Lost and confused...

June 29, 2009 12:56 PM

What can I expect if I go off the pill?

Here's a bit of history and some pretty personal details, but, sadly enough, I don't really have anyone in my life who I feel comfortable talking to about this. Anyway...

I have been on the pill since I was 18 and I am now 32. I have never had any issues with it and have always been good about taking it until about six months ago when something just shifted. Now, I have trouble remembering to take it and it just doesn't feel right for me anymore.

My husband and I do want to have children, but the past couple years have been very difficult (family problems, starting a business, etc.) and have left us emotionally and financially drained. It seems that things are getting back on track and we are thinking that in another year or two, it will be time to start moving towards parenthood. I know that there is never a right time (my mother continually harangues me about the fact that I am getting older), but it is important to me for the announcement of a baby on the way to be a happy thing.

We are not the most sexually active couple; my husband does not have a very high sex drive and, while I enjoy being sexual, intercourse has always been painful for me (I secretly hope that having a child will help with this, although it scares me too). The past couple years, we have both pretty much just dropped into bed exhausted every night and cuddled. Maybe this will change since a lot of these difficult situations are getting better, but it certainly has seemed a waste to be on the pill during this time period.

I have never used any other method of birth control (except one time). I don't want to continue with the pill or do the shot because I want to return to a natural hormonal state. I can't tolerate condoms because they are so painful. I don't know what else might work. I also don't know if being on the pill for so long might effect my ability to get pregnant. I also don't know if it is OK to not have a terribly sexual marriage. I just need help. Thank you.

posted by melangell to health & fitness (23 comments total)

If you stop taking the pill, you can get pregnant the next day. Of course, that doesn't mean you will, but just that the pill is not preventing a pregnancy.

Condoms should not hurt; maybe you need more foreplay or lubrication. But, there are other birth control methods. Planned Parenthood offers exams and birth control on a sliding scale (you pay according to your income). They can also talk to you about your options, to help you find the best one for you.

Here's how often you and your partner should have sex: Exactly as much or as little as you two want. If you are both happy, then it is OK.
posted by Houstonian at 1:10 PM on June 29

I have never used any other method of birth control (except one time). I don't want to continue with the pill or do the shot because I want to return to a natural hormonal state. I can't tolerate condoms because they are so painful. I don't know what else might work. I also don't know if being on the pill for so long might effect my ability to get pregnant. I also don't know if it is OK to not have a terribly sexual marriage. I just need help. Thank you.

Being on the pill shouldn't affect your ability to become pregnant in the long term. It takes a few months to wear off, but it does wear off.

My own personal favorite alternative-to-condoms is one that is a little hard to find in the U.S.A. (if that's where you are) -- the cervical cap. It works basically the same way as a diaphragm, except it's more form-fitting to the cervix. Which gives it many advantages -- unlike with the diaphragm, you can put it in and leave it there for up to 24 hours, having sex as many times as you want during that period. It's nearly impossible to detect, for either of you; the only times I felt it were when I was close to the 24-hour mark; it exerts a little bit of suction to hold itself in place, and after 24 hours, that suction once in a while just got mildly uncomfortable. On the other hand, sometimes it's completely indetectible to the point that you may run the risk of forgetting it's there (I once spaced out completely and left it in for a full WEEK -- the smell when I removed it was Not Pleasant, and I had to get an emergency antibiotic from my doctor to make sure I didn't develop any infection.) You also have to use contraceptive goop, but you use a lot less than you do with a diaphragm.

The biggest disadvantage you may find is just trying to find one - cervical caps are approved by the FDA, but they are not widely available these days because everyone is playing with pills of various sorts. They were more widely available when I got mine, in '98...but the thing still works (I re-visited my doctor when I wanted to start using it again, in '08, and she said it would work fine still; the nurses, however, did not recognize what I had and apparently I confused the hell out of all of them). I am a zealous fan, though, and would urge you to at least press your doctor to consider this as an option - there ARE ways to get them. The only other disadvantages are if you forget it's there and leave it in for more than a day (see above), or if you're not really shaped well enough to fit one of the available sizes - some women just aren't.

Give it a shot.
posted by EmpressCallipygos at 1:11 PM on June 29

Going off the pill may help to energize you--long-term use does seem to wear you down, make you put on weight, and has been linked to depression.

