With birth control pills, regular monthly bleeding doesn't provide any health benefits. Find out how you can 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.

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 called withdrawal bleeding. 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.

Delaying your period can help you manage 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 or anemia
  • 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.

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, ask your doctor which option might work for you.

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.

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.
  • Track breakthrough bleeding in a calendar or diary. Typically, careful tracking offers reassurance that breakthrough bleeding is decreasing.
  • Go back to taking your birth control pills as prescribed. You'll likely have less breakthrough bleeding if you don't try delaying your period by skipping the inactive pills.
  • 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.

Withdrawal symptoms and unscheduled bleeding may be reduced 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.

Breakthrough bleeding isn't a sign that the pill isn't working. Be sure to keep taking the pills, even if you experience bleeding, to lower your risk of unplanned pregnancy. If breakthrough bleeding becomes heavy or lasts more than seven days in a row, contact your doctor.

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

  • Jolessa and Quasense (generic versions of Seasonale). 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.
  • Amethia, Ashlyna and Camrese (generic versions of Seasonique). 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.
  • Rivelsa (a generic version of Quartette). With this 91-day regimen, you take active pills for 84 days — or 12 weeks. Each pill contains a constant dose of progestin but the dose of estrogen gradually increases — starting with 20 micrograms (mcg), moving up to 25 mcg and moving up again to 30 mcg — at three distinct times during the regimen. Then you take one week of pills containing a very low dose of estrogen. Your period occurs during week 13, about once every three months. The gradual increase in estrogen in Quartette may decrease episodes of breakthrough bleeding experienced during early cycles of extended-cycle pills compared with other extended-cycle pills.
  • Amethyst. 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. Breakthrough bleeding can occur — especially when you first start taking the pills — but tends to decrease over prolonged use of the medication.

It's possible to delay or prevent your period with continuous use of any birth control pill. This means skipping the inactive pills and starting right away on a new pack. Talk with your doctor about this option.

Your doctor might recommend a schedule such as the following:

  • Take active pills six 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.

That depends on how long you're trying to delay your period. Talk with your health care provider about your goals, so that you can make the best choice for you.

March 17, 2018