If you're a millennial woman, there's a good chance you started the pill at 14 or 16. Not for sex. For cramps, breakouts or a period that showed up whenever it wanted.
Now you're in your 30s, coming off birth control, and your cycle feels like a stranger. Late periods. No period. Cramps you forgot you had. And one question on repeat: did the pill hurt my fertility?
Here's what the research says, what Chinese Medicine sees, and the 3 herbs to know after the pill.
Key takeaways
-
Birth control doesn't make you infertile. In a review of 22 studies, 83% of women were pregnant within a year of stopping. Age plays a bigger role than the pill. Fertility starts to decline gradually around 32.
-
The pill can keep cycle issues out of view for years. When you stop, they often come back.
-
Dong Quai, White Peony and Bupleurum are 3 classic Chinese herbs for life after the pill.
Can birth control make you infertile?
No. A 2018 review of 22 studies on fertility after birth control followed 14,884 women who stopped contraception. Within 12 months, 83.1% were pregnant. How long they'd used it didn't change the results.
A 2020 BMJ study of 17,954 women trying to conceive found the same thing. Fertility returned within about 3 cycles after the pill or ring, and 5 to 8 cycles after the shot. Years of use had little or no lasting effect.
So why do so many of us feel like something's off? (Planning ahead? Here's how to transition off birth control naturally.)
Why your cycle feels different after the pill
The pill pauses ovulation. The monthly bleed you get on it is a withdrawal bleed, not a true period. If you started at 15 for painful or irregular periods, your own cycle has been on hold ever since.
When you stop, what was going on before often comes back. Common changes after the pill:
-
Late or missing periods (post pill amenorrhea)
-
Irregular cycles
-
Breakouts along the jaw and chin
-
Cramps and heavy flow returning
-
Mood swings before your period
Then there's timing. The American College of Obstetricians and Gynecologists says fertility declines gradually starting around age 32 and faster after 37. That's age, not the pill. Over 35 and not pregnant after 6 months of trying? ACOG recommends a fertility evaluation.
What Chinese Medicine sees after the pill
Chinese Medicine reads your period as a monthly report card. After the pill, Doctors of Chinese Medicine often see two patterns:
-
Blood deficiency: light or late periods, low energy, feeling dizzy when you stand up.
-
Liver Qi stagnation: mood swings before your period, tender breasts, cramps and cycles that wander.
The goal is to nourish Blood and keep Qi (vital energy) moving. More on the patterns of imbalance behind period changes.
The 3 best herbs after birth control
These three work together in Xiao Yao San, the "Free and Easy Wanderer," one of Chinese Medicine's most used women's formulas.
1. Dong Quai (Angelica Sinensis or Dan Gui)
Called the "female ginseng," Dong Quai (Dang Gui) nourishes and moves Blood. It's the classic herb for light, late or missing periods.
-
Research review: A review of Angelica sinensis describes its long traditional use for irregular and missing periods.
-
Paired with White Peony: In a 2016 meta-analysis of Danggui Shaoyao San, the Dong Quai and Peony formula, it beat painkillers for period pain across 3 trials and beat placebo in a fourth.
-
Go deeper in the Elix guide to Dong Quai.
2. White Peony Root (Bai Shao)
Known as the "woman's herb," White Peony nourishes Blood, soothes the Liver and eases cramping, especially with licorice.
-
Lab studies: In human uterine-lining cells, peony and licorice were linked to lower prostaglandin levels, the compounds behind period cramps.
-
Research review: Paeoniflorin, peony's main compound, shows anti-inflammatory and immune-balancing actions in animal studies.
3. Bupleurum (Chai Hu)
Bupleurum is Chinese Medicine's go-to herb for moving stuck Liver Qi. Think PMS tension, spotting, irritability and cycles that run late when you're stressed.
-
Human studies: In a 2024 placebo-controlled trial of 144 women with PMS, Jia Wei Xiao Yao pills (Bupleurum, Dong Quai, White Peony and more) improved emotional and physical PMS scores over 3 cycles. Side effects matched placebo.
-
Animal studies: A Xiao Yao formula brought stress hormones and FSH/LH back toward normal in rats.
Chinese Medicine uses herbs as a team, not solo. Elix’s Cycle Balance can include all three, plus the rest of the Xiao Yao family (Poria, Atractylodes, Ginger, Mint, Licorice, Moutan and Gardenia), when your pattern calls for them. Comparing other options? See the best supplements after stopping birth control.
Cycle Balance: clinically proven and personalized to your pattern
Cycle Balance is Elix's personalized Chinese herbal formula. You take a short Health Assessment, and Elix matches 12 to 18 organic herbs to your pattern. Your formula evolves as your body does.
