Femia > Health Library > Your cycle > Health > Do you still ovulate on birth control? Understanding how it works
Do you still ovulate on birth control? Understanding how it works

- Updated Feb 11, 2025
- Published
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- Most hormonal birth controls prevent ovulation by altering hormone levels and disrupting the menstrual cycle.
- Some methods of birth control, like the mini pill, don’t suppress ovulation in every woman but prevent pregnancy via other mechanisms.
- Incorrect use of birth control can result in ovulation restarting and increase your risk of getting pregnant.
Have you ever wondered how birth control stops you from getting pregnant? Do you still ovulate on birth control, or is there another way it works? Finally, what effects can birth control have on your cycle and fertility?
To answer these questions and help you decide on the right birth control method for you, we need to have a look at the science behind your menstrual cycle, how birth control interrupts it, and what that might mean for your body.
Femia offers the most accurate tool for determining ovulation and fertile days
What is ovulation, and how does birth control affect it?
Ovulation occurs when an egg is released by an ovary. It happens during the ovulation phase of the menstrual cycle – around 2 weeks before the start of your next period. When you ovulate, a mature egg is released from an ovary and travels down the fallopian tube where it can be fertilized by sperm. But, in order for your ovaries to be able to release an egg, several key things need to happen first.
Ovulation begins in the brain, specifically in the hypothalamus, which releases gonadotropin-releasing hormone (GnRH). This hormone signals the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
FSH stimulates the ovaries to develop follicles, one of which will release a mature egg during ovulation. LH triggers the release of this egg from the ovary. These hormones also regulate the production of estrogen and progesterone, which control the menstrual cycle.
Some types of birth control work by disrupting this process—they suppress the release of LH and FSH, preventing the ovary from releasing an egg and stopping ovulation. If ovulation doesn’t occur, pregnancy cannot happen.
👉Find out more: Signs of ovulation after stopping taking birth control pills
How does birth control affect ovulation?
1. Combined hormonal birth control (estrogen and progestin)
Includes: The pill, patch, and ring
- Releases a steady stream of estrogen and progestin into the body.
- Disrupts the hypothalamus-pituitary-ovarian axis (HPO axis).
- Stops the hypothalamus and pituitary from producing FSH and LH.
- Without FSH and LH, the ovaries don’t develop or release an egg, preventing ovulation.
2. Progestin-only birth control
Includes: The mini pill, hormonal IUD, implant, and injection
- Contains only progestin (a synthetic form of progesterone), which can still disrupt ovulation in a more subtle way.
- Depending on the dose and method, it doesn’t stop ovulation all of the time for every woman.
- Progestin prevents pregnancy in additional ways. It thickens cervical mucus, making it difficult for sperm to reach the uterus. It also thins the uterine lining, reducing the chances of implantation.
Do you still ovulate on birth control?
Whether or not you still ovulate while taking birth control depends on the type of birth control you take. Let’s have a look at the different types of birth control and how they impact ovulation:
Type of birth control | Effect on ovulation | Other |
---|---|---|
Combined hormonal birth control (the pill, patch, and ring) | Typically suppresses ovulation completely | • Thickens cervical mucus, making it hard for sperm to enter the uterus
• Thins lining of the uterus, preventing implantation |
Progestin-only pill (the mini pill) | Suppresses ovulation in some women
According to the American College of Obstetricians (ACOG), 40% of women will continue to ovulate. | • Thickens cervical mucus
• May thin the uterine lining in some women |
Intrauterine device (IUD or the coil) | • Hormonal IUD: suppresses ovulation in some women
• Non-hormonal IUD: doesn’t affect ovulation | • Hormonal IUD: Thickens cervical mucus; thins uterine lining
• Non-hormonal IUD: affects sperm motility making it hard for them to enter the uterus and reach the egg. Also works through a local inflammatory effect that hinders implantation. |
Implant (Nexplanon) | • Stops ovulation
• One of the most effective progestin-based contraceptives, with the highest efficacy in suppressing ovulation among similar methods | • Thickens cervical mucus
• Thins uterine lining |
Contraceptive Injection | • Stops ovulation
• It can take up to a year for ovulation to return after stopping the injection. • Long-term use may be associated with decreased bone density | • Thickens cervical mucus
• Thins uterine lining |
Barrier methods | Does not stop ovulation | Barrier methods like condoms, the cervical cap, and the diaphragm work by preventing the sperm from reaching the egg. They do not affect ovulation or change the uterine environment. |
Why might ovulation still happen on birth control?
