Illustration by Emma Günther
Skipping your period using birth control pills
All you need to know about skipping your period safely
Top things to know about skipping your period on the pill:
Some forms of birth control can help you skip your period
There’s no medical need to have a “period” during each cycle
Skipping a period on certain forms of birth control doesn’t make your birth control less effective
You can use the Clue app to track how skipping your period with birth control affects you
Most hormonal birth control, like the pill, patch, and ring, regulate hormone levels in a way that mimics a menstrual cycle (1). This means you take active hormones for three weeks, followed by a week-long withdrawal of the hormones (1). The bleeding experienced during this last week is due to a drop in reproductive hormone levels (1). This causes the lining of your uterus to release and exit through the vagina (2).
Many refer to this vaginal bleeding as a “period.” However, it’s not the same as the period you experience when you’re not using hormonal birth control. It’s called withdrawal bleeding and is usually lighter than menstrual bleeding (2,3). Some people find withdrawal bleeding reassuring, but there’s no medical need for you to bleed each cycle (3).
Skipping your placebo pills (the hormone-free pills at the end of your pack) or using a new ring or patch straight away means you also skip the hormone withdrawal, and likely won’t experience a “period”. Some people have a medical reason to skip periods, like migraines, anemia, a history of blood clots, or premenstrual dysphoric disorder (PMDD) (4). However, you don’t need a medical reason to skip your period on birth control.
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What are placebo pills?
The placebo pills in your birth control pack do not contain any active ingredients (2). These pills are usually a different color than the active pills (2). They can sometimes contain iron to replace the iron lost during a withdrawal bleed (2,3). Placebo birth control pills do not contain hormones and can be referred to as “sugar pills” or “reminder pills.” Their purpose is to keep you in the habit of taking a pill every day.
Do you have to take the placebo pills?
You don't have to take the placebo pills. Research suggests that it’s safe to skip them to extend your cycle (2). The placebo pills are just a reminder to help you take your pill every day.
There’s no medical reason to take placebo pills unless your gynecological healthcare provider gives you specific medical advice to take them. You can skip them and start the next pack of active pills. If you do choose to skip your placebo birth control pills, you need to start your next pack of pills within seven days.
If you do not start your next pack, the drop in hormones could lead to ovulation and you will no longer be protected from pregnancy (2). You can use condoms during this time for backup birth control.
What happens if you skip the placebo pills?
Skipping your placebo pills will not impact the effectiveness of your birth control. You will not have a withdrawal bleed and you won’t experience any associated symptoms. By continuously taking active pills, you maintain a steady supply of hormones and avoid fluctuations in your hormonal levels (2).
The active pills stop your endometrium (the tissue that lines the uterus) from growing and your ovaries from releasing an egg (ovulation). Continuous use of active pills, therefore, reduces your number of bleeding days. If you skip the placebo pills, you may also notice reduced period pain and fewer hormonal headaches (2).
So, is it safe to skip my “period” on the pill?
Yes, it is generally considered safe to skip your withdrawal bleed while on the pill (2). There is no medical need to experience vaginal bleeding each cycle. Hormonal birth control pills thin the uterine lining, preventing a "build-up" of tissue in the uterus (3). Skipping periods on the pill may actually make birth control more effective and reduce the chance of ovulation (2).
How to safely skip a period using oral contraceptives
If you don’t want to experience a withdrawal bleed, you can start a new pill pack instead of taking the placebo pills. Skipping placebo pills and switching to active pills does not affect contraceptive efficacy (2). If you are on the pill, then the choice to have your period or to skip it is up to you (1,2). There are no rules for how many periods a person should have (1).
It’s important to ask your healthcare provider for medical advice about which type of birth control is right for you. If you are considering the birth control pill, you can choose between monophasic pills (each pill contains the same dose of hormones) and multiphasic pills (hormone dosage changes throughout the pack) (1). Both types allow you to skip your period. The best choice for you will depend on your preferences, goals, and health history (1).
Another option is the mini-pill, also known as the progestin-only pill. It’s usually taken for 28 days with no scheduled hormone-free time (1). If you are on a type of mini-pill that consists of 24 active and 4 placebo pills, speak to your healthcare provider about the possibility of skipping the placebo pills. Research on this is limited, so. your healthcare provider can help you make the right choice (1).
It’s possible to experience some spotting or breakthrough bleeding when you’re on an extended (longer cycles) or continuous (no periods) schedule. Spotting is common at the beginning of extended or continuous use (2). After a while, spotting and breakthrough bleeding decreases for most people (2).
What are the benefits of skipping my period?
Doctors began prescribing birth control pills for continuous (no periods) cycles in the 1960s to help people with heavy menstrual bleeding, anemia, and bleeding disorders (2,5-6). Since then, continuous cycles have been used for other common health conditions like hormonal headaches, endometriosis, period pain, genital irritation, tiredness, bloating, breast tenderness, premenstrual syndrome (PMS), and premenstrual dysphoric disorder (PMDD) (2,5-6).
