Karen’s Free Health and Fitness Tips

If you are on the birth control pill, the first step in trying to get pregnant is to stop the pill. After all, the pill works by preventing ovulation, and you need to ovulate first if you want to get pregnant.

But what’s going on if you stop the pill and you don’t get your period for some time? Is there something wrong?

Missing your period is also called amenorrhea. And the very first thing that comes to mind when you don’t have your period if you could be pregnant.

Even without getting your period first there might be a chance you are pregnant. Taking a pregnancy test will pretty much tell you whether your are pregnant or not. A negative pregnancy test, especially if it’s repeated over a week or so, usually means that you are not pregnant.

But is there anything wrong if your period hasn’t come for 2-3 months after stopping the pill? And when should you see your doctor?

First of all let me reassure you. The sort of delay you’re experiencing after going off the pill is quite common and here’s what’s going on:

Combined contraceptives, containing both estrogen and progesterone, are the most commonly used oral contraceptives. They prevent ovulation by maintaining certain hormone levels and suppressing other natural hormones that would otherwise stimulate the ovaries to ripen and release an egg. By taking combined oral contraceptives, you prevent an egg from developing, or being released, for that cycle.

While a woman is on the pill, the menstrual period doesn’t come - as it usually does, as a result of ovulation - but because of the sudden decrease in hormone levels during the one week per month when the pills she takes are placebos, when they don’t contain any hormones.

Because their cycle is controlled by the pills, women taking oral contraceptives are used to getting regular menstrual periods every 28 days.

When you stop taking the pill entirely, the constant hormone level that suppresses ovulation stops. Your body has to start its own hormone production and may sometimes need some time to regain its normal rhythm. The ovary itself has to get ready so that an egg can mature and can be released.

While there are several hundred thousand eggs in the ovaries ready to mature, they may need some time before your first new ovulation.

Your regular menstrual period is usually the result of ovulation, not the other way around.
Menstrual bleeding usually results from a decrease in natural hormone levels about 14 days after the ovulation, if you’re not pregnant. The average woman takes one month to three months to start ovulating again after stopping the pill. Sometimes ovulation may occur sooner; other times, it may take longer. So the first sign that your ovulation has returned is usually the reappearance of your regular menstrual cycle, a couple of weeks after ovulation.

“Post-pill amenorrhea,” the absence of a menstrual period after you stop the pill, is seen in about one in 30 women after they stop the pill. Until you start menstruating regularly, it’s going to be difficult to tell exactly when you’ve ovulated, unless you start checking for other signs of ovulation.

To improve your chances of predicting the day of ovulation, you may want to do the following:

Use a basal body temperature thermometer and create a temperature chart Check your cervical mucus for signs of ovulation Add an ovulation-prediction kit (OPK)

You might want to have sex regularly, once a day or every other day, around the time you think you might be ovulating or when the ovulation-prediction kit shows you are about to ovulate, just to make sure you don’t miss the important day of ovulation.

If your menstrual period doesn’t return, or if it continues to remain very irregular for several months, that may be a sign that you haven’t started ovulating regularly yet.

If your menstrual cycle has not returned by three months, or more, after you stop the pill, you probably want to see your Ob-Gyn and discuss what to do next.

By: Amos Grunebaum

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