Skipping periods on birth control

February 22, 2008 6:31 AM

Skipping periods on birth control - how does it work, and why didn't it when I tried?

I took a pack of birth control pills (21) as usual, and decided to move straight on to the next pack without taking 7 days off for my period. (I did this because I wanted to not have my period for Valentine's day.) I should also mention that the first pack of pills was also my initial month (have been on birth control in the past, but just started again). I didn't pause before starting the 2nd pack, but plan to stop for 7 days before the next pack, as per the instructions.

I thought this was ok, but a couple days into the new pack, I started to bleed - not full menstrual strength, but some spotting. This has been going on for about a week, and seems to be slowing down. So, it looks like I had a very light period anyway, despite my attempt to use birth control to skip it this month. Why did this happen? Is there anything wrong with what I did? What if I continue to have spotting for a long time?

In general, how should one go about using birth control to skip periods, and how often is it okay to do this? Why did I not succeed in doing this?

One more question: is the 7-day placebo/no-pill period flexible? Can I stop the pills for fewer than 7 days? Since my packs don't contain placebo pills, I'm worried that I will forget to start again after 7 days' break. If I decide to start taking pills again after 3 or 4 days and do this long term, is there any negative affect?

Lastly, does any of this affect the contraceptive protection I am getting? I would assume not, but better safe than sorry...

posted by anonymous to health & fitness (13 answers total)

You did it right but it takes a few months for your body to get used to the hormones and their influence on your cycles. Your body was just doing it's normal thing so you had breakthrough bleeding. Once you've been on the pill consistantly for a few months, you'll be able to skip a period with no problem. I think you need the full 7 days to start and finish out your period. I don't know the answer to your second question but I would think that you would need to finish out any period that you have started completely before starting a new cycle. IANAOB but have many years of pill experience. Good Luck!
posted by pearlybob at 6:46 AM on February 22, 2008

Skipping periods works because basically what birth control does is trick your body into thinking you are pregnant by adding hormones. When you stop for those placebo days, your body realizes you are pregnant and "miscarries" causing period like bleeding, but you never ovulated, so you aren't even having a real period.

According to my doctors, only some birth control can be used to skip periods. Basically if your pill is the same strength for every pill, you can skip periods with them, but pills like Ortho TriCyclen gets stronger in hormones as the month goes on, so you can't really skip periods with that as the new pack starts at a lower dosage of hormones that the last week you had. Also, spotting can happen with birth control even if you aren't skipping periods, especially if you are on a new brand. Also, did you use backup protection against pregnancy this month? You are supposed to for the first month on a new pill/starting up again, or else you can get pregnant and spotting is a symptom of that. Not to worry you but....
posted by JonahBlack at 6:51 AM on February 22, 2008

I've been taking pills nonstop for more than 12 years (they all thought my doctor was crazy at the time), with a few 7-day breaks each year; the times I saw spotting the most was 1) at the beginning of taking them, which you are experiencing now as your body adjusts; and 2) when it had been several months (10-12) without a break, and I guess the lining building really wanted to come out, or something. Once I took a week off and had a normal period, the intermittent spotting went away.

Of course YMMV, I've read that different people have different problems with spotting or skin trouble or any number of symptoms that are listen on the packet.

Not taking a pill for only 3-4 days is fine, but it's likely to increase intermittent spotting as your body is getting mixed signals. In terms of contraception, it shouldn't be a problem, but as with every method the more risks you take the more likely you're going to hit the jackpot.
posted by Melismata at 6:51 AM on February 22, 2008

Let me clarify. Like JonahBlack, I also have gone months skipping the placebo week and just having one or two periods a year. Never had a problem. My Dr also feels this is fine and it has been great for me. I wasn't clear on that point. When you do choose to stop the real pills and let your body have a period, I would think it would be good to go the full week and allow a full period but I could be wrong. Whatever you do, give your body time to adjust and use other contraception to be sure!
posted by pearlybob at 6:58 AM on February 22, 2008

Skipping periods works because basically what birth control does is trick your body into thinking you are pregnant by adding hormones.