What are the side effects of skipping my period?
Side effects from skipping a period are similar to the side effects of taking birth control (17).
Common side effects include:
Breakthrough bleeding or spotting: Unexpected bleeding is common in the first few months of skipping periods with birth control (7). The good news is that this unpredictable bleeding usually decreases over time (7).
Nausea: Some people experience nausea on the pill. If this is the case for you, taking the pill before bed might help (8).
Mood: There isn’t much research that specifically focuses on mood and the use of extended birth control. However, skipping periods is sometimes suggested for people who experience mood changes around their period while taking the pill (7).
Breast tenderness: There isn’t any research on breast tenderness and skipping periods. It’s likely that if you experience breast tenderness around your period, skipping periods would reduce breast pain. If breast pain or tenderness is bothering you, a breast exam from your healthcare provider can help you rule out anything serious (9).
Sex drive: Skipping periods might be good for your sex drive. Lots of people report that having periods gets in the way of their sex life (7).
Blood clots: If you have a history of blood clots, talk to your healthcare provider about your birth control options. There’s likely another method that’s better for you (2,10).
What types of birth control pills are available?
Not all hormonal birth control pills are the same. Different brands of pills contain varying levels of estrogen and progesterone, and some contain only progesterone. Some work if you want to skip a period, while others do not.
The mini-pill
The mini-pill contains only one hormone, progestin (the synthetic version of progesterone). It usually comes in a pack of 28 pills and doesn’t have a hormone-free interval. However, one type of mini pill, called Slynd, does have a hormone-free interval (11). It contains 24 active pills and 4 placebo pills (11). Most versions of the mini-pill must be taken within the same three hours every day to be effective (1), but Slynd has a longer window (11).
Combination pills
Combination pills contain two hormones: estrogen and progestin (1). They are the most common type of hormonal birth control pills (1).
There are different formulations of combination pills available:
Pills designed as 28-day cycles
Extended-use formulation: Where you’ll have cycles that last three months, with a one-week hormone break and a withdrawal bleed during the last week of the pack (12).
Continuous formulation: When active pills are taken for a year with no withdrawal bleeds (12,13).
Low-estrogen pills
Low-estrogen pills contain 20 μg of estradiol or less. People report higher rates of breakthrough bleeding when taking these pills compared to other types of pills (13-14).
What other birth control method can I use to skip my period?
Hormonal birth control pills are not the only option if you want to skip your period. The patch and the vaginal ring can also be used continuously to avoid a withdrawal bleed or “period” (1).
Vaginal ring
NuvaRing
To make sure you don't get a period and remain protected from pregnancy, don’t leave your NuvaRing outside of your vagina for more than three hours in any 24-hour window. This ring can last up to five weeks, so you can change it every three to five weeks. An easy way to do this is to pick a day of the month (e.g., the 1st) and stick to changing your ring on that day (13).
Annovera
Annorva is a different kind of ring that contains enough hormones to last a full year (or 13 cycles). Continuous use of Annorva hasn’t been well studied. Talk to your healthcare provider if this is your preferred form of birth control, and if you’d like to use it to skip periods (13).
Transdermal patch
Twirla and Xulane
Ask your healthcare provider about using these patches to skip your periods. Skipping periods is possible, but it is considered an “off-label” use, meaning it hasn’t been studied yet (13).
Birth control that changes period patterns
Some birth control methods are designed to “set it and forget it,” meaning they last longer than other methods. This usually results in fewer periods. Other birth control methods that reduce periods for extended amounts of time include:
Injectable contraceptives
Depo-Provera
The birth control shot is designed to affect your uterus in a way that will reduce the number of periods over time. In studies, up to 3 out of 10 people stopped having periods after their first injection. Up to 5 out of 10 people stopped having periods after 4 injections. After 2 years, about 7 out of 10 people have stopped having periods (1).
IUDS
There are five types of IUDs available in the USA. The IUD affects the uterus in a way that will change bleeding patterns, and bleeding can be unpredictable with an IUD. IUDs that contain hormones might reduce the number of periods you have, but they are not the best option for skipping periods (1).
Subdermal implants
Nexplanon
The implant might reduce the number of periods you have, but, again, it’s not the best option for skipping periods (1).
Your healthcare provider can help you choose the right method for you, depending on your circumstances and needs (15).
The importance of tracking your birth control pills
Tracking your birth control pills with Clue can help you avoid missing pills. If you miss a pill, it is not safe to rely on Clue’s fertile window as a backup, since Clue can’t accurately predict your fertile days in this case. You can use Clue to set a daily pill reminder or to tell you when it is time to start a new pack so that you do not extend your hormone-free interval.
You can also track other experiences, such as headaches, mood changes, fatigue, or bowel movements. This helps you understand your body and identify patterns related to your hormonal birth control. Tracking can ultimately increase awareness of how your body works (16).
