Maybe you’ve heard it’s a myth that birth control can negatively affect your future fertility. But while it’s true there are no studies showing that it directly interferes with conception, we also don’t have extensive research on the long-term impact of birth control on women’s health. In fact, there’s a lot we don’t know about fertility in general, let alone the intricacies that may come with using hormonal birth control for a decade or longer! What we do know: Hormonal birth control works by several mechanisms, including shutting down brain-ovarian communication to prevent ovulation, altering the cervical mucus, and thinning the endometrial (uterine) lining. The underlying cause of these symptoms may very well be due to polycystic ovarian syndrome (PCOS), hypothalamic amenorrhea, thyroid disease, or other medical conditions that can lead to difficulty conceiving. This means that if you used birth control for symptom management, then you may find it difficult to get pregnant when you stop. Does this mean birth control causes fertility struggles? No, but it likely prolongs the time it will take women to address their health problems, potentially putting them behind the eight ball when they do eventually decide they want to get pregnant. It’s also important to note that there are women with a history of regular periods who report missing periods within six months of discontinuing hormonal birth control. This symptom has been termed post-pill amenorrhea1. Several small studies4 have shown that women using the pill have lower levels of CoQ10, which can affect fertility. In fact, one study5 concluded that suboptimal CoQ10 levels can cause fertility problems due to the decrease in mitochondrial function, which in turn leads to age-associated egg deficits. As we age, the production of CoQ10 in the body declines and is one factor in the decrease in mitochondrial function in the ovaries. This means that the combination of birth control and the natural aging process can hinder your fertility. If you’re over 35, are a past or current smoker, have a family history of early menopause, or any condition that increases oxidative stress, then hormonal birth control is one more factor that could contribute to these issues by way of lowering antioxidant protection. As a naturopathic physician who helps optimize hormone health after birth control, I advise coming off of birth control a minimum of six months before trying to conceive, with two years being the ideal. This allows time for you to address potential issues masked by birth control, rebuild your nutrient stores, and prepare your body for pregnancy. Wherever you are on your journey with the pill—whether you’re still taking it or have recently stopped—you can begin to implement the following steps to improve your fertility now. It takes 90 days for the egg you ovulate to mature, so what you do today can help your eggs in future cycles.
