Continuous Cycling with Birth Control Pills
written by Sharon Lenton, CNM

Having fewer periods per year has been proven to provide great benefits to some women.  Scientific research has shown that continuous cycling of birth control pills can decrease your risk for ovarian and endometrial cancer.  If you have painful, heavy periods or suffer from PMS this method can help to reduce these symptoms. 

Normally women have a period (or vaginal bleeding) for one week each month, as a result of the breakdown of the lining of the uterus because a pregnancy did not occur.  During a woman’s reproductive life, there are approximately 450 periods or 13 per year.  Birth control pills can affect this process by preventing the lining from  building up and suppressing ovulation (the release of an egg).  The period that they have, called a withdrawal bleed, is the result of hormone levels dropping during the “pill free” or placebo week.  Placebos are also commonly known as “sugar pills” because they are unmedicated and used to help you to keep track of where you are in your birth control pill cycle.   

You can use the continuous birth control cycle method to regulate having your periods at a convenient time to suit your lifestyle.  This is achieved by using a monophasic birth control pill; all the active pills are the same dosage. Just skip the placebos, and start using the next packet of birth control pills.

Ideally, you should take your sugar pills in order to have your period at least three to four times a year.  If that time falls around your vacation, or at a time when you really don’t want to have your period, you still have the freedom to manipulate your cycles.  There has been research done on continuous cycling of birth control pills and no adverse reactions have been noted in comparison to using birth control pills in the conventional method.  In fact, continuous cycling may be more beneficial especially in preventing pregnancy.

The typical birth control pill cycle is 21 active pills, then 7 sugar pills.  With continuous cycling you may be taking up to 84 active pills and then 7 sugar pills.  Now, remember how we counseled you on what to do if you missed any pills between 1 and 21….?

Normally, you’d be taking pills 1 through 21 thirteen times a year.  With continuous cycling, you would only be taking pills 1 through 84 four times a year.  This method reduces the potential pregnancy risk from missed pills when you have your 13 times a year to only 4 times a year.  If you forget any pills from 22-84, then you can just “forget” them for a total of seven days, and have one of your “periods” and restart the pills again after the seven days.

The major disadvantages of continuous cycling are that many women experience break-through bleeding or spotting for the first 3-6 months while adjusting to this new regime. In addition, you will need more packets of birth control pills per year to do continuous cycling.  If you are experiencing break-through bleeding or spotting, this may be managed by increasing the time between your sugar pills in increments.  

For example, if you are having break-through bleeding after 5 weeks of use, take the sugar pills and “have a period”.  In the next cycle, aim for 6 or 7 weeks before taking the sugar pills and so on until you start having 12 to 13 weeks of continued birth control pill use without bleeding.  Even if your body only tolerates 6-7 weeks before wanting to “bleed”, you have still reduced your annual periods from 13 to 6!

Just remember that it is crucial that you do not miss any pills from 1-21 and that you never take more than 7 sugar pills in a row.

As for your prescription, we can write one for more pills for continuous cycling.  Because most people are taking birth control pills to prevent pregnancy, it is imperative that you understand the concept of continuous cycling before trying to change the way you take your pills.  For this reason we strongly encourage you to make an appointment with our office to discuss dosaging and ensure that you fully understand how to use the continuous birth control pill cycling method.

To find out more, you can go to one of the following websites:

www.noperiod.com
www.seasonale.com