Do You Ovulate on Birth Control? What to Expect from Your Body
If you have been taking hormonal birth control for a while, you might be curious about how it is affecting your body. Maybe you are concerned about some side effects you are experiencing and want to change methods — or perhaps you are thinking about going off birth control altogether so you can conceive. Whatever the case, here is what you can expect from your body and your ovulation when taking (and stopping) birth control.
How Ovulation Works
Ovulation is the release of an egg from the ovaries. For most women, it occurs about halfway through your menstrual cycle. In order to understand how birth control affects ovulation, we need to comprehend what happens in our bodies during ovulation.
During the first phase of your menstrual cycle after your period, the follicular phase, follicles containing immature eggs start to develop in your ovaries. Eventually, one follicle emerges as dominant, meaning it grows larger than the rest.
When you are about to ovulate, your body’s hormone levels start to shift. Luteinizing hormone, or LH, surges 12 to 24 hours prior to ovulation. This LH surge tells the ovaries that it is time to release an egg. Estrogen levels also rise prior to ovulation.
The ovary containing the dominant follicle receives these hormonal signals and releases an egg. That egg travels down the fallopian tubes, where it stays alive for just 24 hours. If the egg is fertilized by a sperm within 24 hours of ovulation, pregnancy occurs. If not, the egg dies off and your menstrual cycle continues as usual.
How Birth Control Works
Hormonal birth control comes in several forms including:
- Birth control pill (aka oral contraceptives)
- Birth control shot/injection (Depo Provera)
- Birth control patch
- Vaginal ring (NuvaRing)
- Hormonal Intrauterine Device (IUD)
- Contraceptive Implant (Nexplanon)
Oral contraceptives fall into two categories:
- Combination pills, which are the most common type. This version uses both estrogen and progesterone and requires one pill to be taken at the same time every day.
- Progestin-only pills, or mini pills, contain only progesterone. This version needs to be taken within the same 3-hour window each day to be effective.
Regardless of what type of hormonal contraceptive you use, the main premise is the same. The contraceptive releases man-made hormones (synthetic estrogen and progesterone) into your body to trick your brain into thinking you have already ovulated.
Typically, your hormones rise and fall throughout your cycle. When you are on birth control such as an oral contraceptive, however, your progesterone and estrogen levels stay more consistent throughout your cycle.
Hormonal birth control prevents surges in natural hormones as well as pregnancy by:
- Blocking the signal for the ovary to release an egg
- Thickening the cervical mucus so sperm cannot reach the egg (if ovulation occurs)
- Thinning the uterine lining, making it inhospitable for implantation of a fertilized egg
These changes in your normal cycle make it nearly impossible to track your ovulation while on a hormonal contraceptive. If using a fertility tracker such as Mira while on birth control, you won’t see a fertile window because you usually will not ovulate.
However, it can be helpful to use a tracker to confirm that ovulation isn’t occurring. According to the CDC, birth control is effective 99.7% of the time, so your chances of getting pregnant are slim if you use it properly. However, there are some things that can cause hormonal birth controls to be ineffective, including missed doses, vomiting, and interference from other medications. Using an ovulation tracker along with birth control can provide some additional peace-of-mind.
Ovulation and Birth Control
Depending on what type of birth control you use, your ovulation may be affected in different ways — or not at all. Here’s what happens to your body and your ovulation when you’re using birth control.
How Birth Control Impacts Ovulation
Non-hormonal forms of birth control, such as condoms or the copper IUD, do not affect ovulation because they do not release hormones. Most women, however, use hormonal forms of birth control containing synthetic progesterone (progestin) or a combination of progestin and synthetic estrogen (ethinyl estradiol).
Hormonal birth control releases hormones that interfere with your menstrual cycle’s normal patterns. Normally, rising and falling levels of estrogen and progesterone throughout your cycle let your body know, for example, when to ovulate or when to menstruate. But because hormonal birth control releases steady amounts of these hormones all the time, they keep hormone levels more consistent, masking the signals your body would usually send to tell you to ovulate or menstruate.
Do you ovulate on birth control?
Each type of hormonal birth control affects ovulation in a different way. Depending on the hormones and the dosage found in your particular type of birth control, you may or may not ovulate when using birth control.
In general, combined forms of birth control containing both progestin and ethinyl estradiol work to prevent ovulation as long as you use them consistently and effectively. Progestin-only forms of birth control usually halt ovulation but do not do so in a consistent manner. About 4 in 10 women using progestin-only birth control still ovulate.