When I went off the pill, it took me over six months to get pregnant with our first, and I was happy with that time period. For our second, when I went off the pill again, I was pregnant within a week. So, obviously, there's a big YMMV in there.

About your sex life--if you and your husband were happy with infrequent sex, I figure you wouldn't be writing. I'm thinking that "sex has always been painful for me" is a big part of this.

Sex was painful for me, too, at one point in my life, and I just thought, honestly, that it was natural. Since I was orgasmic, and it wasn't THAT bad, I just figured it was like that for every woman who wasn't a porn star. That was REALLY dangerous thinking.

Do NOT ignore pain. Mine got much worse before I did anything about it. It turned out to be endometriosis, which became so severe I had to have a complete hysterectomy. You may also have a problem with not enough lubrication or even an allergic reaction to your husband's sperm--there's lots of reasons for pain with intercourse that you can DO something about.

I'm also not surprised that, given your experiences, your husband's sex drive is low; a loving partner wouldn't want to hurt you and knowing sex is painful could be affecting his desire, too.

So please do check those boxes at the ob/gyn and make a point of letting your doctor know that this pain is not just an occasional, we-were-trying-an-exotic-position thing. I think that will help your sex life a great deal, and certainly help with other birth control methods, like condoms, which should not hurt you.
posted by misha at 1:19 PM on June 29

P.S. I forgot to mention that my husband and I have discussed me going off the pill and he is OK with me making this change, so this is not a covert mission.
posted by melangell at 1:20 PM on June 29

Sex should not be something that's always painful. Ask your doctor about why that might be happening.
posted by tehloki at 1:22 PM on June 29

I am recently off the pill after being on them for a couple of years longer than you. I'm 36, and I've never had kids either. I stopped them in early May because I was having increasingly irregular menstrual cycles, probably due to hormonal and weight fluctuations associated with my treatment for thyroid cancer. I'm planning to get an IUD in a couple of months at the recommendation of my gyno.

I imagine that the effects of going off the pill will be highly subjective. But here's what I've had since stopping them in early May: no period at all (but I had been bleeding for almost 7 weeks straight before that, so who knows what's going on there- I'm for sure not pregnant), swelling of the feet (I'm having this checked out by my endocrinologist), ongoing breakouts on my chin after having no skin problems for years. My boyfriend says that my skin feels softer. And maybe this is TMI, but I've experience female ejaculation (twice now) with climax for the first time in my life. It was never anything I strived for, or even considered much... so you can color me surprised at that one.

As far as your sexual relationship with your husband... I think that's highly subjective too. I can tell you that my bf and I experienced something similar during the last couple of years... we were both laid off, both of his parents fell ill and died, and I was diagnosed and treated for thyroid cancer. During that time, there was a lot more cuddling than sex, and that was okay with both of us. Now that things are (knock wood) looking up, we've had much more energy and interest in sex.

With regards to alternate forms of BC, it's always a good idea to talk to your doctor about these things. I've done a bunch of research about the Mirena IUD, and hope it will be the right choice for me. Other non-hormonal things you might consider are the sponge and the diaphragm.
posted by kimdog at 1:28 PM on June 29

To clarify... Mirena is a form of hormonal BC, but there are other IUD's that aren't.
posted by kimdog at 1:32 PM on June 29

Being on the pill can decrease your sex drive, so you may find yourself more interested in sex once you are off of it. I agree that condoms can be uncomfortable - but using a good lube can help - if you've tried this and they still hurt, you may have an allergy to latex. There are non-latex condoms made, so they might be worth a try.
posted by 5_13_23_42_69_666 at 1:32 PM on June 29

Have you only used latex condoms? Perhaps you are experiencing pain because you have a latex sensitivity or allergy. Experimenting with polyurethane or lambskin condoms might help.

It's also possible that the pill is causing your intercourse pain problems. The level of estrogen in some pills causes some women to experience dryness or pH changes that lead to constant low-grade yeast infections. The pain issue might naturally improve after you go off the pill.

If it doesn't, though, some other possibilities are that you might have vaginismus or vulvar vestibulitis syndrome. They're intimidating sounding conditions, but they're both treatable.

