Does birth control make you infertile?

A common question we’re asked at our clinics is whether birth control can cause infertility. For that much-needed reassurance, the simple answer is that contraceptives do not make you infertile.

Many people worry and ask things like, can the pill make you infertile or does birth control decrease fertility? The truth is that most contraceptive methods, including the pill, do not have any long-term effect on your fertility once you stop using them.

We understand you may still have questions, so here is everything our fertility experts want you to know about birth control and your fertility.

Understanding birth control methods

If birth control stops you from getting pregnant, could it interfere with your natural fertility? It’s a logical question, and to understand why the answer is no, it helps to know how contraception actually works.

Different types of contraception work in different ways:

• Barrier methods like condoms, diaphragms, sponges or the cervical cap prevent sperm from entering the cervix.

• Short-acting contraceptives, such as the pill, mini pill, patches, or vaginal rings, contain synthetic hormones that stop the release of an egg, prevent sperm from reaching the cervix, and reduce the chances of embryo implantation.

• Long-acting contraceptives like the intrauterine device (IUD), implant or injection work in similar ways to short-acting methods but last much longer.

Some people ask, can the pill make you infertile or does birth control decrease fertility over time? The answer is no. Both short- and long-acting contraceptives are fully reversible and do not cause infertility. Short-acting methods are named as such because they leave your system quickly, often allowing ovulation to resume within days or weeks after stopping.

The main difference is that short-acting methods must be taken consistently, whereas long-acting options like the IUD or implant provide continuous protection for months or years, until removed by a doctor.

How birth control works

Birth control works by delaying your fertility and preventing pregnancy. This means you are still fertile, but contraception temporarily pauses the processes needed for conception. It does not cause infertility, and your natural fertility resumes once you stop using it.

With the exception of barrier methods and the copper coil (non-hormonal IUD), most contraceptives use synthetic hormones such as oestrogen and progesterone to prevent pregnancy. These hormones have a three-fold effect that makes conception much less likely:

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1. They stop the ovaries from releasing an egg during each cycle

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2. They thicken cervical mucus, making it more difficult for sperm to enter the womb

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3. They thin the womb lining, making it harder for a fertilised egg to implant

Some people wonder, can contraception make you infertile or does the pill make you infertile? The answer is no. These effects are fully reversible once you stop taking birth control. However, it can take up to three months for your regular periods and ovulation to return, depending on the type of contraception used.

Learn more about female fertility, including understanding the menstrual cycle and when it’s possible to become pregnant.   

Temporary effects of birth control

The synthetic hormones in contraceptives cause a range of effects – some are desirable, and some less so.  

Alongside the more obvious effect of preventing pregnancy, some people take birth control to help make their periods more regular, manageable or light and to improve hormonal symptoms such as acne.  

The less desired effects of birth control include breakthrough bleeding (spotting), headaches, nausea and weight gain. Though, the NHS states that more evidence is needed on whether these are caused by hormonal contraceptives or other factors.  

The effects of contraceptives are temporary and tend to go away once you stop taking them. This includes their main effect – preventing pregnancy. Sometimes, there’s a delay in your fertility coming back, but things should return to normal after three months.   

Delayed return to fertility after stopping birth control

Some people find that their regular period takes a few months to return after stopping birth control. This is also known as post birth control amenorrhea, which is a temporary side effect of contraceptives.  

With this in mind, you may want to stop birth control three months before trying to conceive. If you’re not quite ready for a possible pregnancy, you can use barrier methods until the time is right.  

Always speak to your doctor before stopping birth control. If your periods haven’t returned regularly after three months, book an appointment with your doctor or a fertility specialist, as you may need a fertility assessment and other tests to find out what’s causing this.  

The only exception is the injection method. It’s not possible to reverse the injection, so you’ll need to wait until it naturally clears from your system. It can take up to one year for your regular cycle to return.  
 

Considerations for long-term birth control users

When worrying about the effect of birth control on fertility, some people wonder whether it makes a difference how long you take contraceptives. Whether you use birth control for one month or ten years, experts advise the same thing, which is that contraceptives won’t make you infertile.  

The main fertility consideration for long-term birth control users is that fertility reduces with age. In theory, you could take contraceptives for decades, but it’s likely that once you stop, natural age-related changes will make pregnancy more challenging.   

Natural family planning methods

Experts wouldn’t usually avoid recommending birth control because of concerns about its effects on your fertility, as there’s little to no evidence to support this. However, there might be other reasons you want to stop or avoid contraceptives.  

Barrier methods and natural family planning are two ways to reduce the chances of pregnancy without taking hormone-based birth control.  

• Barriers, like condoms, diaphragms or cervical caps are 92-98% effective when used correctly every time you have penetrative sex, and can be used with spermicide to increase their effectiveness  
   

• Natural family planning involves tracking the fertile window to avoid sex at times when pregnancy is possible and is 91-99% effective when used correctly 

The withdrawal method (removing the penis before ejaculation) isn’t an effective method of contraception, as sperm can be present in pre-ejaculate fluid.  
 
We always recommend talking to your doctor about contraceptives and family planning methods.