The number of women using modern contraceptive methods has soared in the past two decades to over 851 million, reports the World Health Organization. They include oral contraceptive pills, implants, injectables, patches, vaginal rings and IUDs – and while these hormonal methods may temporarily delay a return to fertility if you decide to have a baby, studies show your normal hormonal levels will return.
A systematic review and analysis in the journal Contraception and Reproductive Medicine concluded categorically that “Contraceptive use regardless of its duration and type does not have a negative effect on the ability of women to conceive following termination of use and it doesn’t significantly delay fertility”.
Some 22 studies involving nearly 15 000 women who stopped using contraception showed the pooled rate of pregnancy was 83% within the first 12 months, adding that “it was not significantly different for hormonal methods and IUD users”.
Hormonal contraceptives work by influencing hormone levels to prevent your ovaries releasing mature eggs, and some of these hormones may take longer than others to leave your system and allow your natural levels and menstrual cycle to return.
According to a 2020 study in the British Medical Journal, injectables resulted in the longest delay (five to eight menstrual cycles), followed by the patch (four cycles), oral contraceptives and vaginal rings (three cycles), and hormonal and copper IUDs and implants (just two cycles).
“The fastest return to fertility would be after removing a copper or progesterone IUD,” confirms Benoni gynaecological oncologist Dr Elize Wethmar. “Often women start using the COC (combined oral contraceptive pill) or progesterone-based IUD due to an underlying gynaecological problem, for example PCOS (polycystic ovary syndrome) or endometriosis. In this instance, the return to normal ovulation after hormonal problems (for example with PCOS) or anatomical problems (due to, for example, blocked fallopian tubes secondary to endometriosis or a long-standing pelvic inflammatory condition) might need to be addressed after the cessation of the COC/IUD.”
How to stop if you want to conceive?
Some women conceive straight away, but others experience a delay and irregular periods, menstrual cramps, and changes in weight and mood swings as their own hormones take over.
Help to prepare your body by reducing stress, exercising and eating well. Speak to your health provider about possible nutritional deficiencies – studies have suggested that women taking oral contraceptives may have depleted levels of folic acid, vitamins B2, B6, B12, C and E, and the minerals magnesium, selenium and zinc, compared to other women. Ask about addressing this with a balanced diet and possibly supplements, says Dr Wethmar.
Also ask about checking your blood glucose levels, which may be affected by hormonal contraceptive use; and about restoring your gut microbiome, which plays a big part in regulating oestrogen levels. To improve your gut microbiome, have foods high in prebiotics and probiotics, such as whole grains, yoghurt and green tea, and avoid sugary snacks and artificial sweeteners.
Watch for signs of infertility
Whether or not you have been on hormonal contraceptives, if you have not gotten pregnant after 12 months of unprotected sex (or six months, if you’re over 35), speak to your health provider, Dr Wethmar says. You may have infertility issues that have been masked by taking hormonal contraceptives.
These include being significantly overweight or underweight, having blocked fallopian tubes, uterine fibroids, infections, tumours, autoimmune disease, thyroid issues, PCOS or endometriosis, which need to be medically or surgically addressed.
Your partner’s fertility should also be checked. “Conceiving, pregnancy, and the care of a human being is a team effort,” says Dr Wethmar. “Both partners carry an equal responsibility and both partners should be evaluated as soon as an infertility question is raised.”
Hormonal contraception can’t cause infertility, so you should know that the problem lies elsewhere – and today, so do many ever-improving solutions. Explore them with an experienced fertility health professional.
Also read: HPV - know the facts
IMAGE CREDIT: 123rf.com
* Reliance on any information provided on this Website is solely at your own risk.
The content of this Website is provided as a service to you for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing symptoms or need medical advice, you should seek the advice of your healthcare professional.