Taking ‘the pill’. A different approach to make this method work best for you

posted by: Jonathan Shaw

A bit of background…

When the combined pill was initially made in the 1950’s it aimed to mimic a woman’s natural cycle. Therefore, it is licenced to be taken for 21 days followed by a pill-free week. During this week, people experience withdrawal bleeds, similar to a period. Since the 1950’s we have learnt more about the combined pill and recognise that there can be many benefits to skipping or not taking any breaks at all.

Benefits of skipping pill breaks include:

1. Decreasing the length and frequency of breaks makes the pill more effective.
2. Some people experience less trouble with headaches, bloating and period pain when fewer breaks are taken.

Is it safe to skip monthly pill-free days/weeks?

Bleeds during pill breaks happen due to the lack of hormone present –  that’s why we refer to them as withdrawal bleeds.

It is safe to skip monthly bleeds by taking several packets in a row continuously. Blood doesn’t build up inside, because the womb lining stays thin. Fertility returns immediately after stopping the pill, even if a withdrawal bleed has not been introduced for a long time.

So why have a break at all?

Skipping breaks (pill-free weeks) can sometimes increase the chance of experiencing irregular bleeding, which can be resolved by introducing a short break when this happens. We also recognise that many people want to have monthly breaks. If you prefer taking your pill this way, you should continue. It’s all about what works best for you!

Similarly, it is possible to skip breaks with the combined patch and vaginal ring. Below outlines possible ways this can be done:

Shortened hormone free interval:

Combined pill – The pill is taken for 3 weeks then stopped for 4 days.

Combined patch – The patch is changed weekly for 3 weeks then stopped for 4 days.

Vaginal ring – The vaginal is used for 3 weeks then removed for removed for 4 days.

Bi /Tricycling regime:

The pill, patch or vaginal ring is used continuously for 2 or 3 months followed by a 4-day break.

Flexible extended use:

The combined pill, patch or vaginal ring is used continuously until breakthrough bleeding occurs for 3-4 days. A break of 4 days is then advised.

*Remember the patch must be changed weekly and the vaginal ring must be changed every 21 days. These alternative ways of using your contraception only apply to combined hormonal contraception (the combined pill, patch and ring), the progestogen-only pill must always be taken without breaks. For further information on the progestogen-only pill click here.