How long does birth control stay in your system? (Spoiler: For most types, not long at all)

In 2017, the CDC released a report that showed more than half of all people with ovaries in the US between the ages of 15 and 49 were actively using some form of birth control. Of that group, 22.9% were using a hormonal contraceptive. So, it's understandable that many people might want to know how these synthetic hormones affect the body and how long they linger.

Here's your answer in a nutshell: "Give things three months to return to normal," explains OB-GYN and Modern Fertility medical advisor Dr. Eva Luo, MD, MBA, FACOG. "Long-acting reversible contraceptives (like the hormonal intrauterine device, or the IUD) generally promise a return of fertility right away, estrogen-containing contraceptives (like the pill) can take about three months, and Depo-Provera (the shot) can take as long as 18 months."

In this article, we’ll go deeper into how long different forms of hormonal birth control stay in the body so you can make informed decisions about your reproductive health.

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Before we dive into how long hormonal birth control stays in your system, let’s take a step back and get a refresher on how birth control works to prevent pregnancy. Today’s options for birth control come in many different shapes and sizes, but for the purposes of this article, we're going to stick with hormonal contraception (as opposed to barrier methods, like condoms, or the non-hormonal IUD). These methods use synthetic hormones to trigger a response in your body that prevents pregnancy — though the responses they trigger vary slightly.

The birth control pill (also called the combination pill or combined oral contraceptive), ring, patch, implant, and shot (also called the injection) all work by:

• Suppressing ovulation

• Thickening cervical mucus

• Preventing the uterine lining (endometrium) from thickening

The minipill (aka progestin-only pill) that contains norethindrone (a progestin) doesn't suppress ovulation for all users because the dose of progestins isn't high enough — instead, it works by thickening the cervical mucus and preventing the uterine lining from thickening. A newer minipill option that contains another progestin, drospirenone, does work by suppressing ovulation.

The hormonal IUD primarily works by thickening the cervical mucus, but also prevents the uterine lining from thickening. Like the minipill, it may suppress ovulation in a smaller percentage (up to 55% depending on the dose of progestins) of people.

In order to answer this question as precisely as possible, let's walk through each form of hormonal contraception separately:

• The hormonal IUD: As soon as a hormonal IUD is removed from your body, the hormones are no longer in your system. Expect menstrual cycles and ovulation to normalize within two months after the removal of an IUD.

• The pill and minipill: The hormones from the pill or minipill will leave your system 48 hours after the last pill was taken. Expect your menstrual cycles and ovulation to return to your "normal" within three months after stopping the pill.

• The implant: Clinical trials for Nexplanon, the only birth control implant available in the US, show that pregnancy can happen as quickly as 7-14 days after removing it — so that's likely how long the hormones remain in the body. Expect to resume "normal" cycles within three months of removing the implant.

• The ringYou're no longer protected against pregnancy after the ring has been removed from the body for 48 hours. Expect menstrual cycles and ovulation to normalize within three months after removing the ring.

• The patch: There's no protection against pregnancy 48 hours after the patch has been removed. Expect menstrual cycles and ovulation to normalize within three months of removing the patch.

• The shot: The Depo-Provera shot is a single injection designed to protect you against pregnancy for three months (meaning the hormones are likely out of your system after that). This form of birth control can suppress ovulation for up to 18 months (people with lower body-fat percentage might see ovulation return on the earlier side).

So you’re ready to pursue pregnancy after stopping contraceptives. We know that, in many cases, the medication will leave your body within 48 hours. But that doesn’t necessarily mean that your body will be quite ready for pregnancy 48 hours after you stop using birth control.

All forms of contraception that contain hormones work by altering your menstrual cycle — and there may be an “adjustment period” of around 90 days as your typical cycles return. But this is not caused by lingering birth control hormones. 90 days is the estimated amount of time it takes for an ovarian follicle (which develops and releases an egg) to go from actively developing (preantral in medical-speak) to ready for ovulation (preovulatory). 90 days gives your body enough time to ovulate an egg that hasn't been affected by synthetic hormones (cue "normal" ovulation).

But, adds Dr. Luo, "there are plenty of patients who stop taking oral contraceptive pills or other forms of hormonal contraception and get pregnant immediately," she says. That 90 days is the average adjustment period before "normal" menstrual cycles return — you won't necessarily have that same experience.

If your cycle doesn’t start 90 days after stopping birth control, this could be a sign of an underlying issue that birth control was managing (like polycystic ovary syndrome or thyroid conditions). If this happens, seek out medical advice from your healthcare provider so they can help you investigate what's going on. The only outlier for this 90-day guidance is if you're transitioning off of the Depo-Provera shot. This is the only type of birth control that's known to cause a delay, up to 18 months, in the return of ovulation.

Regardless of your method of birth control, no — you don't need to do or take anything to “cleanse” your body of the synthetic hormones from birth control. They'll leave on their own.

In 2018, researchers conducted a systematic review to understand how likely people were to conceive within 12 months after going off hormonal contraceptives. They found that:

• Ex-oral contraceptive (pills) users: 87.04% pregnant within 12 months

• Ex-hormonal IUD users: 84.75% pregnant within 12 months

• Ex-shot users: 77.4% pregnant within 12 months

• Ex-implant users: 74.7% pregnant within 12 months

While there's little data on ex-ring and patch users, you can expect a similar time to pregnancy as oral contraceptives.

Whether you’re thinking of changing or discontinuing your birth control method, remember that for most forms of hormonal birth control, the medication will leave your system after about two days. If your body takes longer than three months to get back to its pre-birth control self, check in with your healthcare provider to see if there could be an underlying condition impacting your cycles. The only form of hormonal contraception that may cause your body to take longer than three months to return to your "normal" is the Depo-Provera shot.

This article was medically reviewed by Dr. Eva Marie Luo, MD, MBA, FACOG, an OB-GYN at Beth Israel Deaconess Medical Center and Clinical Lead for Value at the Center for Healthcare Delivery Science at Beth Israel Deaconess Medical Center.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

December 06, 2021

Written by

Ashleigh N. DeLuca

Fact checked by

Eva Marie Luo, MD, MBA, FACOG

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About the medical reviewer

Eva Marie Luo, MD, MBA, FACOG