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Going off the pill can be a major decision—bigger than many women realize. Considering that many women start the pill in their teenage years these days, if you’re going off of it at the age when you’d like to have kids, it’s quite possible that you’ve been on the pill for well over a decade. Many of us don’t realize just all the changes the pill causes in our body. This is in part due to the fact that, for many of us, the pill works to fix certain issues or alleviate certain annoyances (like PMS or acne). Naturally, you don’t really think about it when a medication takes problems away. But your pill has been hard at work in your body, and while its effects may not be as obvious as those of, say, a painkiller or antidepressant, they are there and your body will notice when they go away. Here’s what can happen when you go off the pill.

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The hormones exit within two days

First, it’s important to know that the hormones will be completely gone from your body within one or two days of stopping the pill. That means you should get on a new form of birth control quickly if you plan on having sex.

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Your breasts may shrink

The hormones in the pill may have made your breasts slightly engorged, so you could see a little extra room in your bra size.

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Your moods may get worse

Your particular pill—the dosage and dominant hormone—along with just your genetic makeup will cause different effects. Some women feel that their moods get worse when they go off the pill.

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Your mood may improve

On the flip side, your moods may improve. Again, your particular pill along with your body will determine this outcome.

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You could lose weight

Pills with higher dosages of hormones can cause a slight weight increase—typically of five to seven pounds—so you may find that you lose weight when you go off the pill.

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Your PMS symptoms can reappear

Many pills work to minimize PMS symptoms, from the cramps to the fatigue to the mood swings. You might experience PMS the way you haven’t since your teenage years when you go off the pill. Be ready with Midol and hot pads.

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Your period can be heavier

If you had a heavy estrogen pill, then it’s likely your periods will get heavier. You may want to stock up on super tampons or heavier pads. Don’t worry: your flow should eventually regulate.

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You may get acne

When you go off the pill, your body will likely experience a testosterone increase, and this can lead to acne breakouts. Have some good concealer on hand until your hormones regulate.

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Your libido may increase

It’s possible that the pill had been crushing your sex drive and going off of it can mean you feel up to doing the deed more often. This can be great if you’re in a relationship, and not-so-great if you aren’t.

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You’ll instinctively try to take it

You’re so used to taking it at the same time each day. It’s one of the items you pack in your purse every day. You set an alarm for it. Your body instinctively knows that around a certain time, you have to take it. Ignoring all of those instincts will be hard at first.

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You’ll feel worried the first time you have sex

Even if you’re using condoms, you can’t help but feel worried. In the past, your body was surging with hormones protecting you against impregnation. It was like a fortress. Now, nothing but a little rubber stands between you and becoming pregnant.

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Your period can be irregular

Your period may be irregular for several months after going off the pill. That’s nothing to worry about. However, if you don’t get a period at all for several months after going off the pill, see a doctor.

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You can lose hair on your head

In rare instances, women notice the hair on their head thins slightly after going off the pill. Typically, it should regain its thickness.

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Or get thicker hair elsewhere

When you go off the pill, your body may experience a spike in androgen, which regulates male characteristics like voice and body hair. You may see darker, thicker hair on your back, chest, arms, face, or neck.

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Your vitamin D levels can drop

Some women experience a drop in vitamin D levels after taking the pill. You may want to consider taking a vitamin D supplement, especially if you’re trying to become pregnant.