Reprints

A single copy of this article may be reprinted for personal, noncommercial use only.

Delaying your period with birth control pills

By Mayo Clinic staff

Original Article:  http://www.mayoclinic.com/health/womens-health/WO00069
The Mayo Clinic Diet Book, learn more

Free

E-newsletter

Subscribe to Housecall

Our weekly general interest
e-newsletter keeps you up to date on a wide variety of health topics.

Sign up now

Delaying your period with birth control pills

If you take birth control pills, you may not need to have a monthly period. Find out how to use the pill to have more control over your cycle.

By Mayo Clinic staff

Are you interested in having fewer periods? It's possible with birth control pills. Find out how and get answers to common questions about using birth control pills to delay or prevent periods.

How does it work?

Traditional birth control pills are designed to mimic a natural menstrual cycle. A traditional pill pack contains 28 pills, but only 21 are active — containing hormones to suppress your fertility. The other seven pills are inactive. The bleeding that occurs during the week you take the inactive pills is withdrawal bleeding, which looks like a period. This is your body's response to stopping the hormones. If you skip the inactive pills and start a new pack of active pills right away, you won't have this withdrawal bleeding.

The bleeding that occurs while you take the inactive pills isn't the same as a regular period. Nor is the bleeding necessary for health. This is good news if you take birth control pills and want more control over your menstrual cycle, either for personal or medical reasons.

What are the benefits of delaying your period?

Delaying your period can treat or prevent various menstrual symptoms. It might be worth considering if you have:

  • A physical or mental disability that makes it difficult to use sanitary napkins or tampons
  • A condition worsened by menstruation, such as endometriosis, anemia, asthma, migraines or epilepsy
  • Breast tenderness, bloating or mood swings in the seven to 10 days before your period
  • Headaches or other menstrual symptoms during the week you take inactive birth control pills
  • Heavy, prolonged, frequent or painful periods

In addition, menstrual bleeding is sometimes simply inconvenient. You may want to postpone your period until after an important exam, athletic event, vacation or special occasion, such as your wedding or honeymoon. Delaying your period may also help you save money, since you may use fewer hygiene products or pain relievers.

Is it safe for all women to delay menstruation?

If your doctor says it's OK for you to take birth control pills, it's probably safe to use them to delay your period. Not all doctors think it's a good idea to delay menstruation, however. Even those who support the option may not mention it unless you bring up the topic. If you want to try delaying your period, you may have to take the lead. Ask your doctor which option might work for you.

What are the drawbacks to delaying your period?

Breakthrough bleeding — bleeding or spotting between periods — is common when you use birth control pills to delay or prevent periods, especially during the first few months. Breakthrough bleeding typically decreases over time, however, as your body adjusts to the new regimen.

Another drawback of routinely delaying your period is that it may be more difficult to tell if you're pregnant. If you have morning sickness, breast tenderness or unusual fatigue, take a home pregnancy test or consult your doctor.

What can be done about breakthrough bleeding?

Breakthrough bleeding usually decreases with time, but there are some things you can do in the meantime:

  • Stay on schedule. Missing a pill makes breakthrough bleeding more likely.
  • Keep taking the pills as directed. Breakthrough bleeding isn't a sign that the pill isn't working. If you stop taking it, you risk unplanned pregnancy.
  • Track breakthrough bleeding in a calendar or diary. Typically, careful tracking offers reassurance that breakthrough bleeding is decreasing.
  • Ask your doctor about taking a short pill-free break. If you've taken active pills for at least 21 days, your doctor may suggest stopping for three days to allow bleeding that resembles a period and then taking the pills again for at least 21 days.
  • If you smoke, ask your doctor to help you quit. Women who smoke are more likely to experience breakthrough bleeding than are women who don't smoke.

If these suggestions don't help or the breakthrough bleeding becomes heavy or lasts more than seven days in a row, contact your doctor.

Are any birth control pills specifically designed to lengthen the time between periods?

Yes. These are referred to as continuous or extended-cycle birth control pills. The following are currently available in the U.S.:

  • Seasonale, Jolessa and Quasense. With this regimen, you take active pills continuously for 84 days — or 12 weeks — followed by one week of inactive pills. Your period occurs during week 13, about once every three months.
  • Seasonique and Camrese. With this regimen, you take active pills for 84 days — or 12 weeks — followed by one week of pills containing a very low dose of estrogen. Your period occurs during week 13, about once every three months. Taking low-dose estrogen pills instead of inactive pills helps reduce bleeding, bloating and other side effects sometimes associated with a hormone-free interval.
  • Lybrel. This pill contains low doses of both progesterone and estrogen and is designed to be taken continuously for one year. There are no breaks for hormone-free intervals, which means no periods.

