We have come a long way since then in terms of our attitude to sexuality and our relationship with the church.
Imagine for a minute how different the world would be if the pill never became an option. The pill has changed the way that women think about the consequences of sex. It has allowed many of us to develop our potential to a much greater extent.
Being able to have sex without having to worry about rushing into marriage or parenthood has allowed women to focus on education and building careers before starting families. For the first time in history, the pill has allowed women to plan. So yes, on the face of it, the pill has been a liberator.
Beyond contraception, the pill is now prescribed for “period regulation,” for stopping periods for social reasons, and even for managing acne. The five effects here primarily concern the combined oral contraceptive pill, especially when you are coming off it to try for a baby. The combined pill suppresses ovulation while you take it, but its contraceptive action is reversible.
If you’ve recently stopped hormonal contraception and your cycle feels unsettled or slower to return than you expected, it doesn’t necessarily mean anything is “wrong.” These are often the physiological shifts that occur when your body begins reconnecting the natural hormone rhythms that were suppressed. The five effects below help to explain what is happening beneath the surface – and why the transition can take time.
1. How the pill works: suppressing ovulation
Most combined oral contraceptive pills work by suppressing ovulation.
When ovulation is paused, your body’s natural hormone rhythm is also suppressed. Changes to cervical mucus make sperm passage more difficult, and changes to the womb lining also contribute to the pill’s contraceptive action.
During the 21 days of active pills, synthetic oestrogen and progestogen are taken every day. These synthetic hormones prevent the normal hormonal ups and downs that would usually lead to an egg being released. During the 7-day break, a bleed happens – but this is not the same as a natural period (more on that below).
This suppression can affect the usual communication between the brain, the pituitary gland, and the ovaries. When you stop taking the pill, your body has to reconnect this natural conversation, and that re-start does not always happen immediately.
2. The pill doesn’t regulate your cycle
The bleed experienced during the 7-day break from the pill is not a true period; it is a withdrawal bleed in response to stopping synthetic hormones. So when someone experiences a “regular cycle” while on the pill, this is not due to their own hormonal rhythm. It is a pharmaceutical-induced response. When patients experience missing, heavy, or irregular periods, they are often prescribed the pill as a way to “regulate” or “balance” hormones. In reality, the pill does neither of these things.
It prevents ovulation, which is the source of your own progesterone. A better way to describe the pill’s function is that it suppresses hormones rather than balances them. Any hormone imbalance that led to the pill being prescribed in the first place has not been addressed. It will still be present when the medication is stopped – which is often when women notice that the original problem has never really gone away.
3. The pill does not preserve egg count
Being on the pill for a long time, it can be easy to assume that the eggs you “didn’t use” while on it are somehow stored or preserved.
Unfortunately, this is not the case. Follicles containing your eggs continue to enter development, and only a small minority reach ovulation. Most are lost through atresia — the process in which follicles stop developing and are broken down. The pill prevents ovulation, but it does not prevent this follicle loss.
Your egg reserve continues to diminish while you are taking the pill. The pill does not “save” eggs for later life; it simply stops those eggs from being released.
4. How hormonal birth control affects gut health
Combined hormonal contraception can change the variety of bacteria in your gut and the amounts of particular bacteria. The pill can also affect how those bacteria process amino acids, the building blocks of protein. The following symptoms and infections have also been linked with pill use or stopping it — that does not mean changes in gut bacteria caused them:
- Yeast infections (thrush)
- Urinary tract infections (UTIs)
- Bloating or digestive discomfort
- PMS symptoms or hormonal fluctuations returning after stopping the pill
Gut flora are involved in hormone regulation and oestrogen metabolism. These bacteria influence how much oestrogen is reabsorbed from your gut into your blood. They also break down parts of your food and produce compounds used in gut and metabolic function. A varied diet supplies nutrients for your body as well as food for these bacteria.
5. The pill can affect nutrient status
The pill can affect several vitamins and minerals your body needs for fertility, hormone balance and early pregnancy.
Folate
Folate is a water-soluble B vitamin your body uses to make DNA and divide cells. It also takes part in methylation — chemical changes involved in how genetic instructions are used. Folate levels can be lower in the blood during pill use. Your body needs an adequate supply before conception as well as during early pregnancy.
Riboflavin (B2)
B2 helps your body produce energy and supports cell function and growth. The pill can also affect riboflavin status.
Vitamin B6
B6 helps your body process protein, carbohydrates and fats, and make neurotransmitters — chemical messengers such as serotonin. Blood levels of its active form can be lower while taking the pill.
Vitamin B12
Your cells use B12 when making and regulating DNA, making fats and producing energy. B12 levels can be lower in the blood during pill use.
Vitamin C
Vitamin C helps chemical reactions take place in your body, including those needed to make collagen. It also acts as an antioxidant. During pill use, white blood cells can contain less vitamin C.
Vitamin E
Vitamin E is an antioxidant that protects your tissues from damage caused by reactive molecules known as free radicals. Blood levels of vitamin E can be lower with some pill formulations.
Zinc
Zinc is involved in making and using genetic material, including DNA and RNA. Your cells also use it to communicate, use genetic instructions and control cell death. Zinc levels in the blood can also be lower in women taking the pill.
Selenium
Selenium helps antioxidant enzymes work and is also needed for thyroid function. Blood selenium levels can differ with hormonal contraception — lower levels and higher levels are both possible.
Magnesium
Magnesium is needed for more than 300 chemical reactions in your body. Women taking the pill can have lower magnesium levels in the blood.
Your body needs this nutritional support before conception, while eggs are developing and the womb lining is preparing for implantation. A varied, nutrient-dense diet brings these nutrients together, but only if you’re eating this way regularly.
That is where the practical challenge begins. What are you going to have for breakfast, lunch and dinner this week? The meals need to target the necessary nutrients, the ingredients bought and the food prepared. Knowing where to start can be the hardest part.
Over my 20 years of working with couples who are trying to conceive, I have found that learning skills around planning and prepping meals is crucial, and the benefits are endless….
✅ You don’t have to think about what’s for dinner tonight, it was planned last weekend.
✅ All your shopping for the week can be done at one time, saving you hours.
✅ By prepping everything in one go, more time is saved.
✅ By having meals that lend themselves to either being frozen for future use or being good for lunch next day means less time being spent in the kitchen.
✅ You save money too as there will be less waste, spoiled food, and fewer lunches bought out.
✅ And of course, because you are eating to a healthy meal plan, your fertility is supported.
Does hormonal birth control delay time to pregnancy?
Yes, conception can take longer after stopping the pill, with a reduced chance of pregnancy during the first few cycles. When you have spent years preventing pregnancy and are ready for a baby, that delay can be frustrating.
There can also be changes in the signs that help you recognise your fertile days. After stopping the pill, cervical mucus can have fewer of the clear, slippery and stretchy qualities associated with fertility. This mucus helps sperm survive and travel towards the egg. Changes in its quality, together with later ovulation timing, may help explain why conception takes longer in those early cycles.
Planning when to stop the pill is one part of preparing for a baby. Putting the right nutritional support in place deserves the same advance planning — and can begin while you are still taking it.
Preparing for pregnancy after the pill
I am a firm believer that there is a solution to every problem. As Clinical Lead at Now Baby, my role is to help you understand what your body needs so you can move forward with clarity and confidence.
Because hormonal contraception can influence nutrient status and hormone signalling, recovery is often about restoring what has been depleted and supporting the body as ovulation re-establishes. In practice, that means prioritising bioavailable, comprehensive nutritional support before trying to layer on anything more complex.
The Mediterranean diet brings that breadth of nutritional support into your diet. Closer adherence was associated with 44% lower odds of difficulty conceiving and higher live-birth rates
Supporting development before conception
Once the decision is made to grow your family is made, the anticipation becomes very exciting. How long it takes to see those 2 blue lines and start calculating your due date depends on a number of factors and your nutrition status is one of them. From egg quality, to ovulation, to implantation and early embryo development, each stage relies on metabolic stability and nutrient availability. Pregnancy takes 9 months and no one wants it sooner because we understand that process requires a specific amount of time. That also applies to your egg quality. Your egg maturation during the 90 days before ovulation will decide what happens next so instead of having to figure it out yourself, I have created the Mediterrean Fertility Nutrition Protocol to give you the framework for both metabolic stability and nutrient availability during this crucial phase of pregnancy preparation.