This is a very common misconception (ha!), but the pill does not trick your body into thinking you are pregnant! The pill works by suppressing ovulation through artificially stable hormone levels: Birth control pills are a synthetic form of the hormones progesterone and estrogen. They prevent ovulation by maintaining more consistent hormone levels. Without a peak in estrogen, then, the ovary doesn't get the signal to release an egg.

The OP did everything right to stack her pills, it just doesn't always work, especially the first time. The reason you bleed on a normal 21 day on/7 day off cycle of pills is that the drop in hormones when you stop taking the pills causes a withdrawal bleed. If you keep taking active pills, theoretically your hormone levels should remain the same and you won't bleed. Obviously it didn't work this time, but it's probably because it was your first pack of pills for a while.

One more question: is the 7-day placebo/no-pill period flexible? Can I stop the pills for fewer than 7 days? Since my packs don't contain placebo pills, I'm worried that I will forget to start again after 7 days' break. If I decide to start taking pills again after 3 or 4 days and do this long term, is there any negative affect?

Yes, absolutely you can shorten the placebo break, and you may actually be safer from pregnancy if you do so (simply because one of the more common mistakes when taking pills is not taking the first pill of a new pack on time).
posted by Violet Hour at 8:09 AM on February 22, 2008 [3 favorites]

I have tried that trick three times, and it has never worked for me. I am on an even-hormone pill, and still didn't work. In fact, now my period occurs during week 3 of the pill pack, not the placebo week.
posted by lemonade at 8:22 AM on February 22, 2008

Yeah, JonahBlack mentions monophasic vs. triphasic pills, and how it's not so recommended to do this with the latter. If you are taking triphasics (eg. orthotricylcen) you might get the breakthrough bleeding because when you start back on week 1, you're taking the lowest dose of hormones again, so you're getting a bit of hormone withdrawal.
posted by gaspode at 8:48 AM on February 22, 2008

I did this and consulted my doctor first, and this was with ortho tri-cyclen, a tri-phasic pill.
She said not to start a new pack from week one, but from week three.
So after you first pack is finished, get a new one, and go for week three. You can take week three up to 3 times, fully skipping one cycle.
The hormones in the first two weeks aren't strong enough, and you will still have some withdrawal bleeding.
posted by idiotfactory at 9:18 AM on February 22, 2008

Another issue is that if you're taking a really low dose pill (something with 20 mcg of estrogen like Alesse or Mircette) you'll be more likely to have breakthrough bleeding when taking the pill continuously. You should expect to have some breakthrough bleeding the first three or so months of skipping your period, but if it's really heavy or continues past that, you might want to switch to a pill with more estrogen.
posted by thisjax at 9:21 AM on February 22, 2008

I don't remember Mrs. Silvertree's pill script right now, but I know her doctor recommended she switch pills in order to be able to skip. Might want to call your doc and have a quick chat about it.
posted by Silvertree at 9:50 AM on February 22, 2008

I tried to skip on the Ring and had the same problem. Grotty brown blood, too. If I was going to try this again I would definitely switch to something else.
posted by herbaliser at 11:51 AM on February 22, 2008

I've tried this on a number of pills and it doesn't really work for me either. At one point on Alesse I could skip one but when I tried to skip the second I'd just start to bleed. That was the most successful I ever was with it. I got so annoyed with the whole thing I stopped taking the pill altogether last fall.
posted by loiseau at 2:11 PM on February 22, 2008

Data point: I have been period-free for almost seven years now by just skipping the fourth (placebo) week, with my OB/Gyn's approval (she, and several women in her office, also use the pill to eliminate periods). I use a generic version of a common pill, called Junel, however, I have previously used other variants of Ethinyl Estradiol and Norethindrone pills. I ad some spotting at first, but it's incredibly rare these days - once I went three or four days without any pills and had little spotting. Definitely consult your doctor, but be assured that skipping is pretty common these days.
posted by TochterAusElysium at 10:11 AM on February 24, 2008 [1 favorite]