Regardless of what birth control method you're using or how much sex you want to have, you really, really owe it to yourself to get the pain issue checked out. Find a gyno who specializes in pelvic pain disorders; the average GP or gyno may not do a good job of diagnosing you or offering all possible treatment options.
posted by thisjax at 1:34 PM on June 29

Buy Taking Chaege of Your Fertility. TTA (trying to avoid) sounds perfect for you guys.
posted by k8t at 1:36 PM on June 29 [1 favorite]

Since you have been on hormones which were not naturally your own for more than a decade, I would expect that you might experience a bit of pill fallout.

My doctor told me, and led me to an article which basically said that being on the pill may make us choose the wrong partners. I am not implying that that is what you did, but there is still a chance that you may go through a myriad of changes after going off the pill. In my own experience, I went off the pill and never got my own period, fell out of love with my boyfriend (bye bye hormones!) went back on the pill, went off it, found out I had PCOS, and am back on.

It may also ramp up your sex drive, so an alternate form of birth control is key. And I n'th the pain is not okay during sex, so perhaps you should go see a good Ob/Gyn to deal with that and make a plan for going off the pill. They can help keep tabs on what's going on, and if things aren't working as they should. If you're in the LA area, I can give you a great recommendation. Good luck!
posted by anniek at 1:37 PM on June 29 [1 favorite]

You're 32 and can write a paragraph. I'm guessing you're smart enough to have regular gynecological exams.

Get another gyno, please. If you don't feel comfortable talking with your gyno about this stuff (most of which has medical answers....rather than the internet opinions you are getting), you need to get one that will be more useful for you.

Good luck.
posted by hal_c_on at 1:44 PM on June 29

There's never a perfect time to have a child. If you and your husband love each other and it won't bring you to complete financial ruin, why not go for it?
posted by inturnaround at 1:50 PM on June 29

I was on the pill for about as long as you and stopped taking it for somewhat similar reasons. It is generally agreed that going off the pill, even after 14 years, won't directly affect your ability to conceive.

Condoms shouldn't be painful, but nonoxynol-9 is evil stuff that makes a lot of women itch madly and dry up. The irritation also seemed to lead to more yeast infections. Try plain, un-spermicided condoms and water-based lube.

Nthing finding a gyn that a) is interested in your sexual health and b) you are willing to talk to about your sexual health.

What can I expect if I go off the pill?

Ovulating is really freaking weird. Hilariously so. I didn't know that my sex drive had really decreased until I went off the pill. A few months later: "what's that weird pinchy twinge and ZOMG why am I so worked up I'd hump this tree if I can justify that it's shaking it's branches provocatively. "

If sex is painful from a lack of natural lubrication, this may be moot after you've been off the pill for a few months. Be aware that if your sex drive does increase, and your husband's does not, you two will have to discuss this discrepancy.
posted by desuetude at 2:25 PM on June 29

I was on the pill continuously for about six years. I had a small pill-free interval before switching to the ring a few months later. I had no ill effects going off and my cycle was back to its normal state in about two months.

You might consider that there are some options that are much lower doses of hormones than the pill, and that you might have no side effects by simply changing the type and levels of hormones. Nuvaring is one (vaginal ring) and Mirena is another (hormone releasing IUD).

If you want a completely hormone-free option that's not condoms and very reliable, a copper IUD is your best choice (one brand name is Paraguard), but they're designed to last 5-10 years. They can be removed sooner than that, but it might not be worth the hassle if you start trying for kids in a year. If you want something more short-term, the cervical cap or diaphragm might be for you, but user error is a much bigger deal with those two methods than with an IUD. If you're bad at taking your pill, you might not do so well with properly fitting a cap every time.

The vast majority of pill users return to a normal cycle within 3-6 mos after stopping, and can get pregnant at that time. It might even be sooner than that, but don't be alarmed if it takes up to 6 mos. Longer than that, and you should talk to a gynecologist.
posted by slow graffiti at 2:42 PM on June 29

Just a personal anecdote: I've tried various forms of birth control and different pills over the 7 years I've taken it.... Different pills have always effected me differently.

I've also regularly stopped taking pills when they weren't necessary, because I don't like feeling that my hormones are being continuously manipulated. That being said, the most recent time that I stopped taking the pill I had much more intense pms and period than I'd had since I'd been on the pill. I began taking the pill again and found my hormonal shifts quite well regulated by the pill itself.

