For most women, birth control pills are safe, reliable, and easy to use. One of the most common questions is whether it’s necessary to take the last week of birth control pills in your monthly pack.
The answer comes down to how well you can stay on schedule without that last week of pills. These are placebo pills, and they aren’t used for preventing pregnancy. Instead, the pills allow you to have your monthly period while staying on track with your daily pill.
Keep reading to find out more.
Birth control pills work by preventing the ovaries from releasing an egg. Normally, an egg leaves an ovary once per month. The egg enters the fallopian tube for about 24 hours or so. If it isn’t fertilized by a sperm cell, the egg disintegrates and menstruation begins.
The hormones found in birth control pills prevent your ovaries from releasing an egg. They also thicken the cervical mucus, which makes it harder for sperm to reach an egg if one is somehow released. The hormones can also thin the uterine lining, which makes it difficult for implantation to occur if an egg does get fertilized.
Many combination birth control pills come in 28-day packs. There’s three weeks worth of active pills that contain the hormone or hormones necessary to prevent pregnancy.
The last week’s set of pills typically consists of placebos. Placebo pills are placeholders meant to help you stay on track by taking one pill every day until the next month starts.
The idea is that if you stay in the habit of taking a pill every day, you’ll be less likely to forget when you need to take the real thing. The placebos also allow for you to have a period, but it’s usually much lighter than it would be if you weren’t using oral contraceptives.
Even though you’re taking placebo pills, you’re still protected against pregnancy as long as you’ve been taking the active pills as prescribed.
Some women choose to skip the placebos and continue taking active pills. Doing so replicates the cycle of an extended or continuous-cycle birth control pill. This can reduce the number of periods you have or eliminate them altogether.
Skipping the placebo pills can have many benefits. For example, if you tend to get migraines or other uncomfortable symptoms when you take placebos, you may find those symptoms disappear or are reduced significantly if you stay on active pills during this time.
Also, if you’re a woman who tends to get prolonged periods or if you have periods more frequently than normal, this may help you better regulate your period. Remaining on the active pills allows you to skip your period with minimal side effects.
You may be wondering whether it’s safe for your body to go weeks or months without a period. Your period is simply the body shedding the lining of your uterus following ovulation. If no egg is released, there’s nothing to shed and you don’t menstruate.
You may find some reassurance in having a period, even a light one. It can help you gauge whether or not you’re pregnant. Some women may say that it also seems more natural.
Some doctors recommend having your period at least once every three months. There are a few oral contraceptives designed for that very schedule.
With continuous birth control pills, you take an active pill every day for 12 weeks and a placebo every day for the 13th week. You can expect to have your period during the 13th week.
Many women have no health problems if they stay on extended cycle pills for months or years. Your doctor may have strong feelings one way or the other on the subject.
You should discuss the issue of delaying your period and what your options are when it comes to pills or any other type of long-term birth control methods.
If you skip placebos and take active pills continuously for months and then change your birth control methods for whatever reason, it may take a month or two for your body to adjust.
If you’ve gone without your period for a long time, it may be harder to notice if don’t get your period because you’re pregnant.
Continuous birth control can result in some light bleeding or spotting in between periods. This is very common. It typically happens during the first few months you’re on the pill, and then it may not happen again.
It’s sometimes referred to as “breakthrough bleeding.” It’s not always clear why breakthrough bleeding occurs, but it may be due to your uterus adjusting to a thinner lining, also known as the endometrium.
You should speak with your doctor if you have spotting or any other symptoms that concern you.
Birth control pills aren’t the only way to stop your periods. An intrauterine device (IUD) is a long-term birth control solution that’s well-tolerated by many women. An IUD is a T-shaped device that may or may not be treated with progestin.
An IUD can both thin the uterine wall to help prevent implantation and increase cervical mucus to keep sperm away from the egg. Depending on the type of IUD you get, you may notice that your monthly flow is heavier or lighter than it was before implantation.
Another pill-free option is the birth control shot, Depo-Provera. With this method, you receive a hormone shot once every three months. After the first three-month cycle, you may notice lighter periods or you may not get a period.
You can skip the placebo pills if you take your active pills as prescribed and don’t miss days routinely. However, birth control pills don’t protect you from sexually transmitted diseases (STIs). You should use a barrier method, such as a condom, to protect against STIs.
The long-term use of birth control pills is generally safe for most women. Birth control pills are usually not recommended for women who:
- have blood clotting disorders
- have a history of heart attack
- have some forms of cancer
- are currently pregnant or trying to get pregnant