Can you delay your period with traditional birth control pills?

It's possible to delay or prevent your period with continuous use of any birth control pill. This means skipping the placebo pills and starting right away on a new pack. This works best with monophasic pills, which have the same amount of hormones in every pill.

Your doctor might recommend a schedule such as the following:

  • Take active pills 6 weeks in a row. You'll need to use two pill packets. Take the active pills from the first packet, discard the remaining inactive pills, and then take the active pills from the second packet. Don't take a break between packets.
  • Take the inactive pills from the second packet. When you've taken the active pills from the second packet, you'll have taken six weeks of active pills. Take the inactive pills from the second packet during week seven. This is when you'll have your period. To reduce withdrawal symptoms and unscheduled bleeding, your doctor may suggest taking inactive pills for only three or four days rather than the full seven days.

If you don't have unpredictable bleeding or other significant side effects, your doctor might suggest you take the active pills continuously for nine weeks in the next cycle and 12 weeks in the cycle after that.

Is it better to delay your period with 28-day birth control pills or with continuous or extended-cycle pills?

The choice of birth control pill is up to you and your doctor. Keep in mind that you can reduce withdrawal symptoms and unscheduled bleeding by taking inactive pills for only three or four days rather than the full seven days or by replacing inactive pills with low-dose estrogen pills.

References
  1. Kaunitz AM. Hormonal contraception for suppression of menstruation. http://www.uptodate.com/home/index.html. Accessed Oct. 24, 2011.
  2. Sulak PJ. Continuous oral contraception: Changing times. Best Practice & Research Clinical Obstetrics & Gynaecology. 2008;22:355.
  3. Nelson AL. Communicating with patients about extended-cycle and continuous use of oral contraceptives. Journal of Women's Health. 2007;16:463.
  4. Braunstein JB, et al. Economics of reducing menstruation with trimonthly-cycle oral contraceptive therapy: Comparison with standard-cycle regimens. Obstetrics & Gynecology. 2003;102:699.
  5. Anderson FD, et al. Long-term safety of an extended-cycle oral contraceptive (Seasonale): A 2-year multicenter open-label extension trial. American Journal of Obstetrics & Gynecology. 2006;195:92.
  6. ACOG committee opinion No. 448: Menstrual manipulation for adolescents with disabilities. Obstetrics & Gynecology. 2009;114:1428.
  7. Seasonale/Jolessa (prescribing information). Woodcliff Lake, N.J.: Teva Pharmaceuticals; 2010. http://www.tevausa.com/default.aspx?pageid=47. Accessed Oct. 17, 2011.
  8. Freeman SB. Continuous oral contraception: Strategies for managing breakthrough bleeding. Advance for Nurse Practitioners. 2008;16:36.
  9. Memmel L, et al. Contraception. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:567.
  10. Edelman A, et al. Management of unscheduled bleeding in women using contraception. http://www.uptodate.com/home/index.html. Accessed Oct. 24, 2011.
  11. Hickey M, et al. Unscheduled bleeding in combined oral contraceptive users: Focus on extended-cycle and continuous-use regimens. Journal of Family Planning and Reproductive Health Care. 2009;35:245.
  12. Seasonique/Camrese (prescribing information). Woodcliff Lake, N.J.: Teva Pharmaceuticals; 2010 http://www.tevausa.com/default.aspx?pageid=47. Accessed Oct. 17, 2011.
  13. Lybrel (prescribing information). New York, N.Y.: Pfizer; 2010. http://www.pfizer.com/products/rx/prescription.jsp. Accessed Oct. 17, 2011.
  14. Teichmann A, et al. Continuous, daily levonorgestrel/ethinyl estradiol vs. 21-day, cyclic levonorgestrel/ethinyl estradiol: Efficacy, safety and bleeding in a randomized, open-label trial. Contraception. 2009;80:504.
  15. Sulak PJ, et al. Prospective analysis of occurrence and management of breakthrough bleeding during an extended oral contraceptive regimen. American Journal of Obstetrics & Gynecology. 2006;195:935.
  16. Frederick CE, et al. Extended-use oral contraceptives and medically induced amenorrhea: Attitudes, knowledge and prescribing habits of physicians. Contraception. 2011;84:384.
  17. Gallenberg MM (expert opinion). Mayo Clinic. Rochester, Minn. Oct. 25, 2011.
WO00069 Jan. 21, 2012

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

  • Reprints
  • Print
  • Share on:

  • Email

Advertisement


Text Size: smaller largerlarger