So you’ve made a decision to come off your birth control pill (or you’re thinking about it), and you’re curious as to what to expect. The pill has been your steady partner against acne, cramps, and unexpected pregnancies for years, but it may be time to part ways and you’re not sure how it’s going to go.

The birth control pill delivers a steady stream of hormones that suppresses your body’s natural hormone production and prevents ovulation. Ovulation is when an egg is released in preparation for fertilization from sperm, so if ovulation is suppressed, then pregnancy is prevented.

Given its hormonal regulation, the pill often helps to decrease acne, lighten menstrual flow, lessen or get rid of cramps, and reduce PMS symptoms. It is also protective against breast and endometrial cancers. However, on the flip side there are potential risks associated with having exogenous hormones in your body, such as for blood clots, and there is the possibility of experiencing a decreased sex drive, bloating, and headaches from the pill.

If you’re interested in coming off the pill (for a variety of reasons), here are 5 things that you could expect:

1. Your period might become irregular and heavy

Although it may not be as bad as when you were a teenager, your heavy and unpredictable periods may return after the steady flow of hormones from the pill is gone. However, they tend to back off a bit after a few months of being off the pill.

2. Your skin may fight back

The pill helps to correct hormone imbalances that lead to acne and unwanted hair growth. Without the regular timing and levels of hormones from the pill, your own hormones become wacky and acne and chin hair may appear.

3. Three letters – PMS

Look out hangry, mama’s got a new mood in town! Going from “I can’t stand to be around you” to “I need you to give me a hug” within the span of 10 minutes may become the new normal, in addition to other signs of PMS, such as breast tenderness, chocolate cravings, and menstrual cramps.

4. You may become more frisky

During ovulation, a whole lot of hormones and brain signals get released to tell you to start procreating (it’s a survival instinct). With ovulation, a woman’s body experiences a sharp drop in estrogen, allowing its opposition, testosterone, to take the lead. Testosterone increases sex drive. With the artificial dampening of this response and preventing ovulation, females likely don’t feel this increased sex drive when on the pill. Therefore, without the pill and with regular ovulation you may start to feel more frisky mid-cycle!

5. You could become pregnant immediately

Yes, you have the potential to be fertile as soon as you stop the pill! If your plan isn’t to get pregnant, ensure that you are using alternate forms of contraception.

If these side effects of coming off the pill are not something that you’re looking forward to, I’ve guided women through this transition many times with great results and I’d love to work with you. There are many highly effective and well-researched medicines that I use to assist the body to smoothly balance, assist, and to regulate its own hormone production once the artificial hormones from the pill are stopped. Also, if you’re interested in learning more about contraception and hormones, I’m here to help.

Special thanks to Dr. Megan Bernard for her help in putting this article together!