood, and hormones. Observational studies have suggested a link between hormonal contraceptives and inflammatory bowel disease (IBD). Oral estrogen has been shown to promote intestinal permeability (aka: leaky gut) and can also contribute to the development of inflammatory diseases (like Crohn’s disease).

Support your gut lining and microbiome with:

• A daily probiotic that contains Bifidobacterium infantis

• Bone broth and collagen

• Fiber-rich fruits and vegetables

• Fermented foods like sauerkraut or kimchi

• Avoiding processed foods, sugar, and excess alcohol
  
  

Follow the DRESS protocol

DRESS = Diet, Rest, Exercise, Stress, Supplements.

The DRESS Protocol is a foundational lifestyle approach developed by Functional Diagnostic Nutrition® (FDN) to support healing and restore optimal health. This holistic framework recognizes that symptoms often arise from underlying dysfunction in the body's core systems, and that true healing requires a multi-faceted approach rather than a quick fix.

• Diet: Colorful, whole foods, protein-rich meals

• Rest: Aim for 7–9 hours of quality sleep

• Exercise: Move your body, but avoid overtraining, which can increase cortisol and lead to further hormonal imbalance

• Stress: Reduce stress through breathwork, walking, journaling, or therapy

• Supplements: Vitamins and minerals have a huge impact on fertility, so  prioritize essentials like a good prenatal, magnesium, and omega-3s
  
  

Educate yourself

Knowledge is empowerment. Some must-reads:

• Beyond the Pill by Dr. Jolene Brighten

• WomanCode by Alisa Vitti

• Period Repair Manual by Dr. Lara Briden

• Body Love by Kelly LeVeque (especially helpful for blood sugar balance and PCOS)
  
  

Related: What to know about the Mediterranean Diet for fertility—aka the fertility-boosting diet

Non-hormonal birth control alternatives

When transitioning off hormonal birth control, you might be wondering: How can I prevent pregnancy naturally without throwing my hormones off again?

The great news? There are multiple effective, non-hormonal birth control methods that allow you to stay in sync with your natural cycle—and even learn more about your body in the process.

Fertility Awareness Method (FAM)

FAM is a science-backed method of tracking your cycle to identify your fertile window—the days you’re most likely to get pregnant. When used correctly, it can be up to 98% effective.

FAM teaches you to observe and chart:

• Basal body temperature (BBT):
  Your temperature slightly rises after ovulation due to increased progesterone. Taking your temperature every morning (before getting out of bed) helps pinpoint when ovulation has occurred.
  
  

• Cervical mucus changes:
  Throughout your cycle, your vaginal discharge changes in texture and appearance. Fertile cervical mucus is clear, stretchy, and resembles egg whites. Tracking these changes can help you anticipate ovulation.
  
  

• Menstrual cycle patterns:
  Monitoring cycle length, ovulation day, and PMS symptoms helps you understand your body’s unique rhythm over time.
  
  

Tools to make FAM easier and more accurate, try the following:

• Natural Cycles app (FDA-cleared, pairs with a thermometer)

• TempDrop (a wearable BBT thermometer)

• Oura Ring (tracks temperature trends, sleep, and readiness)

• Read Your Body (a more customizable charting app)
  
  

Tip: FAM requires consistency and daily tracking—if that feels overwhelming, start with just one metric (like BBT or cervical mucus) and build from there.

Organic condoms

Condoms remain one of the simplest, most accessible forms of birth control—and when you go organic, they’re also better for your body.

Why choose organic condoms?

• Made without latex, spermicide, or synthetic fragrances

• Gentle on sensitive skin and better for vaginal pH

• Sustain Natural and Lola are great brands to try

Copper IUD

The copper IUD is a small, hormone-free device that’s inserted into the uterus by your doctor. It works by releasing copper ions, which are toxic to sperm, preventing fertilization.

Benefits:

• 99% effective

• Works for up to 10 years

• No daily tracking or remembering to take anything
  
  

What to consider:

• Can increase menstrual bleeding or cramping, especially in the first few months

• Small risk of copper sensitivity or toxicity (very rare)

• Not ideal for those with a history of heavy periods, endometriosis, or pelvic inflammatory disease

Always discuss with your provider to see if this is a good long-term fit for your body.

Phexxi

Phexxi is a prescription, hormone-free contraceptive gel you apply before sex. It maintains the vaginal pH in an acidic range, which decreases sperm mobility and prevents them from reaching the egg.

