This is an extremely common question in my practice: “How soon before trying to conceive should I go off birth control?” My recommendation is to give yourself at least 3 months off of hormonal birth control for optimal fertility and a healthy pregnancy. Here are the reasons why:
1. Hormonal birth control depleted B-vitamins, as well as zinc and magnesium. Most of us aware of the enormous need for folate in pregnancy to prevent neural tube defects in babies, so going straight from a nutrient-depleted state to pregnancy could increase your risk. The other reason this is important is that many women (up to 30%) carry defects in their methylation pathways, which affects how they utilize folate, and how they absorb folic acid. These women are at particular risk of folate deficiency in early pregnancy. (See my article on Methylation here). During your three months off hormonal birth control, start taking prenatal vitamins, especially ones that contain the activated form of folate called 5-MTHF. It is very important that you take high quality prenatal vitamins for at least 3 months prior to conception, to prevent any deficiencies that may be harmful to your pregnancy.
2. It may take some time to regulate your menstrual cycle. It may take several months to get back to your normal menstrual cycle, and it is not unusual for it to take three months or even more to menstruate at all, especially if you have had any issues with irregular periods in the past. Give yourself time to get your body back into optimal hormonal balance, without the added stress and pressure of wanting to get pregnant right away. There are many Naturopathic treatments that can help regulate your menstrual cycle, ranging from diet changes and herbal supplements to acupuncture.
3. Your uterine lining may be thinner after many years on the pill. A study from 2012 found that women who were on birth control pills for 10+ years had a higher likelihood of having a uterine lining that was too thing for conception (less than 0.7 mm). Signs of a thin uterine lining could be a very light menstrual cycle, even after coming off the pill. (Talukdar N, Bentov Y, Chang PT, Esfandiari N, Nazemian Z, Casper RF. Effect of
long-term combined oral contraceptive pill use on endometrial thickness. Obstet
Gynecol. 2012 Aug;120(2 Pt 1):348-54.)
If you are planning to try to conceive soon, remember to give your body some time to regulate, and also to correct for any nutritional deficiencies. This is one simple way to reduce your chance of pregnancy complications.