Menstruation after the pill

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Maybe you’ve decided it’s time to have a baby. Or, you’re just ready to be off contraception. When you go off the pill, you expect your menstrual cycle to get back to normal; but what happens when your cycle doesn’t start?

Post-pill amenorrhea 
This condition is a lack or delay of menstruation after you’ve stopped using a birth control pill. It might carry on this way for up to six months. In most cases, the effect is temporary and your cycle may return on its own after a couple of months.

Causes
Birth control pills supress your pituitary gland. This little part of your body is about the size of a pea, but it plays a vital role in regulating body functions. This gland produces hormones, like the follicle-stimulating hormone (FSH), and luteinising hormone (LH). These hormones get the follicles in the ovary to develop. Ovulation doesn’t happen without FSH and LH, which is how pregnancy is ultimately prevented. The pill stops your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it may take some time for your body to return to normal production of these hormones. When you take birth control pills for a long period, the negative feedback to the pituitary gland may continue even after you’ve stopped taking the pill.

What can you do about it?
Technically, this isn’t a medical condition, but if you don’t get your period within the first three months, take a pregnancy test or go see a doctor. Once you stop taking the pill, your ovaries take about two weeks before the process of ovulation starts again and normal menstrual cycle restarts after a few months. Sometimes, post-pill amenorrhea may be referred to as irregular and light periods, rather than the lack of menstruation; although the cause remains the same.

Can I get pregnant after stopping the pill?
Research suggests that most of the time, birth control doesn’t necessarily have a negative impact on fertility. Many women go off the pill and conceive on the very first cycle. Your body will gradually begin to get back to its normal state. The good news is that you can get pregnant during your first cycle after stopping the pill.

When do I see the doctor?
The time limit to get your period may vary; it could be between six to nine months. See your doctor if you’re anxious and the wait feels too long. He may advise an active treatment that can be started as soon as possible. He may prescribe Clomiphene Citrate. This is a medication that’s used to treat infertility in women who don’t ovulate. It works by stimulating your pituitary gland to produce FSH and LH. There are other medications available that your doctor may prescribe too.

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