Question Title: Affects of birth control pills

Dear Keri:
Fatigue is not a symptom of discontinuing birth control pills. It is a very common symptom and if it has been present for 1 week, I would first look to lifestyle or transient illness ("the flu") reasons.
I ask patients to use barrier contraception (foam, condom, diaphragm) from the last "pill period" until the first spontaneous menstrual period. The average time between these two events is 6 weeks, can be 12 weeks in some women, and up to 6 months for others. This is why one hears of women who became pregnant without having a menstrual period. Although uncommon, it creates confusion to make the diagnosis and to date the pregnancy.
Multiple vitamins containing more than 0.4 mg folic acid daily (often they contain 1 mg) are recommended in women attempting pregnancy. A balanced diet without excesses of any substance is also good.

KeywordsL oral contraceptives

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