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How Taking Birth Control Can Affect Trying to Conceive

DrSugar Answers: Birth Control and Trying to Conceive

DrSugar is in the house! And she's answering your health-related questions.

DrSugar,
I just read your post about getting off of the pill and having irregular periods afterward. I am thankful for your article as I had experienced two to three months of no period! I am looking to conceive possibly in the next three to four years and wondering if you were able to do so after being on the pill for an extended period of time . . . I understand that irregular ovulation will certainly make conceiving more challenging but I'm interested to know your experience with this. Thanks!
Baby on the Brain

I received this question from a reader after my recent post on what to expect when stopping oral birth control pills. I thought it was a great topic to discuss, and I will also share my personal, ongoing struggle with trying to conceive, so read more.

Assuming you have started menstruating again, it will be important for you to start keeping track of your cycle lengths. Because you are interested in conceiving in about three to four years, this gives you a long period of time to determine if there are any problems with irregular ovulation and menstruation. Should you determine that you have irregular ovulation, you should consult with a gynecologist or your primary care physician to determine the cause.

First and foremost, infertility is a very common problem. According to the Centers For Disease Control and Prevention, about 10 percent of women in the United States ages 15 to 44 have difficulty getting or staying pregnant. But infertility is not always a woman’s problem. According to the Mayo Clinic, in about 20 percent of cases, infertility is due to a cause involving the male partner.

For women, the most common causes of infertility include fallopian tube damage or blockage, endometriosis, ovulation disorders, polycystic ovarian syndrome (PCOS), early menopause, or benign uterine fibroids. Fallopian tube blockage or damage usually results from inflammation of the fallopian tube; chlamydia, a sexually transmitted disease, is a common cause. Endometriosis occurs when uterine tissue implants and grows outside of the uterus, often affecting the ovaries or fallopian tubes; the condition can lead to chronic pelvic pain and infertility. Ovulation disorders generally include problems that affect the hormones involved in ovulation. This can include injury or tumors of the pituitary or hypothalamus in the brain or excessive exercise and starvation.

Polycystic ovarian syndrome (PCOS) develops when a woman’s body produces an excess of male hormone (testosterone), which in turn affects ovulation. Early menopause (or premature ovarian failure) is the absence of menstruation and the depletion of ovarian follicles before the age of 40. Other causes of infertility in women include thyroid problems, cancer and its treatment, excessive caffeine intake, and medical problems such as diabetes and kidney disease.

There are a number of risk factors that can contribute to infertility. Age is an important factor. According to WebMD, the number of infertile couples rises with increasing age. The chances of having a baby decrease by three to five percent per year after the age of 30. The reduction in fertility is seen to a much higher extent after age 40. Tobacco smoking can also affect fertility in both males and females, and among American women, infertility is often due to a sedentary lifestyle and being overweight. Conversely, women who are underweight (especially due to eating disorders) are also at higher risk for infertility. Too little or too much exercise has also been shown to increase the risk.

Whew. I know that was a lot of information all at once, so I’ll slow things down and share with you my journey with trying to conceive. I'm 31 and I was on the pill for 12 years. I stopped the pill about one and a half years ago as my husband and I were hoping to begin trying to conceive. After I stopped the pill, I had very irregular cycles that were five to 12 weeks in length. I finally decided to see a doctor about nine months after stopping the pill. After lab tests and a pelvic ultrasound, I was diagnosed with oligo-ovulation (which means that I did ovulate, but it was a rare occurrence). My lab tests showed a slightly elevated testosterone level, and the pelvic ultrasound revealed possible PCOS.

Although my gynecologist did not feel that I truly met the diagnosis for PCOS, he prescribed a common medication for women who have PCOS. I was started on Clomid, which stimulates ovulation by causing the pituitary gland to release the hormones needed for egg growth. I have been on this medication for the past four months, three of which have resulted in ovulation. I have also modified my lifestyle by gaining some weight (I always had a very healthy diet and active lifestyle), stopping caffeine intake, and undergoing acupuncture not only for fertility but also to reduce stress. I remain hopeful that I will conceive in the near future.

I encourage any of you who are thinking of or are already trying to conceive to see your primary care doctor or gynecologist for preconception evaluation and planning. Also, if you have been trying to get pregnant for six months or longer, it is recommended to seek consultation for evaluation and workup.

Have a question for DrSugar? You can send to me via private message here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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