When to start birth control: Everything you need to know

    Updated 19 January 2023 |
    Published 22 September 2022
    Fact Checked
    Medically reviewed by Dr. Jennifer Boyle, Obstetrician and gynecologist, Massachusetts General Hospital, Massachusetts, US
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    Whether you’ve just had sex for the first time or just had a baby, it can be hard to know when to start using birth control and which option is best for you. Here, an expert explains what you need to consider before starting birth control.

    It can be difficult to know when to start birth control. You might be starting to think about having sex and want to protect yourself. You may have used birth control before but have taken a break. Or perhaps it’s been recommended as a solution for other conditions, like acne or PCOS. 

    First things first, it’s really important to remember that everyone is different. “There’s no wrong time” to start birth control, says assistant professor of obstetrics, gynecology, and pediatrics, Dr. Beth Schwartz. “It depends on what you’re using it for and when it can be helpful.” You can find out more about the different types of birth control using an app like Flo. 

    It’s estimated that 72% of women in the US will use more than one type of contraception in their lifetime, with people trying an average of three different methods. Just because your loved ones use one type of birth control or a method worked for you in the past doesn’t mean you have to use it now. There are so many different options. 

    Here, a Flo medical board member answers questions on when you might want to consider starting to use birth control, from when you first become sexually active to just after you’ve had a baby.

    When to start birth control: You’re thinking about having sex for the first time

    Dr. Schwartz highlights that many people start thinking about using birth control when they’re considering becoming sexually active. “A lot of my patients haven’t had sex yet but are dating somebody or are thinking about it or just want to be safe before they go to college, for example,” she says. 

    The thought of speaking to your family health care provider about sex and contraception might sound like a less-than-appealing activity to you, but don’t be nervous. It’s empowering that you’re taking a step to protect yourself and any partners. If you’d like some backup and support during your first appointment, consider reaching out to a trusted friend or loved one.  

    At your appointment, your health care provider will likely ask you about your medical history, any sexual experiences you’ve had before, and the relationships you’ve been in. They will also ask you when you had your first period, how regular your periods are, and if you experience any symptoms during your menstrual cycle (cramping, mood changes, or headaches, for example.) 

    You don’t need to come to the appointment 100% sure of which method you want to use as your health care provider should be able to give you lots of helpful information. But if you’d feel more comfortable looking at your different options beforehand, they’ll be able to answer any questions you might have. They may even suggest a method that sounds great for you that you hadn’t considered before.

    It’s important to note that barrier methods of birth control, like condoms, are the only method of contraception that can protect you from sexually transmitted infections (STIs). And if your only experience with learning about STIs is the awkward “talk” you received in school, then don’t worry. Your health care provider will be able to explain anything you don’t understand. 

    If you feel uncomfortable at any point, know that you’re well within your right to stop the appointment or ask your medical professional why they are asking you certain questions.

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    When to start birth control: You’ve stopped taking birth control, but you want to start again

    There are several reasons why you might stop taking a particular type of birth control. You might have experienced negative side effects associated with your current method of contraception. Alternatively, you might be struggling to access the birth control you’re currently using in the place you live. If you’ve stopped taking birth control but want to start again, then it’s really important to contact your health care provider as soon as you can. 

    And it’s so important to remember that everyone is different, and there is a right birth control choice out there for you.

    "I do hear a lot of my patients saying that they want to be off something and give their body a break, but there’s really no medical reason to do that."

    “We usually recommend that people switch from one method to another one with no break in between,” says Dr. Schwartz. “Because that way, you’re not leaving yourself exposed to potential unplanned pregnancy, and you’re not letting the medication wear off.” 

    She continues: “I do hear a lot of my patients saying that they want to be off something and give their body a break, but there’s really no medical reason to do that.”

    You’ll know the reasons that you want to start and stop birth control, and they can be incredibly personal to you. You should never feel pressured into taking a certain type of birth control. However, in the event you do come off contraception and you’re not hoping to become pregnant, it’s absolutely vital to take precautions to prevent an unplanned pregnancy. 

    There’s currently no evidence that suggests that long-term use of contraception negatively impacts your ability to have a baby in the future. If you’re at all concerned about the birth control that you’ve been prescribed, then reach out to your health care provider. You may like the idea of continuing to have a period and monitoring your cycle without using hormonal contraceptives. In this case, barrier protection like condoms or a non-hormonal IUD could be a good fit for you.

    Some hormonal contraceptives, such as the combined pill, patch, or ring, have a four to seven-day break every month where you will have a withdrawal bleed. This isn’t the same as a normal menstrual period. Birth control pills prevent ovulation (when your ovaries release an egg for conception). The bleed you have on the pill, patch, or ring is your body’s reaction to the decrease in hormones during those off days. 

    When to stop birth control: You’re thinking about having a baby

    If you’re currently using birth control and are thinking about having a baby, you’ll likely be curious as to how long it takes for the effects of your contraception to be “washed out”’ of your system. 

