‘I’ve been on the pill since I was 16. Will it make getting pregnant more difficult at 34?’

Dr Frankie Jackson-Spence is an NHS Junior Doctor and Media Medic. Alongside her NHS work, she runs an educational social media page @drfrankiejs dedicated to busting common health myths.

Dear Dr Frankie,

I have been on the contraceptive pill since I was 16, I’m now 34 and have been trying to conceive since coming off the pill three months ago. My period hasn’t returned yet, and now I’m concerned about how long I was taking the pill for. Will this affect my chances of getting pregnant?

– Anonymous

Dear Anonymous,

It’s a common misconception that the oral contraceptive pill (“The Pill’) negatively affects fertility and it can be really frightening for women who hear this myth! Rest assured, there is no scientific evidence to support the claim that contraception type, or duration of use negatively affects fertility*. Take comfort in the fact that women who use hormonal contraception are just as likely to conceive as those who have never used hormonal contraceptives.

While some women get pregnant straight away after stopping the pill, everyone is different and it can take between three and six months for periods to return after stopping without it being a cause for concern. You can still start preparing for potential pregnancy by optimising your general health: stopping smoking, reducing alcohol consumption and taking pre-pregnancy supplements such as folic acid daily. If periods haven’t come back six months after stopping, then it’s worth mentioning to your doctor.

Some women however, do experience delays or difficulty getting pregnant following being on a hormonal contraceptive such as The Pill. And it’s easy to point the finger towards The Pill. The most likely explanation is actually that fertility naturally declines with age, particularly over the age of 35. When a woman comes off The Pill after many years, usually at a time when they are trying to conceive, it can be easy to blame The Pill for the delay. It’s important to remember that while we can get hung up quoting statistics and averages, many women over the age of 35 do have successful pregnancies! 

Another real consideration is that many women go on contraception in their teenage years before they really understand their cycle, and it’s possible that the hormones may mask underlying conditions and irregular periods (such as Polycystic Ovary Syndrome). Symptoms may be disguised by years of hormonal contraception and this true diagnosis may go unknown. It may be only once they come off the contraceptive, many years later, that the difficulty in getting pregnant becomes the highlighting symptom. 

It is still the case that unfortunately around 1 in 8 couples will have difficulty conceiving. For the majority (3 out of 4 couples), a cause can be identified, and they may go on to have a successful pregnancy, others have a more challenging journey. During these difficulties, it’s so important that couples are correctly informed so that potential causes can be identified or excluded. Blaming the contraceptive pill for fertility concerns may result in delays accessing the necessary support and treatments. 

If you are concerned about your contraceptive choice or fertility, please do remember that you need personalised advice and don’t delay consulting your own doctor for support. And for those of you that have just come off the pill, take reassurance that it’s safe and enjoy your time trying! 

– Dr Francesca Jackson-Spence

 *The exception to this is the contraceptive injection which can take a few months to wear off. In this case, it may take up to 12 months after the contraceptive injection for fertility to return to normal and your doctor will likely suggest another form of contraception if you are planning on getting pregnant in the near future.