Best for:

• Women who want control over when they use contraception (only needed when having sex)

• Those who prefer a hormone-free, non-daily option
  
  

What to consider:

• Can cause a slight burning or itching sensation in some users

• Not recommended for those prone to UTIs or yeast infections

• Less effective than other methods when used inconsistently

Choosing a hormone-free option is deeply personal and depends on your lifestyle, health history, and goals. Some women love the body awareness FAM brings. Others appreciate the simplicity of the copper IUD. And some prefer on-demand options like Phexxi or condoms.

You might even combine methods—for example, using FAM to track fertile days and condoms during your fertile window for added peace of mind.

Whatever path you choose, know that your decision to step away from synthetic hormones is a powerful act of body literacy and self-trust, and that support, education, and nourishing care can make this transition a smooth one.

A note from WeNatal on making the transition off hormonal birth control

Stopping hormonal birth control can feel like a leap into the unknown, but you’re not alone, and you don’t have to guess your way through it. Whether you’re exploring your body’s natural cycle, trying to conceive, or just want to feel more aligned with your hormones, know this:

• Yes, you can get pregnant after being on birth control for decades.

• No, it’s not always hard to get pregnant—but it may take a little time for your body to recalibrate.

• Yes, there are healthier, hormone-free alternatives to hormonal birth control.

• And yes, while you can quit HBC cold turkey, preparing your body first is the best way to make the transition smooth, symptom-free, and empowering.
  
  

One of the most important steps you can take is replenishing the nutrient reserves that may have been depleted by years of hormonal birth control use. WeNatal for Her's formulation supports hormone balance by supplying key nutrients like methylated B vitamins, magnesium, zinc, and antioxidants. It provides methylated B vitamins to support healthy methylation, a key process for hormone detoxification and regulation. 

Further, WeNatal for Her supports adrenal health and energy with nutrients like magnesium, vitamin C, and zinc, which are critical for hormone production and stress response. Inositol improves insulin sensitivity to support stable blood sugar, which is directly tied to balanced estrogen, progesterone, and cortisol levels. It provides optimal levels of antioxidants (like vitamins A, C, E, and selenium) to help reduce oxidative stress that can disrupt hormone function.

At WeNatal, we believe that every woman deserves to feel confident and supported on her fertility journey—whether you’re planning for a future baby or simply stepping into your most balanced self. Our science-backed, nutrient-rich prenatal supplements are specifically designed to nourish your body before, during, and after birth control, giving you the foundational support you need to thrive at every stage.

Related: Why a healthy diet is not enough for fertility and pregnancy

References

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Khalili H. Risk of Inflammatory Bowel Disease with Oral Contraceptives and Menopausal Hormone Therapy: Current Evidence and Future Directions. Drug Saf. 2016;39(3):193-197. doi:10.1007/s40264-015-0372-y

Li F, Zhu L, Zhang J, et al. Oral Contraceptive Use and Increased Risk of Stroke: A Dose-Response Meta-Analysis of Observational Studies. Front Neurol. 2019;10:993. Published 2019 Sep 23. doi:10.3389/fneur.2019.00993

Mu E, Kulkarni J. Hormonal contraception and mood disorders [published correction appears in Aust Prescr. 2022 Aug;45(4):147. doi: 10.18773/austprescr.2022.037.]. Aust Prescr. 2022;45(3):75-79. doi:10.18773/austprescr.2022.025

Nassaralla CL, Stanford JB, Daly KD, Schneider M, Schliep KC, Fehring RJ. Characteristics of the menstrual cycle after discontinuation of oral contraceptives. J Womens Health (Larchmt). 2011;20(2):169-177. doi:10.1089/jwh.2010.2001

Noachtar IA, Frokjaer VG, Pletzer B. Mental Health Symptoms in Oral Contraceptive Users During Short-Term Hormone Withdrawal. JAMA Netw Open. 2023;6(9):e2335957. Published 2023 Sep 5. doi:10.1001/jamanetworkopen.2023.35957

Oral contraceptives (birth control pills) and cancer risk. Oral Contraceptives (Birth Control Pills) and Cancer Risk - NCI. 

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

Pateguana, N., & Janes, A. (2019). The contribution of hyperinsulinemia to the hyperandrogenism of polycystic ovary syndrome. Journal of Metabolic Health, 4(1), 3 pages. doi:10.4102/jir.v4i1.50

Steward K, Raja A. Physiology, Ovulation And Basal Body Temperature. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: