It could be something as simple as lifestyle factors like stress or overexercise. Or it could be an underlying condition like hypothyroidism.
“It’s common not to get a period after stopping the pill,” explained Gil A. Weiss, MD, assistant professor of clinical medicine at Northwestern Memorial Hospital in Illinois.
“The phenomenon is called post-pill amenorrhea,” Weiss continued. “The pill suppresses your body’s normal production of hormones that are involved in your menstrual cycle.”
He said it can take several months for your body to return to its pre-pill production and, therefore, several months for your period to return. But, in some cases, there is another reason for late or missed periods.
Stress can affect the delicate hormonal balance that controls your menstrual cycle.
“Stress induces the hormone cortisol,” said Kecia Gaither, MD, who specializes in OB-GYN and maternal-fetal medicine. “[This] can interfere with the hormonal regulation of menses via the circuit between the brain, ovaries, and uterus.”
Other symptoms of stress to look out for include:
While small amounts of stress are unlikely to cause changes, long-term or significant stress levels can stop periods.
Finding ways to relieve stress is important for your overall well-being. Consider talking with a mental health professional. They may suggest cognitive behavioral therapy (CBT) or even prescribe medication.
Working out too much can deplete your body’s energy stores to the point where reproductive functions slow or shut down in favor of more essential processes.
This change affects hormones responsible for ovulation, which can lead to a late period.
Adults should aim to exercise moderately intensely, like brisk walking, for 150 minutes a week.
Your body can tell you if you overexercise. You may feel lightheaded or more tired than usual and experience joint pain.
Rapid weight gain and weight loss can negatively affect your menstrual cycle.
Sudden weight loss can halt the production of ovulation-controlling hormones, stopping periods altogether.
Having a higher weight can result in excess estrogen. Too much estrogen can disrupt reproductive processes, sometimes altering the frequency of your period.
Consult a healthcare professional if you’re concerned about your weight or notice other symptoms, such as tiredness and appetite changes. They can check for underlying conditions and advise on the best next steps.
Uterine polyps and fibroids are growths that appear in your uterus. People with polyps or fibroids may have irregular periods or notice spotting between periods.
These growths can also “make periods heavy due to changes in the way the uterine lining is shed,” said Weiss.
Most of the symptoms associated with uterine polyps are period-related. However, some people may experience infertility.
Fibroids, on the other hand, can cause other symptoms like:
- pelvic pain
- constipation
- difficult urination
Sometimes, polyps and fibroids don’t need treatment. But if they cause problems, a doctor can remove them.
Birth control can suppress the symptoms of underlying conditions. But as soon as you stop taking the pill, these symptoms can flare up once again. A thyroid imbalance is one of these conditions.
An underactive thyroid, known as hypothyroidism, means your body lacks thyroid hormone levels.
This condition can cause several period-related problems, including no periods, heavy periods, or irregular ones. You may also experience fatigue and weight gain.
An overactive thyroid — or hyperthyroidism — can result in similar menstrual effects and shorter or lighter periods. This time, it’s because your thyroid produces too many hormones.
Other symptoms of hyperthyroidism include weight loss, difficulty sleeping, and anxiety.
Thyroid imbalances can be treatable with medication, so consult a healthcare professional if you notice these symptoms.
Polycystic ovary syndrome (PCOS) is another underlying condition that can emerge after you stop birth control. It “causes an imbalance between your ovaries and your brain,” said Weiss.
Irregular periods are one of the most common features associated with PCOS. They occur because polycystic ovaries can have difficulty releasing an egg, meaning ovulation doesn’t occur.
People with PCOS also typically have higher levels of androgens, which can lead to acne or excess hair on the face and body.
A range of treatments exist to relieve the symptoms of PCOS. A healthcare professional may prescribe medications and recommend lifestyle changes.
Believing that it takes a while to conceive after stopping the pill is one of the biggest contraceptive misconceptions.
“The quickness with which one becomes pregnant varies” from person to person, explained Gaither. Generally, she said, it takes between 1 and 3 months.
So, if you’ve had penis-in-vagina sex and have noticed menstrual irregularities, take a pregnancy test as soon as possible — just to be on the safe side.
Other early symptoms of pregnancy include:
- fatigue
- swollen or tender breasts
- frequent urination
- nausea
- food cravings
- headaches
- mood changes
It can take a few months for your menstrual cycle to return to usual.
But if you haven’t had a period after 3 months of stopping the pill, book a doctor’s appointment. They can test for underlying conditions and help you decide on the next steps.
Some people also choose to contact a doctor before they stop taking the pill. That way, your healthcare professional can prepare you for changes to your body once you stop taking birth control.
They can also recommend other forms of contraception to prevent pregnancy or to relieve symptoms that your pill treated.
Lauren Sharkey is a journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.