You can still ovulate even when taking hormonal birth control, especially if it’s not used correctly or consistently. Here are some common reasons for ovulating while on birth control:
- Missed doses: Missing a pill can cause hormone levels to drop, especially if multiple pills are missed in a cycle. Lower hormone levels increase the likelihood of ovulating.
- Inconsistent use: Not changing your patch, ring, or getting the injection at the right time can cause hormone levels to drop and ovulation to restart.
- Incorrect use: Not taking the mini pill at the same time each day can lower hormone levels, causing ovulation to occur.
- Method and strength of birth control: Different types of birth control contain different amounts of hormones. Over time, the amount of hormones released can also reduce. For example, the amount of progestin released by the hormonal IUD lowers over time. This means some women may start to ovulate even when taking hormonal birth control.
- Medications: Certain medications can make birth control (like the pill) less effective, meaning you could ovulate that cycle. For example:
- Rifampin (antibiotic)
- Certain HIV medications
- Griseofulvin (ain’t-fungal)
- St John’s Wort (herbal supplement)
- Illness: Vomiting or diarrhea for longer than 48 hours can reduce how well the pill and mini pill work, leading to ovulation.
Femia offers the most accurate tool for determining ovulation and fertile days
What happens if you ovulate on birth control?
Even if you ovulate while taking birth control, it doesn’t mean you will get pregnant. Most hormonal birth controls have backup methods to prevent pregnancy, like thickening cervical mucus to make it difficult for sperm to enter the uterus, thinning the uterine lining to make implantation unlikely, and generally making the uterus a difficult place for sperm to survive.
In certain situations, ovulating while taking birth control can be a sign that your birth control is not working effectively. In these cases, your chances of getting pregnant do increase. This is especially true if ovulation restarts because of inconsistent or incorrect birth control use. Poor use of birth control – like missing doses, or not changing patches or rings at the right time – not only increases your chances of ovulating but also weakens its overall effectiveness in preventing pregnancy.
👉Find out more: How long should you be off birth control before trying for a baby
Common misconceptions about birth control and ovulation
Myth: Ovulation suppression means no periods.
Fact: While it seems logical that not ovulating means you won’t get a period, it’s unfortunately not always the case. When taking the pill, you can have ‘withdrawal bleeding’ in the breaks between packs. This bleeding can act just like a period even though it isn’t one.
Myth: You can’t get pregnant if you ovulate on birth control.
Fact: If you ovulate while taking birth control because of incorrect or inconsistent use, then the chances of getting pregnant are higher. This is because using contraception incorrectly makes you more likely to ovulate and also means that the other mechanisms to prevent pregnancy – like thickened cervical mucus or a thinner uterine lining – can also fail.
Myth: Birth control reduces your fertility in the long term.
Fact: Although this is a widely repeated myth, there is no evidence to suggest it’s true. In fact, a 2018 systematic review and meta-analysis published in the journal ‘Contraception and Reproductive Medicine‘ found that contraception use has no negative effect on fertility, regardless of what type you use or for how long. It’s possible to get pregnant after stopping birth control almost immediately.
Myth: Not ovulating ‘saves’ your eggs for the future.
Fact: Unfortunately, while this would be great, there is no evidence to suggest that by not ovulating each month, you will have more eggs and better fertility in the future. While contraception doesn’t harm future fertility, it also won’t boost it.
Questions from the Femia community
Does ovulation happen during the placebo week of birth control pills?
No, ovulation suppression continues during the placebo week when pills are taken correctly. You may experience what looks like a period during this week as hormone levels drop, causing withdrawal bleeding. But this is not a true period and does not indicate that you’ve ovulated. However, if you miss some pills or start your next pack late, then there is a chance you will ovulate.
Can emergency contraception stop ovulation?
Yes, according to the World Health Organization (WHO), Plan B and similar methods work by stopping or delaying ovulation. However, if you’ve already ovulated before taking emergency contraception after having unprotected sex, it won’t stop the sperm from fertilizing the egg.