In a 3-month clinical study of Cycle Balance with 68 women ages 18 to 36 (NCT05145257):
-
90% felt improvement in PMS and menstrual symptoms
-
85% reported better cycle regulation
-
80% canceled fewer plans and felt more productive
Cycle Balance is a 2026 NewBeauty Award winner. In her NewBeauty Cycle Balance review, editor Britt Fallon wrote: "I've been taking Cycle Balance every day for nine months, and I love it." Dong Quai, White Peony and Bupleurum are all in her blend.
What women coming off the pill are saying
"They were incredibly helpful during my transition off birth control, which I had been on since 16 due to severe period pain and long cycles. Birth control was no longer sustainable for me, and Elix has truly improved my cycle." – Avery
"I used elix for my first ever period off of hormonal birth control pills. Before I tried elix, I was on birth control for years and years since maybe 14 years old because my doctor and my moms friend told me it helped with acne and regulating your cycle... I have never had such a peaceful period in my life." – Sedona l.
"Post-birth control I had no periods, then maybe some dried blood as a “period” later on. A month after using Elix I had my first real period again." – Sydney K.
"I've been on birth control for 10 years and recently came off of it. I've only just started my Elix journey and have already noticed improvements in my cycle. My cramps were manageable and my period has not been as heavy as it once was." – Ari L.
Birth control and fertility FAQs
Does birth control cause infertility?Â
No. A review of 22 studies found 83% of women were pregnant within 12 months of stopping, no matter how long they'd used it.
How long does it take fertility to return after the pill?Â
About 3 cycles after the pill or ring, and 5 to 8 cycles after the shot, according to a 2020 BMJ study of 17,954 women. If your period hasn't come back within 3 months, check in with your doctor.
Can I take Cycle Balance while trying to conceive?Â
Yes. Elix's formulas can be used while trying to conceive but not during pregnancy. If you might be pregnant, wait until your period starts.
Who shouldn't take Cycle Balance?Â
Skip it if you're pregnant or breastfeeding, on prescription blood thinners, diuretics or anti-seizure medication, or have a personal history of hormone-positive cancer. Ask your healthcare provider if you take other medications.
Your cycle after the pill starts now
The pill didn't take your fertility. It put your cycle on pause. Now it's time to get to know it, with herbs chosen for your pattern. Take the Elix Health Assessment to discover your personalized Cycle Balance.
This article was medically reviewed by Dr. Megan MacLaggan L.Ac, DAcCHM
Dr. Megan MacLaggan is a Doctor of Traditional Chinese Medicine, licensed acupuncturist, and certified clinical Eastern and Western herbalist specializing in women's health. In addition to clinical practice and coaching, she writes, teaches, develops curriculum, and consults at the intersection of East Asian Medicine and biomedicine.
Sources
- Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med. 2018;3:9.
- Yland JJ, Bresnick KA, Hatch EE, et al. Pregravid contraceptive use and fecundability: prospective cohort study. BMJ. 2020;371:m3966.
- American College of Obstetricians and Gynecologists. Female age-related fertility decline. Committee Opinion No. 589. Obstet Gynecol. 2014;123(3):719-721.
- Wei WL, Zeng R, Gu CM, et al. Angelica sinensis in China: a review of botanical profile, ethnopharmacology, phytochemistry and chemical analysis. J Ethnopharmacol. 2016;190:116-141.
- Lee HW, Jun JH, Kil KJ, et al. Herbal medicine (Danggui Shaoyao San) for treating primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Maturitas. 2016;85:19-26.
- Imai A, Horibe S, Fuseya S, et al. Possible evidence that the herbal medicine shakuyaku-kanzo-to decreases prostaglandin levels through suppressing arachidonate turnover in endometrium. J Med. 1995;26(3-4):163-174.
- Zhang L, Wei W. Anti-inflammatory and immunoregulatory effects of paeoniflorin and total glucosides of paeony. Pharmacol Ther. 2020;207:107452.
- Li X, Yang Y, Sun J, et al. Effectiveness and safety of Jiawei Xiaoyao pill in the treatment of premenstrual syndrome (liver depression, spleen deficiency, and blood-heat syndrome): a multi-center, randomized, placebo-controlled trial. J Tradit Chin Med. 2024;44(2):373-380.
- Honghua Xiaoyao tablets ameliorate premenstrual syndrome by modulating HPA axis and restoring ovarian estrogen synthesis to attenuate hippocampal neuroinflammation. J Ethnopharmacol. 2026;355(Pt B):120688.
- Elix. Study to Evaluate the Efficacy of Elix's Cycle Balance and Its Impact on PMS and Menstrual Symptoms (NCT05145257). ClinicalTrials.gov. 2022.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This content is for educational purposes and is not a substitute for medical advice. Talk to your healthcare provider before starting any new supplement, especially if you're trying to conceive or take medication.
Â
