Let’s bust a birth control myth. A common question WHA providers hear is whether long-term use of hormonal contraceptives—like the birth control pill—affects future fertility. In other words: Can I still get pregnant after using the pill for a long time?

This is a reasonable concern. Many people spend much of their reproductive years trying not to get pregnant and may use contraceptives for a decade or longer.

Contraception is a tremendous health and social benefit. It allows people to delay and plan pregnancy around life, education and career goals, providing freedom and control over timing.

But when you’re ready to start a family, it’s natural to wonder if the length of time you’ve been on birth control makes a difference.

Do birth control pills cause long-term infertility?

The good news: hormonal contraceptives—including the pill, patch, vaginal ring, and IUDs—do not cause long-term infertility. These methods use low levels of hormones (ethinyl estradiol and a progesterone-like medicine) to prevent pregnancy, mainly by changing cervical mucus so it’s harder for sperm to reach the egg. Some methods also stop ovulation.

Once you stop the pill, patch, or ring—or have an IUD removed—fertility typically returns quickly. That’s why we don’t usually recommend stopping contraception far in advance of trying to conceive.

One exception is the Depo-provera shot. It can take up to 18 months for fertility to return after the last injection, though the average is closer to 10 months.

Research shows that hormonal contraceptives are safe and do not harm future fertility. In fact, birth control pills, Depo-provera, Implanon and the vaginal ring may improve fertility by suppressing endometriosis, which can scar the fallopian tubes. It’s still important to use condoms to reduce the risk of sexually transmitted infections, since most hormonal methods don’t provide that protection.

What to expect when you stop birth control

While fertility usually returns quickly, your body’s natural cycle may take time to return to its natural rhythm. You may become pregnant right away, but it’s also common for periods to be irregular for a few months. This happens because the pill creates an artificial cycle; once you stop it, your underlying rhythm—sometimes irregular all along—re-emerges.

Most people return to a regular cycle within about three months, though it can take up to nine months for some. It’s important to remember that birth control does not “pause” the effects of age on fertility. Sometimes, stopping hormonal contraception can reveal underlying cycle issues such as irregular ovulation, polycystic ovary syndrome (PCOS), endometriosis or abnormal uterine bleeding that were previously masked by hormonal contraception.

Statistically, most people under 35 become pregnant within 12 months of trying to conceive. If you’re not pregnant after one year of consistent trying, schedule a visit with your provider. If you’re 35 or older, make an appointment after six months of trying–sooner if you’ve been diagnosed with or suspect PCOS, endometriosis or another condition that could impact fertility, or have a history of irregular periods.

Three things to do before you stop taking birth control

It’s safe to get pregnant as soon as you stop taking the pill or another contraceptive. But giving your body a healthy start can make a difference:

  1. Start a prenatal vitamin. Begin a daily prenatal vitamin with at least 400 mcg of folic acid one month before stopping contraception. This helps prevent certain birth defects.
  2. Schedule a pre-conception visit. Talk with your provider about your health history, review any medications, and make a personalized plan for pregnancy. This visit is also a good time to talk with your provider about any menstrual concerns, such as painful or irregular periods, heavy bleeding or a history of PCOS or endometriosis, which can affect fertility and may guide your care plan.
  3. Review your lifestyle. A balanced diet, regular exercise, adequate sleep, and limiting alcohol, caffeine, or tobacco all support fertility.

How birth control pills affect fertility

Birth control has been life-changing for countless people, offering freedom and control over timing and family planning. It does not decrease fertility and may actually improve it. When you’re ready to try for pregnancy, WHA providers are here to answer your questions, guide next steps and support you in preparing for a healthy start.