Perhaps you’ve been on birth control for more than a decade, and now you’re worried that long-term use of “the pill” might harm your chances of getting pregnant in the future. Unfortunately, many misconceptions about birth control continue to circulate by word of mouth and online, and we’re here to set the record straight.
Can birth control make you infertile?
Generally, the answer is no. While birth control can prevent pregnancy while you’re on it, most forms of birth control don’t harm your future fertility. This tracks with the broader research: to date, there is no evidence that the pill or other hormonal contraceptives have a long-term negative impact on fertility, and pregnancy rates among women who have used hormonal contraceptives are similar to those who have never used them. It is important to know, however, that if you had irregular periods before you started birth control, those irregular cycles can return once you stop birth control.
Types of birth control
Here’s what you need to know about different forms of birth control and how they each impact your fertility.
Birth control pills, patches, and rings
Birth control pills (BCP) or oral contraceptives are the most common method of contraception. Depending on the type of BCPs prescribed, they work to prevent pregnancy by impacting ovulation, causing changes to your uterine lining or cervix, or preventing sperm from fertilizing the eggs. Birth control patches and rings work similarly to the pill, and your cycle should return soon after their removal.
BCPs have additional benefits that can help preserve fertility, which include:
- Minimize the risk of ovarian cysts
- Help relieve pain from endometriosis or prevent endometriosis from developing or getting worse — in fact, oral contraceptives are often considered a first-line treatment for both endometriosis and severe menstrual pain (dysmenorrhea)
- Reduce the risk of ovarian cancer — research has found that being on hormonal contraceptives for five years or more can reduce the risk of ovarian cancer by nearly 50%, and a 2018 study in JAMA Oncology found that the pill dramatically reduced the likelihood of developing endometrial and ovarian cancers, serving as a preventative treatment
- In patients with polycystic ovary syndrome (PCOS), oral contraceptives can also help control irregular periods and decrease elevated testosterone levels that contribute to excess hair growth and acne
Implants and injectable birth control
Contraceptive implants use a small flexible rod implanted in your upper arm to release progestin, a synthetic form of the hormone progesterone, which is slowly released into the body. The hormones cause the cervical mucus to thicken and thin the endometrial lining. Fertility returns within a few weeks to a month after removing the implant.
Depo-Provera, also known as the “birth control shot” or “depo shot,” is given by injection every 3 months and works by suppressing ovulation and thickening cervical mucus. Generally, most women will stop having regular periods while on Depo-Provera. Once you’ve stopped taking Depo shots, it can take several months to a year before your menstrual cycle resumes and allows you to conceive naturally, but it doesn’t impact your long-term fertility.
Intrauterine devices (IUDs)
IUDs are a highly effective and relatively safe form of birth control. Hormonal IUDs release progestin, which impacts ovulation and fertilization, and many women with an IUD will also stop having periods. Hormone-containing IUDs can also help decrease excessive uterine bleeding and have been shown to reduce painful symptoms associated with endometriosis. Copper IUDs (ParaGard) contain no hormones and work by creating an inhospitable environment in the uterus, preventing fertilization and implantation from taking place. IUDs and hormonal BCPs work similarly in how soon ovulation returns after stopping.
Since IUDs are inserted through the vagina into the uterus, there’s a slight risk of pelvic inflammatory disease. While rare, it’s possible for an infection to spread and cause inflammation, scarring, and/or blockage in your reproductive organs, such as your fallopian tubes. Tubal scarring can block the tubes, preventing eggs from traveling to the uterus. Individuals who have damage to their fallopian tubes are also at risk for ectopic pregnancy.
Barrier methods
Condoms, diaphragms, and spermicide are examples of barrier methods of birth control and don’t use hormones to prevent pregnancy. Instead, they physically block sperm from reaching the egg. Therefore, discontinuing the use of these not only poses no risk to your future fertility, but you can also begin trying to get pregnant right away.
Condoms can help protect your fertility by reducing the risk of sexually transmitted infections (STIs). If left untreated, chlamydia and gonorrhea can spread to the uterus or fallopian tubes. This can cause pelvic inflammatory disease (PID), which can lead to inflammation, scarring, and blockage in your reproductive organs, such as your fallopian tubes.
When to see a fertility specialist
If you’re trying to get pregnant after stopping birth control and don’t conceive after a year (or six months if you’re over age 35), we recommend meeting with a fertility doctor. Infertility affects about 1 in 8 people worldwide, and men and women experience fertility issues at roughly equal rates, so it’s important that both partners undergo an evaluation to help identify the underlying cause. If you have risk factors such as irregular cycles, a history of pelvic infections, fibroids or endometriosis, or prior chemotherapy or radiation treatment for either partner, it’s worth coming in sooner.
Make an appointment with one of our CCRM Fertility specialists today.
