What Happens When You Go Off Birth Control? Here Are 7 Things Doctors Want You To Know

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If you're considering going off birth control — whether you're on the Pill, an implant, or use some other method — you've likely already done some research. However, experts tell Bustle that there are a few aspects of the process that might surprise you, like how long it could take you to become pregnant, and what preparations you should make for pregnancy, if that's something you're planning for. Deciding to stop birth control can be a big milestone — and if you don't know what to expect, the initial period post-birth control can catch you unawares.

To understand what will happen after you stop birth control, it's important to know what your particular method of birth control does. "The combined oral contraceptive pill works by suppressing ovulation," explains Dr. Leena Nathan, an assistant clinical professor at UCLA Health Obstetrics & Gynecology. Other contraceptive methods, such as the copper IUD, use non-hormonal methods to prevent pregnancy around the clock. Going birth control-free can be as easy as stopping condom use, or involve the removal of an IUD or implant. If you make the choice to go off birth control, keep your doctor in the loop as early in the process as possible. Here are seven things that can happen once you stop using contraception.

1. You Can Get Pregnant Right Away

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If you're on the pill, experts tell Bustle, there's no real buffer period between stopping its use and losing its protection: once you stop taking it daily, your body could be ready for pregnancy immediately. "Women should know that when they stop the pill, they can ovulate and get pregnant right away," Dr. Nathan tells Bustle. "I tell my patients not to stop the pill until they are really ready for pregnancy."

This applies to other methods of birth control, too. Dr. Megan Quimper, an OB/GYN at the Ohio State University Wexner Medical Center, tells Bustle, "Many women do not anticipate how quickly they may become pregnant when they stop birth control." Technically, it can happen within the first cycle after discontinuing birth control, so make sure everything is ready in case the test comes back positive within a few weeks of trying. "I commonly hear 'I wasn’t expecting this to happen so quickly' in my office," Dr. Quimper says, so it's important to be prepared.

2. ...Or Not For A While

If you're trying to get pregnant and don't get a positive test the second you put away the birth control, don't worry. If you've been on the pill for a little while, Dr. Nathan says, "it can take longer to begin ovulation again, even up to three months." No ovulation means no pregnancy.

Trying for over three months and still haven't got anywhere? That's not a problem either. "It may take six to 12 months to become pregnant [after stopping contraceptive use], and this is not considered abnormal," Dr. Quimper tells Bustle. Trying to get pregnant can be complicated, so don't worry if tests continue to be negative well after the six-month mark.

3. Your Cycle May Take Some Months To Return To Normal

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People with uteruses who were using hormonal birth control before they decided to stop may find that their body needs some readjustment time. "It's important to know that it may take several months before your menstrual cycle returns to normal after using hormonal birth control," Dr. Quimper tells Bustle. That may mean irregular periods, as well as delays in ovulation. It can take a while before your reproductive cycle settles down into a recognizable rhythm.

A few months without a period after stopping the pill is also common, and is known as post-pill amenorrhea. However, if your period hasn't turned up and you're not using any birth control, it's worth taking a pregnancy test, even if it's your first cycle after stopping the birth control. You may simply have fallen pregnant right away.

4. Your Periods Off The Pill May Be More Intense

Once you stop hormonal birth control like the pill or hormonal IUD, says Dr. Nathan, you should expect "a heavier period and more cramps." It's caused by the way that hormonal birth control tends to operate.

"Birth control often makes cycles lighter and less painful," Dr. Quimper tells Bustle. "Stopping birth control can lead to heavier, potentially more painful menstrual cycles and this is considered normal." This is why people with very heavy periods can be prescribed birth control in order to lessen bleeding in the first place. If you find yourself returning to a level of bleeding you haven't encountered since your pre-birth control days, don't be concerned.

5. You Should Start Prenatal Vitamins Immediately

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If you're stopping birth control use in order to start a family, you need to start taking prenatal supplements sooner than you think. "It is a common misconception that prenatal vitamins are to be started after one gets a positive pregnancy test," Dr. Quimper tells Bustle. Instead, you need to start them as soon as you stop taking birth control if you're intending to get pregnant.

"Women should start prenatal vitamins whenever they stop preventing pregnancy, as prenatal vitamins are most important in the first weeks of life, when a woman may or may not know she is pregnant," Dr. Quimper says. Substitute the pill, the IUD, condoms or your other birth control methods for prenatal vitamins to help the health of any future pregnancy.

6. Your Cramps May Increase

Cramps in general are controlled and lessened by hormonal birth control, so if you had small cramps while on birth control — whether in the week before your period, or during your period itself — they'll likely be more severe once you go off it. "Women should also expect more cramps off the pill," Dr. Nathan tells Bustle.

7. Your PMS May Get Worse

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Coming off the pill or other hormonal birth control may also alter your PMS symptoms. "PMS is characterized by mood changes including irritability and anger," Dr. Nathan says. The pre-menstrual period coincides with lower levels of estrogen and progesterone in the bloodstream, which then has an affect on mood and physical symptoms. "I often treat these mood issues with the birth control pill, which maintains a steady state of hormone in the blood," Dr. Nathan tells Bustle.

If you were on the pill to help control PMS symptoms or noticed a lessening in symptoms when you were using it, expect those symptoms to return. Anti-depressant medications are an alternative for treating the psychological symptoms of PMS, Dr. Nathan tells Bustle, so birth control isn't your only option for dealing with it. (It should be noted, however, that many anti-depressants should not be taken when pregnant, so speak to your doctor about the best options for you.)

There are a lot of variables in play when you start trying for children, and coming off birth control can affect several aspects of your health. It's best to plan out the process with your OB/GYN or doctor to make sure that you're making the best choices for your body.