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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 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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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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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.