Is it okay to use the pill to skip your period?

Top things to know:

• It’s fine to skip your period using the birth control pill
• If you choose to skip your period continually, side effects can include breakthrough bleeding
• You uterus won’t get “backed up”
• Make sure you know which kind of pill you have — monophasic or multiphasic — before skipping

There are many reasons why people choose to skip their periods, such as convenience (e.g. a hot date or vacation), symptom relief, or just personal preference.

Fewer periods means fewer period-related symptoms, such as painful periods (dysmenorrhea), PMS (premenstrual syndrome), or breast tenderness (1). 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 (2).

People who choose to skip their periods experience a decrease in menstrual cramps and premenstrual symptoms (3). Other menstruation-associated symptoms also improve with period skipping, including: menstrual headaches, genital irritation, tiredness, and bloating (1).

Is skipping your period safe?

Medical studies have reported no significant negative health effects when you skip your period using the pill (1). 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 (4).

Are there side effects to skipping your period continually?

The main side effect of having long period-free stretches is an increase in unpredictable breakthrough bleeding (unpredictable midcycle bleeding) (1). The good news is that the frequency of breakthrough bleeding decreases over time (1,3,5). Other than increased rates of breakthrough bleeding, taking your birth control pill consecutively, as opposed to having monthly pill-periods, does not change any side effects (1,6).

A concern about not having a regular period is that you lose the monthly confirmation that you’re not pregnant. Although skipping your period 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 birth control pill doesn’t allow your endometrium (the lining of your uterus) to grow as thick as it normally would, which is why pill-periods (withdrawal bleeding) are much lighter than a natural period (7). If you skip a cycle, the continuous exposure of synthetic hormones will maintain your endometrium at the same suppressed level (8).

How do I go about skipping my period?

There are many different birth control pills containing different types of synthetic hormones and doses. Some pills are are monophasic — meaning they have the same dose of hormones in each pill. Other pills are multiphasic — meaning that the amount 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 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 with planning your period, since you could technically schedule your period for whenever you wish. Just stop taking your pill for a few days (depending on the brand, this could be 4–7 days), and you will have a withdrawal period (9). 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 (9).

If you are taking a multiphasic pill: Take your hormonally active pills as normal, but 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). Simply 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 effects related to continued period-skipping with a multiphasic pill, 4 out of 10 participants reported side effects of breast tenderness and breakthrough bleeding (10).

There are also continuous 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 4 times per year. Another brand goes even further, providing a full year of menstrual suppression (1).

So, it’s okay to skip my period on the pill?

Overall, the consensus is yes — it’s okay to skip your period 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.

However, there is some concern that by normalizing period skipping, people will view their monthly menstruation as unnecessary, a nuisance, and even abnormal (11). 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 the overall health (11). 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.

Download Clue to track when you take your birth control pill.

References

1. Edelman AB, Gallo MF, Jensen JT, Nichols MD, Schulz KF, Grimes DA. Continuous or extended cycle vs. cyclic use of combined oral contraceptives for contraception.Cochrane Database Syst Rev. 2005 Jul 20;(3).
2. Adams Hillard, PD. Menstrual suppression: current perspectives. Int J Womens Health. 2014 Jun 23;6:631–637.
3. Legro RS, Pauli JG, Kunselman AR, Meadows JW, Kesner JS, Zaino RJ, et al. Effects of continuous versus cyclical oral contraception: a randomized controlled trial. J Clin Endocrinol Metab. 2008 Feb;93(2):420–9.
4. Davis AR, Kroll R, Soltes B, Zhang N, Grubb GS, Constantine GD. Occurrence of menses or pregnancy after cessation of a continuous oral contraceptive. Fertility and Sterility. 2008 May 1;89(5):1059–1063.
5. Anderson FD, Hait H. A multicenter, randomized study of an extended cycle oral contraceptive.Contraception. 2003 Aug;68(2):89–96.
6. Nappi RE, Kaunitz AM, Bitzer J. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians. Eur J Contracept Reprod Health Care. 2016;21(2):106–115.
7. The ESHRE Capri Workshop Group. Ovarian and endometrial function during hormonal contraception. Human Reproduction. 2001 Jul 01;16(7):1527–1535.
8. Anderson FD, Feldman R, Reape, KZ. Endometrial effects of a 91-day extended-regimen oral contraceptive with low-dose estrogen in place of placebo. Contraception. 2008 Feb;77(2),91–96.
9. Jensen JT, Garie SG, Trummer D, Elliesen J.Bleeding profile of a flexible extended regimen of ethinylestradiol/drospirenone in US women: an open-label, three-arm, active-controlled, multicenter study. Contraception. 2012 Aug;86(2):110–8.
10. Shulman LP. The use of triphasic oral contraceptives in a continuous use regimen. Contraception. 2005 Aug;72(2), 105–110.
11. Adams Hillard PJ. Menstruation in adolescents: what do we know? And what do we do with the information?. J Pediatr Adolesc Gynecol. 2014 Dec;27(6):309–19.