Updated on July 15, 2019
Top things to know:
It’s fine to skip your "period" on the combined hormonal birth control pill
If you choose to skip your "period" continually, side effects can include breakthrough bleeding
Your uterus won’t get “backed up”
Make sure you know which kind of pill you have—monophasic or multiphasic—before skipping
Some people who choose to skip their “periods” using the birth control pill experience a decrease in menstrual cramps and premenstrual symptoms (3). Skipping your period (withdrawal bleeding) may also improve other menstruation-associated symptoms, including menstrual headaches, genital irritation, tiredness, and bloating (4). Also, people who are negatively impacted by monthly blood loss, such as people with anemia or who have bleeding tendency disorders, might also benefit from fewer “periods” (5).
If you are already taking combined hormonal birth control—like the pill, the ring, or the patch—your ovulation is already being suppressed each month, and the “period” that you are experiencing isn’t actually a real period. It’s a withdrawal bleed. This withdrawal bleeding is caused by the decline in reproductive hormones in your body during days when you are not receiving any hormones from your pill, patch, or ring (1,2).
There are many reasons why people choose to skip these “periods”, such as convenience (e.g. a hot date or vacation), symptom relief, or just personal preference.
Is skipping your “period” safe?
Medical studies have reported no significant negative health effects when you skip your period on the combined hormonal birth control pill (4). That being said, it’s still important to mention that there have been no long-term studies examining the safety of continually skipping your period. Sometimes medical repercussions take a longer time and/or need a larger population sample size to emerge.
If you choose to stop taking hormonal birth control, your natural menstrual cycle and fertility will usually return to normal after one month, regardless of how long you skipped your “period” (6).
Are there side effects of using the pill to skip your “period” continually?
The main side effect of having long bleeding-free stretches is an increase in unpredictable breakthrough bleeding (unpredictable mid-cycle bleeding) (3,4). The good news is that the frequency of breakthrough bleeding may decreases over time (4,7, A). Other than increased rates of breakthrough bleeding, taking your birth control pill consecutively, as opposed to having monthly pill-periods, does cause any additional side effects (4,8).
A concern about not having a regular “period” is that you lose the monthly confirmation that you’re not pregnant. Although skipping your withdrawal bleed with the pill provides you with the same contraceptive protection as before, it also comes with the same risks if you don’t take your pill on a regular daily basis.
But won’t my body get backed up?
No—you won’t get backed up. One thing to keep in mind is that when you’re on the pill you actually don’t have a normal “period”. In fact, the combined hormonal birth control pill doesn’t allow your endometrium (the lining of your uterus) to grow as thick as it normally would, which is why your periods on the pill (withdrawal bleeding) are much lighter than natural periods (9). If you skip a cycle, the continuous exposure of synthetic hormones will maintain your endometrium at the same suppressed level (10).
How can I safely skip my period on birth control?
There are many different combined hormonal birth control pills containing different types of synthetic hormones and doses. Some pills are monophasic—meaning they have the same dose of hormones in each pill. Other pills are multiphasic—meaning that the number of hormones in the pills changes throughout your pack. Your birth control package will indicate which kind of pill you have. You can choose to skip your “period” on either type of pill, but it’s best to consult with your healthcare provider before you start.
If you are taking a monophasic combined hormonal birth control pill
Take your hormonally active pills as normal.
Once you reach your placebo pills (hormone free pills at the end of your pack— these are normally indicated on the package), then simply skip over those and start your new pack the next day as Day 1.
Monophasic dose birth control pills allow flexibility since you can technically schedule your period for whenever you wish. You can stop taking your pill for a few days to have a withdrawal period (11). Note that this is considered “missing two or more pills” even though you are missing them on purpose. You’ll need to use a backup birth control method for seven days to prevent pregnancy.
One study found that if you experience three days of consecutive breakthrough bleeding, choosing to start your period at that time would result in fewer bleeding days throughout the entire year (11).
If you are taking a multiphasic pill:
Take your hormonally active pills as normal.
Once you reach your placebo pills, simply skip over those and start your new pack the next day as Day 1.
With multiphasic pills, it’s ideal to have your period at the end of a pack (as opposed to the mid-pack possibility of monophasic pills).
Finish your current pack and take the placebo pills to bring on your period.
Skipping your period using multiphasic pills is not as well studied as monophasic preparations, which should be taken into consideration when thinking about skipping a period. In one study, although there were no adverse health outcomes related to continued period-skipping with a multiphasic pill, 4 out of 10 participants reported side effects, including breast tenderness and breakthrough bleeding (12).
There are also continuous/extended-use birth control pills on the market. Some pills have 84 days of active hormones followed by 7 days of placebo, giving you your period only four times per year. Another brand goes even further, providing a full year of menstrual suppression (4).
So, it’s okay to skip my “period” on the pill?
Overall, the consensus is yes—it’s okay to skip your withdrawal bleed on the pill. But since there are so many differently dosed birth control pills, it’s always best to first discuss the option of skipping your period with your healthcare provider to make sure that it is a safe and healthy option for you.
There is some concern that by normalizing period skipping, people will view their monthly menstruation as unnecessary, a nuisance, and even abnormal (13). Periods are neither a curse nor a disease. A menstrual cycle is like a vital sign, just like blood pressure, temperature, or respiration rate. It acts as an indicator of overall health (13). If you are on the pill and you want to have a period always, sometimes, or never, the choice is up to you and your preference.
If eliminating your period or withdrawal bleed is something that is important to you, then the standard birth control pill packs may not be the best option for you. There are other forms of contraception, like the hormonal injection, the hormonal IUD, the hormonal implant, or continuous birth control pills, that can cause your period to decrease in frequency and amount, and sometimes stop altogether (A). Speak to your healthcare provider about which type of birth control is best for you.
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Article was originally published on October 5, 2017.