Affects of birth control pills

  Husband and I decided to stop using birth control in order to let nature take it's course.  We would like to have a baby within the next year or two.  This is my first week of not taking my birth control pills.  I have taken them for over 5 years.  Lately, I have been very tired.  I'm trying to get into the habit of eating right and I've already started taking prenatal vitamins on the suggestion of my OB/GYN.  Could the fact that I'm always tired lately have anything to do with not taking the pill?  
  Also, how common is it to be pregnant and still have a "period"?  I've heard that this can sometimes happen.
  Thank you for your response.
  Keri
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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