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. But we understand that you may have more queries beyond this, 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 birth control works.  

Types of contraception work differently:  

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

• Short-acting contraceptives like the pill, mini pill, patches, or vaginal rings contain synthetic hormones to prevent egg release, sperm entering the cervix, and embryo implantation  

• Long-acting contraceptives like the intrauterine device (IUD), implant, or injections have similar effects to short-acting methods but last longer 

Short-acting contraceptives are named as such because they clear from your system quickly. Both short and long-acting contraceptives are reversible, and they won’t affect your fertility.  

The difference is that short-acting methods need to be taken regularly, whereas the IUD or implant are effective for many months or years until they expire or are removed by your doctor.   

How birth control works

Birth control delays your fertility and prevents pregnancy. This means that you’re still fertile, but the contraceptive puts things “on hold” to delay the possibility of getting pregnant.  

Other than barrier methods and the copper coil, contraceptives use synthetic hormones such as oestrogen and progesterone to prevent pregnancy. These have three-fold effects that, together, significantly reduce the chances of getting pregnant. 

1. First, it stops the ovaries releasing an egg each cycle.  
    

2. The cervical mucus gets thicker, meaning sperm can’t enter the womb as easily. 
    

3. And, if both of these aren’t enough to prevent fertilisation, it also thins the womb lining, which prevents any unlikely embryos from implanting. 

These are all reversible once you stop taking contraception, which is why there are no long-term effects on fertility caused by birth control. Though, it can take up to three months for your regular periods to come back.  

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.