    Dr. Schwartz explains that it can really depend on the type of birth control you’re on as well as your own body. “I tell people to stop their birth control when they would be actively happy if they got pregnant,” she says. 

    If you use condoms as your sole method of birth control, then you’ll be able to start trying to conceive immediately. However, if you take hormonal birth control (such as the IUD, pill, or patch), it may take a little longer for you to be able to become pregnant. This is because hormonal birth control affects your reproductive cycle, and sometimes, it can take a little bit of time for your body to get back to cycling on its own.

    It’s estimated that 58% of people conceive within 3 months after having their hormonal IUD removed. A study noted that it took 61.5% of people 3 months to conceive after having their copper IUD removed. This rises to 88% within 6 months. 

    It takes an average of 3 cycles (or months) to get pregnant after you stop taking the combined pill and contraceptive patches. 

    It may take a little bit longer to conceive if you’ve had the contraceptive injection. It’s been suggested that it can take up to 10 months for ovulation to start again. However, every body is different. If you’re at all concerned, then you can speak to your health care provider and use an app like Flo to track your cycle and see when you’re ovulating.

    It’s really important to remember that not everyone will get pregnant within the first few months that they stop taking birth control, and you should prioritize yourself during this period. Try not to put pressure on yourself to conceive immediately after coming off birth control. 

    This is a good time to track your periods and get to know your body and how you cycle now that you’re off birth control. You may want to start taking prenatal vitamins and talk to your healthcare provider about how you can prepare for pregnancy. Most health care providers recommend reaching out, however, if your cycles don’t seem normal and regular again in about 3 months after stopping your method. 

    When to start birth control: You’ve just had a baby and don’t want to think about more just right now.

    Ideally, discussing which birth control method you want to use postpartum is a conversation that you and your health care provider will start during pregnancy. It can be hard to sort through lots of options and make decisions when you are sleep-deprived with your little one. 

    Many medical professionals recommend that you wait between four to six weeks after giving birth before you have penetrative sex. This is so that your body has a chance to heal fully. Keep in mind that it’s possible to become pregnant very soon after having a baby, even if your period hasn’t returned. While sex might be the last thing on your mind while your body is recovering and you’re getting to grips with night feeds, it’s important to speak to your health care provider about the different contraceptive options available to you and to have a plan. 

    The implant, injection, progesterone-only pill, and condoms can all be used immediately after giving birth. “Talking to your doctor about any individual situations and concerns is also important to pick the best method and the best timing,” says Dr. Shwartz. “Usually, we start either immediately after delivery or at the postpartum visit.” 

    Your body has already gone through so much change, and if you’ve used birth control that contains estrogen in the past (like patches, the combined pill, or vaginal ring), it might feel like the most comfortable option to go back to. 

    However, methods that contain estrogen are not recommended for anyone within the first 6 weeks after giving birth. This is because in the initial postpartum weeks, you’re at a higher risk of developing a blood clot in your legs or lungs. Extra estrogen can increase this risk even more. After 6 weeks, your health care provider will assess you and help you find the birth control that feels right for you. During this period, you should continue to use another form of birth control. 

    There’s also a small risk that estrogen-containing methods can decrease how much milk you make. So, if you are breastfeeding, talk to your health care provider about which method is best for you.

    When to stop birth control during menopause

    Menopause (defined as when you’ve not had a period for 12 months) marks the time when you can stop using birth control. This is because you’re no longer at risk of unwanted pregnancy, and you no longer need to regulate your menstrual cycle. 

    However, if you’ve been on birth control for an extended period of time, it can be really difficult to know when you’ve transitioned into menopause.

    “It can be a little bit tricky to figure out when to stop medication. So again, talking with your doctor and weighing the pros and cons of continuing it or stopping it is important,” says Dr. Schwartz. 

    The average age of menopause is 51. However, for some people, their periods may be irregular before completely stopping for around 5 to 10 years. This time frame is known as perimenopause. Some of the key symptoms include: 

    • Hot flashes
    • Night sweats
    • An irregular period
    • Fatigue 

    “A lot of times, if people are doing really well on a method, we’ll encourage them to continue it until around the average age of menopause,” says Schwartz.

    When to start birth control: The essentials you need to know

    Once you’ve decided that you’d like to start taking birth control, one of your main questions may be how quickly it’ll start to work. 

