Hand holding birth control pill packet

Puzzled BC-Taker: On birth control

Dear Sexpert,

I’ve been dating my partner for over a year now, but I fear things are not going well, and we are likely close to the end of our relationship. A couple of months into dating, I decided I was ready to begin being sexually active, and I started using birth control pills. My body seems to have adapted well to them, but I am unsure if I should continue using them if my partner and I break up. I’m afraid that if I keep taking them, others will assume it’s because I have already moved on and that I’m seeing other people. What should I do? If I stop taking them, what should I expect? 

— Puzzled BC-taker

Dear Puzzled BC-taker, 

I am sorry to hear that your relationship might be nearing its end. I hope you and your partner ultimately make the decision that is right for you, and if you do break up, do so respectfully.

Regarding your birth control dilemma: birth control pills, also referred to as oral contraceptives, are a reliable, easily reversed form of contraception, but they can also be used for various reasons beyond pregnancy prevention. Oral contraceptives are generally a combination of the hormones estrogen and progestin — two hormones necessary for the sexual development of the female and for the regulation of the menstrual cycle. Consistently taking birth control pills is a reliable form of contraception and can be easily reversed. 

Each different type of birth control pill has a unique dosage of estrogen and progestin. Those with both the hormones estrogen and progestin are known as combination pills. Combination oral contraceptives can be used to treat hormone-related health issues, such as acne, severe menstrual cramps (also known as dysmenorrhea), and irregular menstrual cycles. Birth control pills may even be prescribed to help relieve endometriosis symptoms, a condition during which the tissue that lines the uterus grows outside of it. There are also pills that only contain progestin, colloquially known as “mini-pills.”

Using oral contraceptives can have several benefits besides their main purpose, such as the lessened probability of developing cysts in the breasts and ovaries, and of developing endometrial and ovarian cancers. Of course, this depends on the person and type of combination pill used.  

Evidently, there are several reasons why someone might use oral contraceptives. Nonetheless, there can be a stigma regarding contraceptive use, so your concerns about the assumptions someone may make are completely valid. However, you know your body better than anyone else, and thus should not be afraid of what others may think of your health-related decisions. Of course, that is easier said than done.

The main thing you should consider is your well-being: What would make you feel the most comfortable? If you are not looking to become pregnant, continuing to take birth control may keep your mind at ease. It is important to note that you can become pregnant immediately after you discontinue taking regular or low-dose oral contraceptives, so consider whether you may engage in vaginal sex in the near future before stopping your regimen. Given that oral contraceptives are easily reversible, you can resume taking them at any point (before their expiration date) after stopping, but they may not be effective at preventing pregnancy immediately. Depending on the type of pill, they may become effective only after seven days of usage. If you plan to have vaginal sex, also use a barrier method, like an internal or external condom, to prevent pregnancy.

Something else you should consider before you discontinue taking birth control pills is whether there are additional benefits of using oral contraceptives and how they affect your current lifestyle. Perhaps you are experiencing a lighter menstruation flow and less cramping, which may be a relief, especially in a high-stress environment where you have less time to rest during the day. Ultimately, it is your decision, but those are two factors to consider. 

If you do decide to stop taking the pill, you should expect your menstruation cycle to return to how it was before birth control. This might mean your menstruation flow will become heavier, and you will have more cramping. It might also take a couple of months for your hormone levels to balance themselves, and this readjustment phase may lead to irregular periods. Fortunately, this readjustment phase is based on how long you were on birth control and may last less than three months.

Before making a final decision, it may be helpful to speak with your healthcare provider, or a Sexual Health and Wellness clinician at UHS, to weigh the pros and cons and consider an alternative contraceptive form — for example, an intrauterine device, patch, or hormonal shot. If you would like more guidance but do not feel ready to speak with a professional quite yet, you can schedule a Wellness Chat with a Peer Health Adviser to explore resources and create an “action plan.” Regardless of your decision, remember that there are many resources available to you on campus if you want to talk through your options or simply to have someone listen. 

The Sexpert 

Information in this article is from MayoClinic, Go Ask Alice Columbia University, Planned Parenthood, and Psychology Today.