Just Facts: Do I Need to Take a Break from the Pill?


RH Reality Check is partnering with Planned Parenthood New York City to publish a series on the facts about various forms of birth control.  Articles in the series will appear on the second Monday of each month.

I’ve heard it, and my guess is that you’ve heard it too. It’s the idea that you’re going to need to take a break from taking hormonal birth control. For a reason other than wanting to get pregnant right away.

The idea behind this usually comes from one of two sentiments. Either: “I have been on birth control for five years now. I think I should stop taking it for a little while, just to give myself a break from hormones.” Or: “I think I want to get pregnant when I’m 31. But I’ll need to stop taking birth control about a year ahead of time, to give the hormones a chance to leave my system.”

While there are reasons you might want to stop taking the birth control pill — such as you want to try out a different method of birth control; you’re fed up with the daily routine; you’re unhappy with your current pill; or you want to get pregnant – you do not need to take a break from taking the birth control pill.

Back to basics.

We’ve outlined exactly what the Pill is in the past, but here’s a refresher:

The birth control pill is an oral hormonal contraceptive that’s taken daily. While there are many different brand name and generic versions of the Pill, they all work basically the same way. The pill is made up of estrogen, progesterone, or a mix of the two hormones. These hormones suppress ovulation, ensuring that a woman’s ovaries won’t release eggs. And they thicken a woman’s cervical mucus, thus blocking sperm from getting past the cervix.

Even though birth control pills all work the same way, that doesn’t mean they’re all the same. They have different mixes and levels of hormones. Because of this, they affect us differently – meaning that the side effects you get with one pill may disappear once you change brands. While many of you do well with whatever brand of pills is prescribed, for others finding the right birth control is a process – trying different brands until you find one that mixes well with your body’s chemistry.

Do you need a “break” from birth control?

No matter how long you’ve been taking the birth control pill, it’s just as effective as it was the day you started. You don’t need to increase your dosage, and the body won’t “get used” to it, making it less effective. The Pill contains hormones that naturally occur in the body, and they don’t accumulate in your body or build up over time. To make a long story short, there is absolutely no need to take a break from hormonal birth control.

However, let’s distinguish between need and want. Although the birth control pill you’ve been on since high school may still technically work fine when it comes to preventing pregnancy, that shouldn’t stop you from exploring other options, if you’re curious about them. Maybe you’re sick of taking a pill every day. Maybe you want to try out a more permanent method, like an IUD. Maybe you just want to try non-hormonal birth control for a little while. There’s no reason why you can’t explore birth control options to find one that fits your lifestyle better. But, if the Pill you’re taking is working for you, rest assured you can keep on taking it without any negative consequences.

But what if I am trying to get pregnant?

Another concern we’ll hear is from women who know they want to get pregnant at some point in the future (usually a year or two), and worry that they’ll need to give their bodies time to “get rid of all the hormones” that have “built up” in their bodies before they’ll be able to get pregnant.

While there are some hormonal methods (like the shot, Depo-Provera) that can delay your body’s ability to get pregnant by a few months, the daily birth control Pill is not one of them.

The birth control pill works as well as it does not because of the amount of hormones in your system, but because it’s a regular daily dosage of hormones. The constant regular intake of these hormones into your system replaces your body’s regularly scheduled hormone production. This prevents your body from producing the hormones that would kickstart ovulation. And without ovulation, there’s no way to get pregnant.

Any interruption in this daily regimen can trigger your body’s natural hormone production back into action, bringing on ovulation and, with it, the chance of pregnancy. Depending on the type, missing a pill by a few days or even hours can start this process.

Think about it: if you’re worried about getting pregnant when you accidently skip one pill, what’s the logic in assuming that once you’re trying to get pregnant, it will mean skipping a lot more than just one pill?

So, yes, some levels of hormones may stay in your body for a little while after you stop taking the birth control pill. But these won’t prevent ovulation, and they have no effect on a pregnancy if you do become pregnant.

Of course, as always, we’re not giving anyone medical advice. Making good decisions about sexual health and birth control is vastly different for each person. That means that no matter how much what we say rings true, you should always discuss these topics with your health care provider to figure out what works best for your health, body, and lifestyle.

But you don’t need to take a break from the birth control pill. Unless, of course, you want to.

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To schedule an interview with contact director of communications Rachel Perrone at rachel@rhrealitycheck.org.

  • j-parker

    Thanks for this column, Erica! I especially appreciate your point that women can get pregnant pretty much immediately after stopping the pill and many other types of hormonal contraception. I got pregnant so fast after stopping the NuvaRing that we couldn’t even figure out my dates for conception – no LMP (last menstrual period) to reliably count from! And I know many others who had the same experience. Bottom line is, assume you can get pregnant right away so protect yourself if you’re not absolutely ready to conceive.

     

    I am wondering if you could say a little more about the issue of taking a break from hormones, however. In all my years doing health ed and options counseling, I don’t think I’ve ever heard a woman say she wants to take a break from the pill because she’s afraid it is losing effectiveness or her body is getting used to the hormones. What I have – and do – hear frequently is a concern that the exposure to synthetic hormones might not be good for her over the long term. Especially since the HRT (hormone replacement therapy) debacle, I think women have questions about how good it is for you to take hormones and for how long. So I’d love to hear your perspective on how to respond to those questions and concerns! Thanks.