Taking the pill continuously is completely safe but, as a type of hormonal contraception, it will impact your body in a number of ways.
One thing you may notice is that your natural menstrual cycle changes and you start having fewer periods or even stop bleeding altogether. Though convenient, this can be alarming at first. So, is it bad to skip your period on the pill? Let's dive into it.
Debunking the myths
Traditional birth control pills were designed with 3 weeks of active pills and 1 week of sugar or placebo pills, which induce withdrawal bleeding that mimics a woman’s menstrual cycle.
As a result, the "safe" length of time to take the pill has long been misunderstood as 3 weeks, when in reality, you can take the pill (and suppress your period) for as long as you like.
In fact, the ‘pill-free week’ was included as a marketing ploy to appeal to the Catholic Church, and to boost female acceptance of the pill by making it seem “more natural".
But times have changed, and they now couldn’t be more wrong. In fact, a 2004 study of 1195 German women found that more than half (57%) were interested in using the pill for extended periods to reduce the frequency of menstrual bleeding [1].
Of those who weren’t interested, 69% gave reasons including fear of pregnancy, infertility, and side effects.
How does the pill work?
Before we dive into what is and isn't safe in more detail, it is helpful to understand how birth control pills work. We'll keep it short (if you want to learn more, you can always take a peek at our guide on the contraceptive pill).
Basically, the pill keeps your levels of oestrogen and progesterone equal at all times, which stops you from ovulating. This means that no mature egg is released, making it impossible for you to get pregnant.
What is extended and continuous cycling?
Extended cycling is the practice of taking birth control pills without any breaks between packs, for a length of time greater than 3 weeks. This is often done for 9 or 12 weeks, but there’s no wrong duration, as long as it works for you.
In continuous cycling, women simply take active hormones every day, without any breaks. If serious breakthrough bleeding occurs, pills aren’t taken for 4-7 days to allow for a withdrawal bleed before restarting [2]. You’re still protected from falling pregnant as long as you take the pill for at least 7 days following the break.
Note: The mini pill, another form of oral contraceptive, is progestin-only and it doesn't include hormone-free pills in the pack. You can take it every day and it will not impact your period. For that reason, this article is mainly discussing the use of combined contraceptives.
Can I fall pregnant if I take the pill continuously?
This is the most common question asked by women when it comes to extended or continuous pill-taking. While no contraceptive is completely foolproof, studies of extended cycling have shown it is as effective, if not more effective, than traditional cycling.
One US study in 2003 reported 0.9% of women fell pregnant over 1 year of extended cycling vs 1.3% in those who followed 28-day cycles [3]. So yes, you’re still covered for pregnancy with extended pill use.
Can taking the pill continuously make me infertile?
There are no long-term side effects linked with taking active pills continuously, compared with the traditional 21-day use.
However, it can take a while for some women to menstruate again after stopping the pill. For reference, in a 2008 study of 187 women who stopped taking the pill after continuous use for 6 months or more, 99% returned to regular cycles within 90 days, and 75% did so within 36 days or less [4].
Are there any side effects?
The most common side effect of continuous or extended pill-taking is breakthrough bleeding or spotting. However, the frequency of spotting decreases over time, and most women stop bleeding entirely within 1 year [3].
However, if you do experience any serious breakthrough bleeding where pads or tampons are needed for 3 days or more, you should take a break for 4-7 days before resuming the pill [2]. You’ll still be protected from falling pregnant, as long you take the pill for at least 7 days following the break.
What are the other benefits of extended cycling of the pill?
That’s right, there are other benefits. Taking the hormonal birth control pill continuously not only allows you to skip your period safely but it’s also been shown to reduce PMS symptoms including headaches, tiredness, bloating, and pain, compared with traditional 21-day use [5].
A lot of women also find it easier to remember the pill when they take it every day, which might explain why some studies find it even more effective for preventing pregnancy than 21 + 7-day cycles.
Can continuous use of the pill help my endometriosis?
It definitely looks like, in some cases, the pill may be able to help endometriosis. A 2003 study trialled 2 years of continuous use with 50 women who had surgery for endometriosis, but still had painful periods while on the regular pill [6].
The results were astounding, with patients reporting the severity of their symptoms had halved, and 80% were satisfied with the results.
As you can see, continuous use of the pill isn't just safe but it can improve your well-being in many ways. The most important thing is that you find a pill that works best for you.
With Kin's pill subscription, you'll get ongoing support from an Australian practitioner who will create a personalised prescription plan based on your own circumstances.
From there, you get your contraception delivered straight to your door 2 weeks before you run out (or earlier, if you prefer) — at no extra cost. Get started today and forget waiting at the doctor or in pharmacy lines to get your birth control.
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