    While some methods of birth control are effective straight away, others can be impacted by your menstrual cycle: 

    • Combined hormonal contraception: The combined pill contains artificial versions of the female hormones estrogen and progesterone. The patch and vaginal ring also contain both estrogen and progesterone. When used properly, these methods are over 99% effective in protecting you from pregnancy. If you start it on the first day of your period (conveniently, this is also the first day of your cycle), then you’ll be protected from pregnancy right away. However, if you start your method at any other time in the month, then you should use barrier protection (like condoms) for the first 7 days.
    • Progestin-only pill: Like the combined pill, the progestin-only pill is over 99% effective when taken correctly, and if you start taking it in the first five days of your cycle, then you are immediately protected. You can figure out what day in your cycle you’re on using an app like Flo. If you start taking it on any other day in your cycle, then you should use barrier protection for at least 2 days.
    • Hormonal intrauterine device (IUD): Hormonal IUDs are known as long-acting reversible contraception (LARC) as they last between 5 and 10 years after being placed. They’re more than 99% effective. However, if it isn’t placed within the first five days of your period, then you should use barrier protection for seven days. 
    • Implant: The implant is also more than 99% effective, but if you don’t have it placed within the first five days of your period, then you should use barrier protection for a week. 
    • Copper IUD: The copper IUD is effective as soon as it’s fitted, regardless of where you’re at in your menstrual cycle. 

    If you’re unsure about any side effects or how effective your method of birth control is, reach out to your health care provider. 

    When to start birth control: The takeaway

    Whether you’re just starting to have sex, have had a baby, or want to change the contraceptive method you’re using, there is a birth control option that will fit your lifestyle. Deciding which contraceptive is right for you is a personal choice, and exploring the different benefits and side effects is the best way to help you make a decision about which you should use. 

    If you have any questions or concerns, don’t be afraid to ask your healthcare provider. They’re there to guide you.

    References

    “Access to Contraception.” The American College of Obstetricians and Gynecologists, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/01/access-to-contraception. Accessed 20 Sep. 2022.

    “Birth Control.” The American College of Obstetricians and Gynecologists,  www.acog.org/womens-health/faqs/birth-control. Accessed 20 Sep. 2022.

    Delbarge, W., et al. “Return to Fertility in Nulliparous and Parous Women after Removal of the GyneFix Intrauterine Contraceptive System.” The European Journal of Contraception & Reproductive Health Care: The Official Journal of the European Society of Contraception, vol. 7, no. 1, Mar. 2002, pp. 24–30.

    Frederiksen, Brittni, et al. “Women’s Sexual and Reproductive Health Services: Key Findings from the 2020 KFF Women’s Health Survey.” Women’s Health Policy, www.kff.org/womens-health-policy/issue-brief/womens-sexual-and-reproductive-health-services-key-findings-from-the-2020-kff-womens-health-survey/. Accessed 20 Sep. 2022.

    Girum, Tadele, and Abebaw Wasie. “Return of Fertility after Discontinuation of Contraception: A Systematic Review and Meta-Analysis.” Contraception and Reproductive Medicine, vol. 3, July 2018, p. 9.

    Gupta, B. K., et al. “Return of Fertility in Various Types of IUD Users.” International Journal of Fertility, vol. 34, no. 2, Mar. 1989, pp. 123–25.

    Jackson, Emily. “Controversies in Postpartum Contraception: When Is It Safe to Start Oral Contraceptives after Childbirth?” Thrombosis Research, vol. 127, Feb. 2011, pp. S35–39.

    Medical Eligibility Criteria for Contraceptive Use. World Health Organization, 3 Feb. 2015, www.who.int/publications/i/item/9789241549158.

    “Menopause.” Mayo Clinic, 14 Oct. 2020, www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397.

    “Sex after Pregnancy: Set Your Own Timeline.” Mayo Clinic, 14 July 2022, www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/sex-after-pregnancy/art-20045669.

    “The Menopause Years.” The American College of Obstetricians and Gynecologists,  www.acog.org/womens-health/faqs/the-menopause-years. Accessed 20 Sep. 2022.

    “Combined Pill.” NHS, 30 Aug. 2022, www.nhs.uk/conditions/contraception/combined-contraceptive-pill/.

    “Contraceptive Implant.” NHS, 30 Aug. 2022, www.nhs.uk/conditions/contraception/contraceptive-implant/.

    “Sex and Contraception after Birth.” NHS, www.nhs.uk/conditions/baby/support-and-services/sex-and-contraception-after-birth/. Accessed 20 Sep. 2022.

    “The Progestogen-Only Pill.” NHS, 30 Aug. 2022, www.nhs.uk/conditions/contraception/the-pill-progestogen-only/.

    “Where Can I Get Contraception?” NHS, 30 Aug. 2022, www.nhs.uk/conditions/contraception/where-can-i-get-contraception/.

    “What Are the Side Effects of Birth Control Pills?” Brown University, www.brown.edu/campus-life/health/services/promotion/content/what-are-side-effects-birth-control-pills. Accessed 20 Sep. 2022.

    Yland, Jennifer J., et al. “Pregravid Contraceptive Use and Fecundability: Prospective Cohort Study.” BMJ, vol. 371, Nov. 2020, p. m3966.

    History of updates

    Current version (19 January 2023)

    Medically reviewed by Dr. Jennifer Boyle, Obstetrician and gynecologist, Massachusetts General Hospital, Massachusetts, US

    Published (22 September 2022)

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