Dear Alice,

I've been on birth control pills for 8 years and I'm thinking about trying a few months off them. They were prescribed when I was pretty young because of very irregular periods. I also was involved in a monogamous relationship for a number of years, so they were convenient. Now I have no steady partner, and am really curious to see how I feel without taking these pills. Would it be ok to go off them at the end of my pill pack or should I consult someone at health services first? If I go off for a few months and my periods are as horrendous as they were when I was younger, would it be safe to start up again on my own (I usually just see someone once per year for pill checks)?

— Dependent on hormones??

Dear Dependent on hormones??,

Considering taking time off from your pill pack? Women go on and off of birth control pills for many reasons. One of the perks of oral contraceptives is that they are easily stopped and the contraceptive effects are quickly reversible. It's recommended that you speak with your health care provider any time that you are looking to change your contraceptive routine — whether you decide to stop taking the pill completely, take a break from the pill, or start taking the birth control pill again.

Typically, a woman's period will start again within three months after she stops taking the pill; most women ovulate promptly and have a period within four to six weeks. However, if your periods were irregular before you began taking the pill, your previous pattern may return for up to one year or longer. In fact, your first non-pill periods may be a week or two late or missed completely.

Exactly when in your cycle you stop taking the pill has little impact on your overall health. If you decide to quit midway through a pack, you may experience some bleeding before your period actually begins. Rest assured that this is quite normal and usually no cause for concern; your body just may need some time to get back on schedule. Should you become sexually active and still do not have a period within three months of going off the pill, a pregnancy test can tell you whether or not you're pregnant. If six months go by and you still haven't seen Aunt Flo, it is recommended that you speak with your health care provider.

If you decide to become sexually active again, it's important to know your options for birth control. There are plenty of birth control choices other than oral contraceptive pills. Some options include:

  • Barrier methods, such as male and female condoms, the diaphragm, the sponge, and the cervical cap
  • Hormonal methods, including the contraceptive patch, ring, and shot
  • Intrauterine devices, also known as IUDs
  • Sterilization, including a tubal ligation for women, and vasectomy for men
  • Natural family planning

Should you decide to go back on the pill for irregular periods and decide to start having sex again, it is highly recommended that you use a barrier method of birth control, such as the male or female condom. This increases your protection against sexually transmitted infections.

Finding the right birth control method can be similar to finding the perfect pair of shoes — you may have to try on a few pairs before you find the right fit! There are plenty of factors to consider when deciding what form of birth control is suitable for you: compatibility with your body, age, health, maturity, financial cost, lifestyle, and partner(s). Besides preventing pregnancy, some contraceptives provide additional benefits, such as lighter and more predictable menstrual cycles, a decreased risk of sexually transmitted infections, and/or a reduction in the risk of certain cancers. With so many choices, it is worth taking the time to find the best fit!

All in all, it is completely safe to take a break from your birth control pills. Speaking with your health care provider may be helpful for deciding when to stop (and start) taking the pill, as well as sorting out the pros and cons of different types of birth control. Columbia students can make an appointment through Open Communicator or by calling Primary Care Medical Services at x4-2284. Kudos to you for taking charge of your reproductive health!


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