Like a defective typewriter, want to skip a .

October 6, 2010 3:31 PM

Does it hurt anything by taking birth control pills continuously to skip a period?

Special event coming up...on the weekend I'm having my period. I'm considering doing what I've heard others say and just skipping the "inactive" pills in my birth control pack and starting the active ones to avoid having my period, but does this harm (a) my body, (b) the effectiveness of the birth control?

Any reason I SHOULDN'T do this?

posted by anonymous to Health & Fitness (25 answers total)

I believe it depends on your pills, but if you are using the sort that are constant dose (i.e., every pill is the same, as opposed to those that have different pills for the different weeks) there should be no problem. I and many other people do this every single month (with permission from our gyno).

But unless there's a pressing need not to, why not call your gynecologist and ask? Or, if that's not possible for whatever reason, call a planned parenthood clinic and get advice from their staff.
posted by brainmouse at 3:34 PM on October 6, 2010

Standard IANAG (not a GYN) goes here.

No, it won't hurt you. I have a period four times a year because I take Seasonale, which is designed to work like that. My GYN told me I don't even have to have them that frequently if I don't want to....
posted by Aleen at 3:35 PM on October 6, 2010

I've asked my doctor the same question in the past. She said it was a perfectly safe thing to do. (I was on constant-dose pills at the time.)
posted by esoterrica at 3:41 PM on October 6, 2010

I do this with my constant dose pills, and have been reassured by a gynecologist and several nurses that it's completely okay.

(obviously, I lose the monthly reassurance that I'm not pregnant so I flip out every time I wake up hungover and nauseous...)
posted by sawdustbear at 3:41 PM on October 6, 2010 [1 favorite]

The only caveat, as suggested by brainmouse, is that if you are on a pill that has different doses for different weeks, like Ortho-tricyclin which I think is still the most commonly prescribed BC, then you need to open 2 packages at once: take the first weeks pills from both packages in a row for two weeks, then the second weeks pills from both packages, and then the third weeks pills from both packages, otherwise you are likely to have spotting because of the changes in hormone levels.
posted by hydropsyche at 3:43 PM on October 6, 2010 [4 favorites]

But, if this is the first time you are skipping a period, you might have breakthrough bleeding anyway.
posted by rachums at 3:43 PM on October 6, 2010 [1 favorite]

IANAD, but my D also says it's completely safe.
posted by biochemist at 3:45 PM on October 6, 2010

Seconding rachums -- you'll be fine protection-wise so long as it's a monophasic pill, but if your body happens to share my body's opinion on the practice, you'll be bleeding for the next month straight. Not fun. My preference in these situations is to delay my period by however long I need to (up to a week, which my body will tolerate without spotting), then have the period, then start a new cycle. You basically need a spare pack to do this...or if you only need to delay a few days, just have a short cycle next month. Once you start really messing around with different length cycles (as opposed to just plain skipping a period) you might want to use backup. But fwiw, my OB-Gyn has me on the NuvaRing for four week stretches with a week off in between.
posted by ootandaboot at 3:51 PM on October 6, 2010

The only downside to doing this, in my experience, is that once you realize you can basically schedule your period when it's convenient and only have one on roughly a quarterly basis, is that you'll never go back to a 28-day cycle. (Why would you?) At a certain point you will start consuming more pills than your insurance will cover, and you'll either have to switch to a pill designed to be taken this way (like Seasonale, which I have no experience with) or in my case I wound up having to pay for three months of pills out of pocket, since my insurance would only cover 12 packs, and if you are skipping the placebo week you wind up taking 15 over the course of a year.

This assumes that whatever it is you are taking is a constant dose pill, of course.

Years ago there was an article in the New Yorker about the guy who developed hormonal birth control, and he intentionally created a 28-day cycle to mimic a woman's average cycle in the hopes that it would seem natural enough to pass muster with the Catholic Church. No luck there, but the reason for the 28-day pack is a cultural one, not a medical/scientific one.
posted by ambrosia at 3:54 PM on October 6, 2010 [7 favorites]

ambrosia: my prescription has to be written in a specific way (has to include "for continuous use," verbatim, and possibly one other condition), but if my doctor gets it right, my insurance will cover it. There are always phone calls, and they always whine about it a little bit, but they cover it.

(For the record, even if you take it "normally" you need 13 packs/year: 4 weeks x 12 packs = 48 weeks or 336 days, quite a bit short of a year).
posted by brainmouse at 3:58 PM on October 6, 2010 [1 favorite]

Yeah, I was just going to add a note to say to keep in mind that it may screw up your prescription refills, so keep an eye on that.
posted by maryr at 3:59 PM on October 6, 2010

As ambrosia mentioned, you'll love having the freedom to skip periods at will. I use Seasonal and have gone for nearly a year without a period. Sometimes I worry that it seems unnatural, but then remember what a pain in the neck having a period can be some times. I love having the control to schedule a period for when it best suits my travel plans, personal life, etc.

If you gyno will provide you with a sample pack or two-you can avoid going over the prescription limit for the year by having a few month buffer.
posted by JennyJupiter at 4:07 PM on October 6, 2010 [2 favorites]

FYI, every gynecologist I've ever gone to (I started going because I wanted to start taking the pill) has agreed to write the prescription explicitly to say that I'm using the 28-day packs as a seasonale-style pill, so I'll need more than the expected amount. And so then my insurance covers it. Obviously, they've all rewritten that description in pharmacese, but if you ask for that I'd be surprised -- nay, shocked -- if you didn't get it.

