Periods and the pill

It takes a while for your periods to come back after you stop taking the pill. Most women will have a period around two to four weeks after stopping the pill, but this depends on you and what your cycle is normally like.

Weight, health, stress, exercise and conditions such as polycystic ovary syndrome (PCOS) can all influence your cycle of periods.

Your periods may be irregular when you first come off the pill, and you should allow up to three months for your natural menstrual cycle to re-establish itself fully.

This is because the pill contains the hormones that stop ovulation (the release of an egg) each month.

The first period after stopping the pill is known as a "withdrawal bleed". The next period after this withdrawal bleed is your first natural period.

It's unlikely that how long you have been on the pill will cause fertility problems. Some women conceive immediately after they stop taking the pill.

However, while the pill doesn't cause fertility problems, it can mask underlying problems you may already have, such as irregular periods.

You can get pregnant as soon as you come off the pill, so it's important to use another form of contraception, such as condoms, straight away.

If you're trying to get pregnant, it's a good idea to wait to have one natural period first. This gives you time to make sure you're in the best physical health for pregnancy – for example, by taking folic acid supplements, giving up smoking and giving up alcohol. It also helps your GP or midwife predict your due date more accurately.

Find out more about getting pregnant

The menopause is the time when your periods permanently stop. In the UK the average age at menopause is 52. The years before the menopause, when symptoms may begin to develop, are known as the perimenopause.

If you're having sex and want to avoid pregnancy, contraception is necessary until you reach the menopause.

It is also sensible to use a barrier method of contraception, such as condoms, to avoid getting sexually transmitted infections (STIs), even after the menopause.

It's advised you use contraception until you've not had a period or any bleeding for two years if you're under 50, or one year if you are over 50.

Taking the combined contraceptive pill may mask the menopause by controlling menopausal symptoms, such as hot flushes and night sweats. It may therefore be difficult to tell when you are no longer fertile.

Hormone test for the menopause

There is no test that can absolutely define when the menopause has occurred. Your doctor can arrange a test to measure your levels of a hormone called follicle stimulating hormone (FSH). This blood test should be taken on the last day of the pill-free interval.

However, the test is usually only used in women over 50 who are using the progestogen-only pill. It is not a reliable indicator that ovulation has stopped in women using the combined contraceptive pill.

If you are taking the combined contraceptive pill, it does not change the time of your menopause, but you will continue to have period-type bleeds during the seven-day pill-free intervals for as long as you take the pill.

The combined pill can be taken until the menopause if you are healthy and a non-smoker. However, it shouldn't be taken if you are 35 or over and smoke.

The progestogen-only pill (POP) can be taken until the menopause if you are a smoker. As the progestogen-only pill does not contain oestrogen, it will not control or mask any menopausal symptoms such as hot flushes.