The body after the pill

Natural body rhythm

Many women don't feel quite right on the contraceptive pill. Whether this is directly due to the artificial hormones they're taking, or simply the knowledge that they're taking these hormones, isn't always clear. But it does lead to several questions about long-term use of the pill, such as:

• When you stop, what helps the body to find its natural rhythm? Are occasional breaks useful to let the body restore its natural rhythm?
• Is there a maximum length of time for which you should take the pill, after which you must come off it?
• How long after you stop does it take the body to become fertile again?

Monthly break

Most women take the contraceptive pill for only 21 days out of every 28-day cycle. Depending on the particular type of pill, they stop (or take a dummy pill) for the last seven days, which induces an artificial bleed or period.

Studies of body chemistry have shown that during this pill-free week, the hormone changes and other effects of the pill all return to normal. In other words, your body rapidly re-establishes its natural cycles and rhythms, all by itself and within a matter of days.

You don't usually need to do anything to help this process, and there's no need to take a regular break from the pill every couple of years.

Long-term risks for smokers

Most research has failed to show that as the number of years you take the pill tot up, so the risks to your health increase (over and above any normal increase in conditions such as high blood pressure that occur as you age).

But some studies have shown that such a risk exists, especially for smokers. For example, one study found that the risk of stroke among smokers increases with age and duration of use of the pill.

The general advice is that smokers should think about stopping the pill after the age of 30, and must change to another method at 35. Looking at it another way, 15 years of accumulated use of the pill should be the absolute maximum for a smoker (and they should stop earlier if they have developed other risk factors from a stroke such as high blood pressure).

There are also links between the pill and various cancers that need to be considered. One such possible link is between the pill and cancer of the cervix, although many experts feel that if there is such a link, it's very small and related to other factors, too.

There's also solid evidence now to show that taking the pill increases your risk of breast cancer, probably by about 25 per cent (to keep this in perspective, bear in mind that the risk of breast cancer in young women is very small so this is a 25 per cent increase of a very small amount). This risk will fall back to the normal level fairly quickly once you stop taking the pill.

You also need to keep these risks in balance by comparing them to the decrease in other types of cancer among women who take the pill – they're less likely to get cancer of the ovary and womb (and possibly the bowel, too).

Women who don't have added risk factors such as smoking, and who are using modern low-dose pills, may chose to continue until they hit the menopause.

The pill and fertility problems

There's no connection between how long the pill has been used and fertility problems.

Some women find that when they stop, it can take some time to conceive. But this is simply because being on the pill has masked problems such as irregular periods, which would otherwise have become apparent much sooner.

Some women conceive within hours of taking their last pill - so if you do stop but aren't yet ready to have a child, ensure you give some thought to an alternative method of contraception.