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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

.

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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kwajmamasita kwajmamasita 6 years
DrSugar, thank you so much for posting this piece and commenters, thanks for your posts. It's really nice to learn about every one's experiences coming off the pill and trying (or not) to conceive.
chloe-bella chloe-bella 6 years
Wow, congratulations Runningesq!!! I'm still years away from having a child, but I just found it really interesting, because I had never heard of people who aren't anorexic and/or elite athletes having to gain weight to get pregnant. After all, Paula Radcliffe and Kate Moss both managed to get pregnant while having about 0% body fat! Also, one of my law school classmates got pregnant (unintentionally) while she was on the pill, after being on it for about 10 years. In fact, she took the pill daily for the first 6 months of her pregnancy because she didn't know she was pregnant. I'm not saying this to contradict Dr. Sugar's observations, but just to point out that it's possible so that people who read these infertility stories don't get a false sense of security.
lawchick lawchick 6 years
My doctor said the only ill effect the pill would have on TTC was that it could take up to 6 months for my cycle to return to normal. It never returned to normal, though, and it's been a year and 6 months now. I don't have any reason to believe that is the fault of the pill. My body just isn't ovulating regularly (without clomid). I did just gain 6 pounds in the hope that would help. I wasn't underweight before (99 lbs at 5'2" before), but I was at the bottom of the acceptable weight range. We'll see in a couple of weeks if this has helped. Good luck to you, and everyone else TTC.
runningesq runningesq 6 years
Chloe -- I went off the pill right after my Ironman and got pregnant 2 months later. (I know one person's story isn't scientific evidence, but I just wanted to share!)
dannysf dannysf 6 years
Thanks Dr. Sugar for sharing your story. I've had many friends who have had a hard time getting pregnant after many years on the pill. One in particular who was told by her doctor to gain a little weight and exercise less - like you. I'm sending this article to her now!
GlowingMoon GlowingMoon 6 years
I identify with DrSugar about maintaining healthy habits for some (healthy) weight gain. I decided to gain some weight for appearance reasons. I was tired of being mistaken for a high school student, as I appeared somewhat scrawny for a grown-up woman (I was a little underweight for my height and body-type). Like DrSugar, I adopted a less strict diet, and lowered my exercise to a moderate level. Now I weigh in the middle end of the healthy weight range. As far as my monthly cycles, there were no changes at all. I was still regular as rain. I still ovulated every month (yes, I do know when I ovulate. My body lets me know). Thus, I think there is a healthy way to gain weight (and still be fertile).
chloe-bella chloe-bella 6 years
Dr. Sugar, I personally am glad you shared your story! I think some people were expecting a more clear-cut "yes or no" answer regarding whether the pill affects fertility. It wasn't clear whether your issues were caused by the pill or by one of the other conditions you discussed. While the other information may not have been specifically on-point to that issue, I thought it was very informative and interesting. Also, I wasn't accusing you of adopting an unhealthy lifestyle. I just was intrigued by your statement that you HAD (past tense) an active healthy lifestyle and was wondering how drastic of a change you were making. It sounds like you still are active and healthy, just at a lower intensity, which answers my question. I'm also on the low-end of the BMI spectrum, so I found it interesting.
DrSugar DrSugar 6 years
Hello all, I apologize if I did not fully address the question. I did address what to expect coming off the pill in a recent column that discussed what can happen in terms of your ovulation, which is what is important in trying to conceive. There is a link to that column in the beginning of the post. To address some of your comments: Chloe Bella: I did not adopt unhealthy habits in order to gain weight. I merely stopped eating such a strict healthy diet and changed my exercise to a more moderate level. I continue to eat healthy and exercise on a regular basis. I was just at the lower end of the healthy weight for my height and my gynecologist said it wouldn't hurt if I gained some weight. Sarah Bee: I was not on the pill for PMDD, I was simply on the pill for contraceptive reasons. Again, I'm sorry that so many of you are upset with my column and perhaps the headline was a bit misleading. I spent a lot of time doing research and writing and feel that this column was not a waste of my time or yours. I hope you will all continue to read my columns and I will spend more time on completely answering the question and less time sharing my personal stories and taking the opportunity to discuss a larger problem.
Fitness Fitness 6 years
Sorry, guys, you are right. The headline "Can birth control pills affect fertility?" was probably a bit misleading. The reader was asking about how birth control might affect one's ability to conceive, and DrSugar took it as a great opportunity to discuss larger fertility issues. Sorry for the confusion. I have changed the headline. I hope you learn a lot from the column!
1apple 1apple 6 years
PS All the best to you Dr. Sugar! Hope it happens very soon for you.
1apple 1apple 6 years
This doesn't quite relate to the question, but for anyone out there who might think that when they go off the pill they'll get pregnant right away...that really might not be the case...I went off at age 28 (9 months ago) and we're still trying. This seems to be the case with most of my friends as well, that it takes a bit of time to conceive.
sarah-bee sarah-bee 6 years
I agree with Anonymous: this piece didn't answer the question at all. Also, she was on the pill for 12 years but why was she on it? Was she purely trying to prevent pregnancy or, like me and several of my friends, was she on the pill to treat symptoms of some condition like pelvic inflammatory disease or PMDD? I appreciate her opening up but I was really hoping for an answer.
chloe-bella chloe-bella 6 years
Does having a "healthy, active lifestyle" adversely impact one's fertility? I know that's the case if someone's anorexic or an Olympic athlete. But does the average person who exercises moderately and eats a healthy diet need to adopt un-healthy habits and gain weight in order to increase fertility?
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