Taking more than 7 days between birth control packs - ?

August 10, 2014 9:11 PM

I just realized that I'll be starting my period a few days after the start of our vacation we have scheduled in a couple of months (ugh). I'm taking hormonal birth control and wondering what the best way is to basically adjust my cycle so that I can start my period about four days later than I'm currently scheduled to.

I'm taking Cyclafem right now and I have two more periods before the one I'll be starting on vacation. I'm wondering if the easiest thing to do is just make the period week between pill packs 9 days instead of 7? What I can't seem to figure out is if I need to use a back-up form of contraception, and if so for how long. (Obviously I'll err on safety's side.) The instructions for Cyclafem say that if you've missed two pills during your first two weeks that you only need to use a back-up method for seven days, but that presumes that you're taking two pills a day for two days to make up for the time you missed.

A friend suggested just skipping the period week and going right into the next pack of pills, but I don't think that will work for me - my period is so eager to arrive that it sometimes shows up on the last day of week three (also ugh).

Any other thoughts? Does anyone have concrete information about the need for use of back-up methods that I just can't find? Thanks!

posted by skycrashesdown to Health & Fitness (5 answers total)

When I wanted to adjust my period a while back, I simply skipped two weeks between packs instead of one. However, this does mean that you'll need 2 weeks of backup contraception... The alternative is to skip the placebo week entirely, as your friend suggested, and just expect the breakthrough bleeding for that cycle. By the time your vacation arrives, your period should be back to normal and time-shifted as desired.
posted by serelliya at 9:45 PM on August 10, 2014

Making your break week (period week) longer than seven days means that you are pretty much starting the pill afresh when you start taking the new pack. You should be using backup as if this were the first pack you were taking ever, and you weren't starting it during your period.
I'm not sure how long would be recommended for your specific pill brand. But if you want to err on the safe side, Scarleteen advises using backup for the first month.

Skipping a break week may or may not work for you, but it any case it does not compromise the pill's protection and so if you are not using backup with your pill now, you will not need it if you decide to go this way.

I would go with your friend's advice and skip the period week, and deal with breakthrough bleeding if that happens. It's not really worse than a period.

(My period used to make me say ugh. Then I bought a menstrual cup. Now I don't mind it anymore.)
posted by Too-Ticky at 12:01 AM on August 11, 2014

if you want to err on the safe side, Scarleteen advises using backup for the first month.

This is incorrect (but common misinformation). All women are protected after seven days of continuous pill- taking. The directions in the pill packets back this up. You absolutely do not need backup for a month. If you want to try to schedule bleeding by extending the break between packs, it wouldn't be a bad idea to use backup for the whole two weeks, since your protection during the placebos is somewhat dependent on starting the next pack on time.

I also think it would be better to just skip the placebos and go straight to a new pack. If you get breakthrough bleeding now from that, it's not likely you will still be bleeding in two months.
posted by Violet Hour at 1:23 AM on August 11, 2014 [2 favorites]

Instead of prolonging the break between active pills you could prolong each of the two cycles by two days by taking active pills from another pack. That way you wouldn't need backup protection. The result would be similar to just starting another pack without the break, but the risk of breakthrough bleeding would be much smaller, I think.
posted by amf at 1:40 AM on August 11, 2014

Are you taking Cyclafem 1/35 or Cyclafem 7/7/7? The first is a monophasic pill and the second is a triphasic pill (meaning there are 3 different phases of pills).

The triphasic pill makes it more likely you will get breakthrough bleeding if you mess around with your cycle at all, and you'd have to be careful if you were going to do something like use pills from a third pack to prolong the cycles, because not all the pills in the pack are the same.

Whether you go with the idea of taking more than 7 days in between cycles or just starting a new pack, either way you may experience unexpected breakthrough bleeding. If you want a reference for the use of backup contraception when starting a new pack while unprotected (at any time during your cycle), here's a link from the American Association of Family Physicians.
posted by treehorn+bunny at 7:49 AM on August 11, 2014 [2 favorites]