You will DEFINITELY NOT ovulate if you are using:
- Combination oral contraceptive pills
- Birth control patch
- Vaginal ring (NuvaRing)
You will PROBABLY NOT ovulate if you are using:
- Birth control shot/injection (DepoProvera)
- Progestin-only oral contraceptive pills (the “mini pill”)
- Hormonal IUD (Mirena, Skyla, Kyleena, Liletta)
- Contraceptive implant (Nexplanon)
How to Stop Ovulation While on Birth Control
If your goal is to prevent ovulation for whatever reason, you should choose a hormonal form of birth control that contains both ethinyl estradiol and progestin. Combination birth control methods stop ovulation more reliably than progestin-only methods.
The combination birth control pill is probably the option that most reliably stops ovulation. However, it will only stop ovulation if you take it every day, at the same time every day. If you miss a dose, you might still ovulate and be able to get pregnant. The patch and the ring also stop ovulation but must be changed regularly in order to work properly. They may also fall off or out of the vagina, which can lead to unplanned pregnancy if they are not replaced immediately.
If you want to be especially sure that you are not ovulating, you might also try continuous birth control. Continuous birth control is a pill taken consistently with no breaks — as opposed to the typical 21 days on, 7 days off schedule of taking oral contraceptives. As a result, you do not have a period when using it. The downside of continuous birth control is that it can be more difficult to tell if you are pregnant.
Tracking your period with a digital fertility monitor like Mira can help you keep an eye on your fertility hormone concentrations to ensure you are not ovulating. If you miss a dose of your birth control, you may want to pay especially close attention to your hormones to see if you ovulate or not before deciding to have sexual intercourse.
How to Get Off the Pill
If you are ready to start trying to conceive and have decided to stop taking hormonal birth control, there are some things you should know. Before you do anything else, always talk to your doctor about changing your birth control method and possible side effects specific to you.
Most women experience what is known as withdrawal bleeding two to four weeks after stopping hormonal birth control. The next period you have after withdrawal bleeding is considered your first natural period after ending birth control. For women who have been on an oral contraceptive for a long time, it can take one to three months for a regular ovulation cycle to return.
Once you stop taking a hormonal contraceptive, your natural hormones will slowly return to normal levels. Your menstrual cycle will begin to normalize and ovulation will start again. As estrogen begins to build up again, the uterine lining will begin to thicken and become ready for a fertilized egg to implant. With these hormonal changes, you might also experience:
- Heavier periods
- Mood swings
Most of these side effects begin to disappear as your body gets used to regular hormonal cycles. If they continue, discuss these side effects with your doctor.
You can start using an ovulation tracker as soon as you stop your hormonal contraceptive. However, it may take a month or more for your hormones to return to normal and for the LH surge to occur. Once your luteinizing hormone returns to normal levels, you can start using your body’s LH surge as an indicator of ovulation.
Understanding how your hormonal birth control affects your fertile window while you are on the pill, and after stopping it, is an important step toward having a healthy relationship with your body. Discussing your birth control options and plans for trying to conceive with your healthcare provider is also a great place to start.
✔️ Medically Reviewed by Dr Roohi Jeelani, MD, FACOG and Lauren Grimm, MA
Dr Roohi Jeelani is Director of Research and Education at Vios Fertility Institute in Chicago, Illinois. Dr Jeelani earned her medical degree from Ross University School of Medicine in Portsmouth, Dominica. She then completed a residency in Obstetrics and Gynecology and a fellowship in Reproductive Endocrinology and Infertility at Wayne State University, Detroit Medical Center, where she was awarded a Women’s Reproductive Health NIH K12 Research Grant. She is board certified in Obstetrics and Gynecology. Dr Jeelani has authored numerous articles and abstracts in peer-reviewed journals, and presented her research at national and international scientific meetings. A Fellow of the American College of Obstetrics and Gynecology, Dr Jeelani is a member of the American Medical Association, the American Society of Reproductive Medicine, and the American Association of Gynecologic Laparoscopists.
Lauren Grimm is Research Coordinator at Vios Fertility Institute in Chicago, Illinois. Lauren earned her bachelor’s degree from Loyola University Chicago, where she also completed her masters in Medical Sciences. Lauren has worked alongside Dr. Jeelani for the last 3 years, authoring a number of abstracts and articles in peer-reviewed journals, and presented her research at national and international scientific conferences. Lauren will be continuing her education this fall at Rush University Medical College in Chicago, IL as an MD candidate.
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