And thus that is what I do. Although it's a little flakier than just going on Seasonale, it's also kind of nice because I'm in a LDR and can have my period around the conjugal visits instead of on a particular schedule (I mean, I suppose one could do that with Seasonale and its ilk, too, but for some reason I feel more free to do it when I'm already messing with the "intended" system).
posted by obliquicity at 4:37 PM on October 6, 2010 [1 favorite]

I took DepoProvera for six years and didn't have a period at all during that time.

Not having a period didn't have any lasting effect on my health whatsoever. And temporarily? I'll admit, it was kind of awesome to reliably not have a period. My gynecological health is great and when I did decide to get pregnant, I conceived on the first try, so obviously not menstruating for more than half a decade didn't have an impact on anything fertility related. (For me, anyway.)

If you specifically don't want a period, you can try Seasonale or DepoProvera which are designed to eliminate menstruation if you're not comfortable simply skipping the placebo week on the regular pill. (Though Depo might backfire and it stays in your system for three months, so that one's a little risky.)
posted by sonika at 4:39 PM on October 6, 2010 [1 favorite]

Sort of a derail but this caught my attention:

(obviously, I lose the monthly reassurance that I'm not pregnant so I flip out every time I wake up hungover and nauseous...)

Is the placebo period really a reassurance that you're not pregnant in the same way a "real" period would be? Based on what I know about it, it doesn't seem like it would be, but I'm not an expert.
posted by wholebroad at 5:30 PM on October 6, 2010 [1 favorite]

Is the placebo period really a reassurance that you're not pregnant in the same way a "real" period would be? Based on what I know about it, it doesn't seem like it would be, but I'm not an expert.

If you're pregnant, you're most likely not going to get a period of any kind, placebo or not. I have a friend who did get pregnant on the pill and she did indeed miss her "placebo" period and chalked it up to stress. So, yes, it is a reassurance. Of course, you can still get a "light period" (implantation bleeding is very often mistaken for this) if you're pregnant even if you're not on the pill, so the placebo period really is just as good as a normal one in that regard.
posted by sonika at 5:45 PM on October 6, 2010 [1 favorite]

One huge caveat about Depo-Provera: Depo is known have a negative effect on bone density, and the primary problem with that is the women most likely to be on Depo (women in their twenties) are establishing their baseline bone density for their adult life. After 30 or so, normal osteoclast (bone-breakdown cells) activity tends to outstrip normal osteoblast (bone-building cells) activity, and not only is it a bit more difficult to maintain one's current bone mass, it may not be possible to make up for the loss of bone mass early on, especially if you're in a high-risk population. (It's kind of like how young people affected by the economy now will be affected for the rest of their lives, income and earnings-wise.) It's really something to be aware of because it's a silent side effect.

A progesterone-only alternative that is local and low-dose, and considered less likely to affect bone mass would be Mirena IUD, though it's tricky insurance-wise, and although many women stop having 'menstrual' bleeding, and most who continue have much lighter bleeding, this is not true of everyone. Like all HBC, YMMV.

Also: I echo hydropsyche on how to handle tricyclic packs and most everyone else on 'it's usually fine to go back-to-back, but why not call your doctor or the office's nurseline and just check for your individual case.'
posted by Uniformitarianism Now! at 5:51 PM on October 6, 2010

IANAG, but, I did this for a couple years straight WITHOUT consulting my gyno, and experienced no health problems (using Femcon). I made out like a bandit with sample packs (less cost to me > concerns about Big Pharma's revenue-boosting tactics) so no insurance problems. I eventually told my gyno, who put me on Seasonique. I still just take it continuously and so far no problems with this either. YMMV and keep your gyno in the loop, you know, for your health.

Irony: I bled for a month straight when I transitioned.
posted by shortskirtlongjacket at 7:21 PM on October 6, 2010

I'll just chime in to add to the chorus of women saying that it's fine to continue taking your birth control pills if they are the constant dose kind. If you are at all uncertain about what kind of birth control you have, just give your gynecologist a call and ask to speak with him/her or the nurse on duty. They'll be able to tell you if it's okay to do.

I began skipping my placebo pills about a year ago after talking with my doctor. It's awesome! I miss out on all of the effects of PMS (at least it seems that way to me) and I don't waste money on tampons.

Oh, and this has never been a concern for me, but I do think it's smart to have stock up on a few at-home pregnancy kits in case you might be at risk for an unplanned pregnancy. You could just plan to take a test once a month if you're at all worried.
posted by pinetree at 7:23 PM on October 6, 2010 [1 favorite]

I used Alesse (sp?) for two years without stopping and never got a period.
I've been off all birth control for about 2.5 years now. I had no problems.
posted by KogeLiz at 8:14 PM on October 6, 2010

I hate my period, so I always skip it. My doctor even wrote my prescription with that in mind (for 3 months, I get 4 packs). You don't need Seasonelle for this, you can do it with any birth control pill. The amount of breakthrough bleeding will depend on the hormones in your specific pill though.
posted by RUPure at 9:01 PM on October 6, 2010 [1 favorite]

You're very likely to spot until you reach the end of the 2nd pack, but you probably won't have any spotting immediately (at least that's been my experience), so your event weekend would probably be free of any periods! Again, your body can react differently than mine did, and this would work if all your active pills are the same. If you have the 3-phase pill it gets more complicated than just taking 2 packs in a row.
posted by KateHasQuestions at 9:19 PM on October 6, 2010

Another option is to get yourself a nuvaring and keep it in all four weeks. I haven't had a period in years.
posted by freshwater at 11:03 PM on October 6, 2010

I've had an implant (slow release hormonal BC) now for nearly five years and have had no periods in that time. It's been fantastic.
posted by emilyw at 2:57 AM on October 7, 2010

For what its worth, Lybrel recieved FDA approval for continuous birth control, so there is some scientific support.
posted by rtimmel at 7:26 AM on October 7, 2010