Extended-cycle birth control pills: Putting periods on hold

Dear Reader,

You bet your buttons there are more period-pausing (or eliminating) options out there, including but not limited to birth control pills! As you mention, Seasonale is one brand name for the “combination pill” which is a formulation of estrogen and progestin — the same hormones used in many of the 21-day or 28-day cycle birth control pills. However, unlike those monthly cycle pill packs, you would take “active pills” (containing the hormones) every day for twelve weeks (84 days) followed by a week of “inactive pills” (placebo) that contain no hormones. Long story short: Seasonale is one of several pill options that allow you to get your period once every three months. If you find that the pill options aren't the right fit for you, there are a number of other contraceptive options that can also lighten or stop periods (more on these in a bit). 

When taking hormonal contraceptives, people get what is referred to as withdrawal bleeding rather than true menstruation. This occurs due to not having the same level of hormones from the contraceptives when inactive pills are taken, rather than due to the body’s actual menstrual cycle. That being said, despite not being actual menstruation, this withdrawal bleeding is still often referred to by health professionals as a period. Pills that give you a period every three months come in a variety of hormone doses including some with lower or fluctuating levels of estrogen throughout the pill pack. If three periods a year sounds like your jam, ask your health care provider about different brands and dosing in this category to find the right fit. If a period every three months is still more frequent than you’d like, you may be able to stop your periods altogether. If you’re interested in officially parting ways with Aunt Flo, talk to your health care provider about combination birth control pills that can be taken continuously with no placebos, ever. No breaks in the hormones means there’s no period, period!

Although the withdrawal bleeding isn't medically necessary, to some, a monthly period is a welcomed reassurance that their body is working properly and that they're not pregnant. But, having fewer (or no) periods may appeal to those who don't want to have their period or those who have:

• Heavy menstrual bleeding
• Long or painful periods
• Bloating, breast tenderness, or mood swings in the ten days prior to menstruating
• Difficulty using sanitary napkins or tampons
• A health condition worsened by menstruation, such as endometriosis or anemia
• An upcoming event during which menstruation would be inconvenient or undesirable (e.g., vacation, a honeymoon, the first week of a new job, or final exams)

Curious about any downsides of using pills to skip periods? Breakthrough bleeding (bleeding or spotting between periods) is common, but typically improves after the first few months. The chances of breakthrough bleeding increase if you miss taking a daily pill or if you smoke. It’s worth noting that there aren’t adverse health risks associated with period skipping or your ability to get pregnant in the future. On the other hand, there are some people for whom combination pills aren't recommended. If you have a history of heart problems or stroke, breast, uterine, or liver cancer, diabetes, a clotting disorder, high blood pressure, migraines with aura, or if you smoke and are over 35, your health care provider may not recommend the combination pill.

If the pill isn’t a great fit for you, not to worry! There are plenty of other period-modifying options out there to consider. Several types of hormonal IUDs and the contraceptive implant have been shown to lighten or eliminate periods altogether after a year of continuous use. The birth control patch and the vaginal ring can also be used to skip periods. For example, if you want to skip your period using the birth control patch, it's possible continue to put new patches on each week, skipping the patch-free week when you'd typically get your period. To use the ring to eliminate periods, leave the ring in place for four weeks, skipping the week that it's generally removed. Switching it on a routine schedule every four weeks for continuous coverage. It's wise to discuss these different options with your health care provider as you navigate your personal and sexual needs.

Here’s to punctuating your calendar a little less frequently, if that’s what you’re after!