Birth Control and Infertility

According to the World Health Organization birth control is used by more than 800 million women around the globe. Beyond contraception, hormonal birth control is used for the treatment of many gynecological and medical conditions. The Guttmacher Institute reports that the average U.S. woman uses contraceptives for 30 years to attain her family planning goal of two children. But what happens when a couple starts efforts to have children or expand their family? Does birth control affect the women’s body’s ability to conceive and carry to full term? 

The World Health Organization (WHO) recently reported that about one in six persons in adulthood has experienced infertility at least once in their life. Infertility is defined as the inability to conceive within one year, or not being able to carry a pregnancy to term. Infertility may occur in a couple’s first attempts to bring a child into the world, or as secondary infertility when they have successfully given birth before, but are not able to carry to term again.

Does the use of hormonal contraception contribute to the burden of infertility? Popular sources throughout the internet give assurance that most birth control does not affect future fertility. However, sources have indicated otherwise. Why do some couples struggle to get pregnant after stopping birth control? We have more questions than answers.

Pregnancy depends on many factors. A hormonal balance of estrogen and progesterone are among the most important factors. Oral contraceptive pills are a combination of synthetic estrogen or progestin. In a woman using hormonal contraception, her pituitary gland is unable to release follicle-stimulating hormone and luteinizing hormone affecting the development of the uterine lining, cervical mucus production, and the development of healthy eggs. Prolonged use of birth control pills is associated with temporary impairment to the ovulatory event. This negative impact on hormonal balance could prevent future pregnancies. It will take time to heal. Once a woman stops taking the pill, regularizing the menstrual cycle may take almost three to six months, depending on the age and the woman’s individual response to artificial hormones. 

Some negative effects of the use of hormonal birth control are related to menstrual bleeding. After a woman stops the pill she can experience extremely heavy blood flow, significantly less blood flow, or no flow at all. This irregularity of the menstrual cycle can cause temporary difficulty in conception. One explanation for menstrual irregularity is the fact that long-term use of combined oral contraceptive pills is associated with adverse endometrial growth. Embryo implantation depends on endometrial thickness. A thinner endometrium after using the pill for more than five years can make it difficult to achieve and carry a pregnancy to term. 

The use of oral contraceptives also impairs the production of cervical mucus. The presence of cervical mucus is essential to achieve pregnancy, indeed pregnancy cannot occur without the presence of healthy cervical mucus. A study published in the Journal of Women’s Health reported that the women who had recently stopped oral contraceptives had lower mucus quality for the first two cycles.

Another issue after stopping birth control is the nutritional deficiencies caused by artificial hormones.  Birth control causes nutritional deficiencies due to its impact on liver function. The low nutrient status after contraception has been associated not only with fertility problems but also with low nutrient status in the fetus. The pill has been associated with a number of nutrient deficiencies including vitamin B6, magnesium, vitamin b12, folic acid, vitamin C, and zinc. After stopping the use of hormonal birth control the level of vitamin D drops.  Also, a recent review reported that birth control pills may exacerbate Insulin Resistance. This condition increases inflammation and contributes to infertility experienced by women, especially if they suffer from PCOS. Insulin resistance can lead to pregnancy loss due to inadequate nutrition and support of the growing embryo.

In sporadic cases, infertility is permanent which may be due to some pre-existing conditions as well. Therefore, women who stop using contraception need to give time to the body to heal and get adequate nutrition. A consultation with health care provider is recommended to evaluate the status of the hormonal imbalance, nutritional deficiencies, and restoration of the fertility cycle.


Effect of long-term combined oral contraceptive pill use on endometrial thickness – PubMed (

Characteristics of the menstrual cycle after discontinuation of oral contraceptives

The Impact of Combined Hormonal Birth Control on Insulin Sensitivity and Inflammation – FACTS (

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