As far as you and your husband's sex life: if you're both happy with your physical relationship I think that is more than ok, there is no normal. On the other hand, I was in a serious ltr where I was always unhappy with the infrequent sexual activity and felt it was a symptom of something else that was wrong in the relationship. I spent some time trying to change things and understand why we rarely had sex and eventually gave up because my partner was not responsive to my attempts. The relationship ended. I don't think, in any way, this is what is going on with you, but I think it's worthwhile to think about if this is a symptom of something else (it was for us). On the other hand, some people just have low sex drives...

Best of luck!
posted by thankyouforyourconsideration at 4:21 PM on June 29

Being on the pill shouldn't affect your ability to become pregnant in the long term. It takes a few months to wear off, but it does wear off.

I think this is a rather dangerous misstatement of the truth. With most modern lower-hormone forms of hormonal contraception, many women get pregnant in the month after they stop using contraception. I have personally known several friends who went off the pill expecting to have a few months before they would get pregnant and finding themselves instead immediately pregnant. My gyn, upon asking her recently what if anything I should know/do before trying to get pregnant said, among other things: "Don't stop using your contraception until you are completely ready to be pregnant".
posted by ch1x0r at 4:38 PM on June 29

FWIW, my wife was on the pill for almost 7 years. She got pregnant two weeks after stopping.
posted by csimpkins at 6:34 AM on June 30

If you stop taking the pill, you can get pregnant the next day.

Yep. That's how I got here. My mum had to wait for the hormones to leave her system for a month or so before she got sterilised; three weeks in she had a 'tummy bug'.
posted by mippy at 8:46 AM on June 30

NB this is one thing that put me off the Pill :)
posted by mippy at 8:46 AM on June 30

>Being on the pill shouldn't affect your ability to become pregnant in the long term. It takes a few months to wear off, but it does wear off.

I think this is a rather dangerous misstatement of the truth. With most modern lower-hormone forms of hormonal contraception, many women get pregnant in the month after they stop using contraception.

I've realized I was basing this claim on the Pill formulation I was taking in 1993, which may indeed have been way stronger stuff. I stand corrected.
posted by EmpressCallipygos at 9:03 AM on June 30

I was on the pill for maybe 15 years before I got off.

I was pregnant within four months of coming off.

I took my basal temp every morning to figure out when I was ovulating. We were trying to get pregnant, so that really worked for us. I read about it in "Taking Charge of Your Fertility." It is a great book if you want to avoid hormonal birth control.

Anyway... when I went off, I guess the biggest surprise was that nothing weird happened. I didn't gain or lose weight, I didn't notice a change in my moods. I did expect my acne to come back, and it did. But a good regimen of presription medications did the trick (I used MetroGel, Ziana and something else to control it topically). The second biggest surprise was that my cycle was something like 54 days long--not the standard textbook 28 day cycle. If you read "Taking Charge," you will learn why/why not the cycles are not 28 days exactly. Nothing was wrong with me, and I conceived within 4 months of stopping the pill. I was amazed at how quickly it happend.

I think you need to talk with the doctor about your pain during sex. It's not supposed to hurt. A good doctor can help you figure out if it's physical, psychological or a combination of the two.

Stress is a big libido killer. Schedule some time to fool around. Enjoy those weekends away every so often. I have a 13 month old now and I would love nothing more than to sneak away to the beach without her.... just my husband... and have a great time. So plan time to be affectionate. Put the cell phones and all business talk aside and just focus on each other for an evening a weekj. See where that goes.

I also think that so long as you are comfortable and secure in your relationship and financially, just jump right in and start trying! There's never a perfect time. But only you and your husband can make this decision.

Good luck!
posted by FergieBelle at 10:43 AM on June 30

It might take months for your cycle to become regular again. During those months, no rhythm method type tracking is going to help you prevent pregnancy since your hormones will be all over the place. Definitely use some other form of birth control if you don't want to get pregnant yet.

After getting off the pill my acne came back, my cramps didn't. Also, once those first few months were over, my periods were almost normal ~25 day cycle, while before the pill it was more of a 21 day cycle with periods lasting 8-9 days, yuck! Supposedly being on the pill suppresses your libido, and once you get off the pill all you want to do is have sex, but I dunno, I'm like that when on the pill too.
posted by KateHasQuestions at 8:16 PM on July 2