Off the pill — Should I talk to doctor?

Dear Alice,

I've been on birth control pills for eight 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??,

Good for you for seeking more information about your prescription medications! You may be interested to know that it’s pretty common to go on hormonal birth control (BC) pills for noncontraceptive reasons (i.e., for reasons other than pregnancy prevention, including menstrual irregularities). In fact, about 14 percent of all pill users take birth control primarily for noncontraceptive purposes. People go on and off of BC pills for many reasons. One of the perks of BC pills is that they are easily stopped and the contraceptive effects are quickly reversible. However, if you do decide to change up your contraceptive routine, you may want to speak with a health care provider to discuss any potential benefits and risks of removing or adding hormones to your body in particular. Read on for more information about reasons for going on the pill, potential outcomes associated with going off the pill, and contraceptive alternatives. 

You describe the conditions under which you started the birth control pill as having “very irregular” periods and that they were “horrendous” when you were younger. Beyond pregnancy prevention, there are a number of reasons a person might take hormonal BC. Some reasons may be to regulate menstrual periods that are absent, infrequent, irregular, heavy, or prolonged. Other potential reasons may include using it as a treatment for certain conditions such as dysmenorrhea, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), endometriosis, polycystic ovary syndrome (PCOS), or acne.  Though it’s unclear what your diagnosis was at the time you first were prescribed hormonal BC, it’s good to know that some people who take it for irregular periods may experience a return of irregularity once they’ve stopped use.

If you do decide to forego BC pills, it’s wise to consult a health care provider first — particularly because you were initially prescribed hormonal BC for noncontraceptive reasons. They can talk with you about your history with menstrual irregularities and together you can come up with a plan of how and when to stop taking the pill. They can also answer questions you might have about what to expect when getting off the pill and how to mitigate any discomfort as you resume your typical menstrual cycle (you can also check out Questions about going off birth control pills for more information).

If you decide to become sexually active again and hope to prevent pregnancy, there are a number of other methods besides hormonal BC pills on the market. No matter which one you go with, though, some factors you’ll want to consider in your decision-making process include: compatibility with your age, current health status, cost, lifestyle, and partner(s). Some contraceptives provide additional benefits, such as lighter and more predictable menstrual cycles, a decreased risk of sexually transmitted infections (STIs), or a reduction in the risk of certain cancers. Doing a little bit of homework on what’s out there can help you find a good fit for your needs.

All in all, it’s generally safe to take a break from your birth control pills. However, if you’ve primarily been taking BC for a reason other than pregnancy prevention, getting some guidance from a medical professional can help you make an informed decision that's best for your personal health.

Last updated May 13, 2016
Originally published Nov 01, 1993