Extended-cycle birth control pills: Putting periods on hold

Originally Published: January 5, 2007 - Last Updated / Reviewed On: March 25, 2011
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Hi Alice,

I'm interested in the 72-day forms of birth control pills. However, the only brand I can seem to find information about is Seasonale. Aren't there more options out there for my sexual needs? Thanks.

Dear Reader,

Aunt Flo isn't always the most welcome of visitors, but you have options to make her visits less frequent. There are currently three FDA-approved extended-cycle birth control pills now on the market: Seasonale, Seasonique, and Lybrel. Seasonale and Seasonique will allow you to have a 91-day menstrual cycle. The pills function similarly to standard hormonal birth control pills. You take active pills for 83 days (12 weeks), then inactive pills (placebo pills with Seasonale or low-dose estrogen pills with Seasonique) in the 13th week. Your period happens in the 13th week, about once every three months. Lybrel, on the other hand, is designed to stop menstruation for a full year and does not include a week of inactive pills like the others (read: no period at all!). Even if you're not taking an extended-cycle birth control pill, women using monophasic birth control may be able to skip their inactive pills and go on to the next pack. Read more about this option in Can I reschedule my period?

Some women don't like the idea of fooling around with their hormones and menstrual cycle. To some people, a monthly period is a welcomed reassurance that their body is working properly and that they're not pregnant. But, altering the menstrual cycle to experience less frequent periods may appeal to women who have:

  • Heavy bleeding
  • Long, frequent, or very painful periods
  • Significant bloating, breast tenderness, or mood swings
  • A disability that makes it difficult to use sanitary napkins or tampons
  • A health condition worsened by menstruation, such as endometriosis, anemia, asthma, migraine, or epilepsy
  • An upcoming event during which menstruation would be inconvenient

Is it dangerous to not have your period or to expose your body to synthetic hormones? Like other oral contraceptives, extended-cycle pills slightly increase your risk of blood clots and cervical cancer. They should not be used by people with:

  • High blood pressure
  • A personal history of stroke, heart attack, or blood clots
  • Migraine with aura
  • Unexplained vaginal bleeding
  • A family history of breast, uterine, or liver cancer

Also, women over 35 who smoke shouldn't use any kind of hormonal birth control. Because this type of pill is relatively new, potential long-term effects are not yet known. However, no serious adverse effects have been shown in multi-year studies.

Possible side effects are similar to conventional oral contraceptives, which include breakthrough bleeding, breast tenderness, nausea, headache, mood changes, leg cramps, acne, bloating, weight changes, and dark spots on the face. Seasonique may temper some of these side effects because the pills taken in week 13 contain a low dose of estrogen, which prevents the dip in hormones that is often the culprit.

Two other FDA-approved pills, Yaz and Loestrin 24 Fe, allow women to shorten their periods by about three days. Each month's packet contains 24 days of active pills along with four placebos. Research shows women using these pills have shorter, lighter periods. Check out other birth control options that may offer similar benefits in the Related Q&As below.

If you're thinking about rescheduling good ol' Aunt Flo's monthly visit, it's a good idea to talk to a health care provider to make sure it's a healthy choice for you. If you're a student at Columbia, call Medical Services at x4-2284 or log-in through Open Communicator to schedule an appointment.