When it comes to understanding how hormonal birth control affects fertility — or if it does at all — there is a lot of confusion. A quick internet search can leave you scratching your head, still unclear on whether it is, in fact, something you should be worried about. All of the speculation aside, there have been several studies conducted on the non-contraceptive side effects of oral birth control.
While there’s no black and white answer here (every woman has the potential of being affected differently by the hormones found in birth control), the majority of research confirms that long-term use of the Pill does not hurt fertility.
Still, you may have lingering questions about how birth control affects fertility. Let’s take a look at what the research says.
1 Oral contraceptives can delay fertility
Hormonal birth control prevents pregnancy in a few different ways. Primarily, they prevent ovulation by stopping the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The hormones present in the Pill — estrogen and progesterone — also make the uterine lining thinner (and thus unable to host a fertilized egg) and cause the cervical mucus to thicken, making it difficult for sperm to move through the female reproductive tract.
Whether you’ve been on the Pill for 1 year or 12 years, when you stop taking it your body needs time to reset back to it’s natural hormonal balance and begin to ovulate. The good news is that, while there can be a delay between stopping birth control and getting pregnant, it’s temporary. In fact, this study found that the “12-month conception rates in former OC [oral contraceptive] users range from 72% to 94% and are similar to those observed in women discontinuing intrauterine devices, progestin-only contraceptives, condoms, and natural family planning.”
Even more interestingly is the results of this study which claim that the longer you take oral contraceptives, the less delayed your conception could be.
So, yes, oral contraceptives can delay fertility but your odds for becoming pregnant, if there are no underlying fertility issues, are great.
2 Hormonal birth control may cover up underlying fertility issues
Pregnancy prevention is far from the only reason that so many women turn to hormonal birth control. The combination of estrogen and progesterone has been shown to help other reproductive issues like endometriosis, polycystic ovarian syndrome, PMS, and irregular menstrual cycles. While the use of contraceptives like the Pill can be a great way to manage symptoms, it can also act as a band-aid that covers up reproductive disorders that greatly impact a woman’s ability to conceive. On the flip side, some research has led doctors to believe that women with endometriosis should take the Pill because it can prevent abnormal menstruation which, in turn, could lead to infertility.
If you started birth control as a way to manage painful or irregular periods, it’s important to have a conversation with your doctor about what to do next. Having these issues do not necessarily mean you can’t get pregnant but they could be the source of your fertility problems — not your birth control. The sooner you identify the reason for fertility issues, the easier it may be to overcome.
3 The Pill can protect against gynecological cancer
Though ovarian cancer is not as common as other types of cancer and is usually found in women who have reached menopause, the impact on fertility for women of childbearing age is high. Because you must ovulate to get pregnant, damage to your ovaries could prevent pregnancy entirely (though it’s important to know that it is possible to get pregnant with one ovary). Likewise, endometrial cancer can cause infertility. The treatments for any type of cancer have the potential to impact fertility in both the short- and long-term. The good news? Oral contraceptives can prevent these types of gynecological cancers.
In a recent article, Dr. Lisa Iversen explains, “What we found from looking at up to 44 years’ worth of data was that having ever used the pill, women are less likely to get colorectal, endometrial and ovarian cancer. So, the protective benefits from using the pill during their reproductive years are lasting for at least 30 years after women have stopped using the pill.”
For women who have family histories of ovarian or endometrial cancer, the Pill could be not only life-saving but fertility-preserving.
What does all this mean for you? Simply that taking oral birth control shouldn’t impact your fertility. If you’re struggling to get pregnant after going off the Pill, you and your doctor should begin exploring why. It’s likely that the birth control isn’t the culprit but, instead, that there is an underlying fertility issue. Knowing what is not causing infertility is an important step in the right direction. The process of elimination can encourage your doctor to search for other possible reasons, allowing you a more in-depth look into your fertility — and all of the treatment options available.