What happens if ovulation resumes after forgetting to take birth control pills?
If you forget to take your birth control and ovulation starts again, then there’s a risk of pregnancy if you’re having unprotected sex. If you haven’t been taking the pill as directed, then it’s best to use a barrier method like condoms as well.
Does ovulation suppression affect long-term fertility?
No, ovulation typically resumes soon after stopping birth control. However, if you have been using the contraceptive injection, it can take up to a year for ovulation to restart.
Are there signs of ovulation while on birth control?
If you’re still ovulating while taking birth control then you might notice signs of ovulation, like a change in cervical mucus or one-sided ovary pain. If you’re not ovulating, you shouldn’t see a mid-cycle change in cervical mucus. If you’re experiencing any unusual symptoms, like a change in vaginal discharge or one-sided abdominal pain, it’s best to seek advice from a healthcare professional.
What should I do if I suspect I’m ovulating on birth control?
If you have any concerns about ovulation while taking birth control, especially if you haven’t been using it correctly, then reach out to your healthcare provider for personalized advice. And in the meantime, use a barrier contraceptive method to prevent pregnancy.
The bottom line
Most hormonal birth control methods suppress ovulation, but some methods like the mini pill don’t stop ovulation in every woman. However, this doesn’t mean you will get pregnant. If you’ve been using your contraception correctly, it will still prevent you from getting pregnant even if you ovulate. This is because hormonal birth control has additional ways of protecting you from becoming pregnant, such as thickening cervical mucus to block sperm from entering the uterus and thinning the uterine lining to prevent implantation.
If you have any concerns or confusion about how birth control works, or you’re not sure if you’ve taken it correctly, then reach out to your healthcare provider and consider using barrier methods in the meantime to prevent pregnancy.
References
- “Are Birth Control Pills Effective? | Do Birth Control Pills Work?” Planned Parenthood, www.plannedparenthood.org/learn/birth-control/birth-control-pill/how-effective-is-the-birth-control-pill.
- Bayer HealthCare Pharmaceuticals Inc. Highlights of Prescribing Information. 2024, labeling.bayerhealthcare.com/html/products/pi/Mirena_PI.pdf.
- Girum, Tadele, and Abebaw Wasie. “Return of Fertility After Discontinuation of Contraception: A Systematic Review and Meta-analysis.” Contraception and Reproductive Medicine, vol. 3, no. 1, May 2018, https://doi.org/10.1186/s40834-018-0064-y.
- Hatcher, Robert A., and Deborah Kowal. “Birth Control.” Clinical Methods – NCBI Bookshelf, 1990, www.ncbi.nlm.nih.gov/books/NBK283.
- Hormonal IUD (Mirena) – Mayo Clinic. www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354.
- “Hypothalamic-Pituitary-Ovarian Axis.” Default, med.uc.edu/landing-pages/reproductivephysiology/lecture-4/hypothalamic-pituitary-ovarian-axis.
- “Long-Acting Reversible Contraception (LARC): Intrauterine Device (IUD) and Implant.” ACOG, www.acog.org/womens-health/faqs/long-acting-reversible-contraception-iud-and-implant.
- McLaughlin, Jessica E. “Female Reproductive Endocrinology.” MSD Manual Professional Edition, 5 Apr. 2022, www.msdmanuals.com/professional/gynecology-and-obstetrics/female-reproductive-endocrinology/female-reproductive-endocrinology.
- NHS inform. “Contraceptive Implant | NHS Inform.” NHS Inform, 22 Oct. 2024, www.nhsinform.scot/healthy-living/contraception/contraceptive-implant.
- “Progestin-Only Hormonal Birth Control: Pill and Injection.” ACOG, www.acog.org/womens-health/faqs/progestin-only-hormonal-birth-control-pill-and-injection.
- Website, Nhs. “What Is the Contraceptive Injection?” nhs.uk, 26 July 2024, www.nhs.uk/contraception/methods-of-contraception/contraceptive-injection/what-is-it
- World Health Organization: WHO. Emergency Contraception. 9 Nov. 2021, www.who.int/news-room/fact-sheets/detail/emergency-contraception#:~:text=Emergency%20contraceptive%20pills%20prevent%20pregnancy,and%20egg%20before%20they%20meet.
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