Missed Period After Stopping Birth Control: What You Need to Know

After stopping the use of oral contraceptives, if menstruation does not occur?

Hello, doctor.
I have been taking the contraceptive pill Qlaira (21 pills) for a year and a half.
The doctor who prescribed it advised me to stop taking the medication for one month after every three months of use.
My menstrual periods for the first three cycles were on March 13, April 10, and May 8, with bleeding lasting only about three days due to the medication, with heavier flow initially and then just brown discharge, or even none at all.
After May, I entered the one-month break from the medication.
Recently, I had sexual intercourse on April 24 and May 1 (both times using condoms).
Before starting the medication, my cycle was long and irregular (35 to 40 days) and I have been diagnosed with polycystic ovary syndrome (PCOS) in the past.
However, based on my experience over the past year and a half of taking the contraceptive pill, even during the month I stopped the medication, my menstrual cycle would still be around 28 days, and the menstrual flow would return to the volume I had before taking the medication (lasting about 5 days).
I expected my period to start on June 5, but today (June 11) it still hasn't arrived.
Since June 5, I have been experiencing a dull pain in my abdomen along with some diarrhea.
Due to the pandemic, I am currently unable to go out, so I would like to ask the doctor a few questions: 1.
Although I have not experienced any abnormalities when stopping the medication before, is it possible that this time the missed period is due to stopping the medication? 2.
Given my situation, should I suspect the possibility of pregnancy? Should I find time to visit a gynecologist?

Cheng Xiaojie, 20~29 year old female. Ask Date: 2021/06/11

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
For pregnancy concerns, please take a home pregnancy test or visit a gynecologist for examination and evaluation four weeks after your most recent sexual intercourse.
2.
The menstrual cycle can be affected by various psychological and physiological factors; if your period is more than two months late, it is recommended to see a gynecologist for examination and evaluation.

Reply Date: 2021/06/11

More Info

When a woman stops taking birth control pills, it is not uncommon to experience changes in her menstrual cycle, including missed periods. In your case, you have been on the birth control pill (specifically, the combination pill) for a year and a half, and your doctor advised you to take a break after every three months of use. You mentioned that your menstrual cycles were previously irregular, ranging from 35 to 40 days, and that you have a history of polycystic ovary syndrome (PCOS), which can further complicate menstrual regularity.

1. Missed Periods After Stopping Birth Control: It is indeed possible that stopping the birth control pill could lead to a missed period. Hormonal contraceptives work by regulating the hormones that control the menstrual cycle. When you stop taking them, your body may take some time to adjust and resume its natural hormonal rhythm. This adjustment period can lead to irregularities, including missed periods or changes in the flow and duration of menstruation. Given your history of irregular cycles and PCOS, your body may need additional time to recalibrate after stopping the pill.

2. Pregnancy Considerations: Since you have had unprotected sexual intercourse on two occasions before your expected period, it is prudent to consider the possibility of pregnancy. While the use of condoms reduces the risk of pregnancy, no contraceptive method is 100% effective. Given that you are now several days past your expected period and experiencing abdominal discomfort, it would be wise to take a home pregnancy test. These tests are generally reliable and can provide you with quick results. If the test is positive, you should schedule an appointment with your healthcare provider to confirm the pregnancy and discuss your options.

3. Symptoms and Next Steps: The abdominal discomfort and diarrhea you are experiencing could be related to various factors, including hormonal changes, stress, or even gastrointestinal issues unrelated to your menstrual cycle. However, if your symptoms persist or worsen, it is advisable to seek medical attention. A visit to your gynecologist can help clarify whether your missed period is due to hormonal adjustments or if there is a possibility of pregnancy. They can also provide guidance on managing any symptoms you may be experiencing.

In summary, it is not uncommon for women to experience missed periods after stopping birth control, especially if they have a history of irregular cycles. It is essential to consider the possibility of pregnancy, especially after unprotected intercourse. Taking a home pregnancy test and consulting with your healthcare provider will help you understand your situation better and determine the appropriate next steps. Remember that your health and well-being are paramount, so do not hesitate to seek medical advice if you have concerns.

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