What does taking the pill for a long time do to your hormones when you stop?
After stopping the pill, your hormone balance generally recovers within a few weeks to months, regardless of how long you have been taking it. If you experience complaints such as high blood pressure, migraines, or persistent cycle problems after stopping, it is wise to discuss this with your doctor.
Women who stop taking the pill see their hormone balance recover fairly quickly. In a small study (six participants), the first ovulation-related hormone peak occurred as early as 21 to 28 days after the last pill. After that, all hormone levels were indistinguishable from those of women who had never used the pill. How long you have been taking the pill makes no difference in this regard.
The picture is similar when it comes to fertility: during the first three cycles after stopping, conception may get off to a slightly slower start, but in the longer term there is no reduced chance of pregnancy. Here too, the duration of pill use had no effect on the likelihood of becoming pregnant.
The pill can raise blood pressure in a small group of women. If you suffer from high blood pressure, this deserves extra attention. The good news is that blood pressure and the associated risk of cardiovascular disease return to normal within about three months of stopping.
Androgens (hormones that can be thought of as 'male' hormones) actually decrease during pill use, which reduces acne in some people. After stopping, androgen levels can therefore rise again; whether you notice this depends on your personal hormone levels before you started. The story is more nuanced for thyroid hormones: measured blood levels rise during pill use, but the thyroid itself does not work harder. This is because the transport protein for those hormones also increases. What exactly happens to those levels after stopping has not been measured in the available studies.
Headaches and migraines are linked to hormone fluctuations in some women, both during use and during the pill-free week. That pattern can change after stopping the pill, although the evidence for this is limited. Severe cyclical breast pain can improve after stopping the pill; this is even recommended as an early treatment step, although there are no hard figures on how large that effect is.
Based on a small observational study (n=6) for hormone synchronisation, a clinical study on fertility after stopping ethinylestradiol/dienogest, a moderate review on blood pressure and cardiovascular risk, and limited narrative reviews for migraine and breast pain. No large RCTs are available for the recovery of hormone balance.