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Is it Safe to Skip Periods on Birth Control?

Is it Safe to Skip Periods on Birth Control? Image
Written by vhigueras
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To get an expert answer to this frequently asked question we turned to Dr. Julie Graves, MD, MPH, PhD, a Family Medicine and Public Health doctor and Associate Clinical Director at Nurx. 

We often hear this question from Nurx patients. The short answer? Yes! When oral contraceptives were first developed, the medical world more or less agreed that women could take the pill continuously without any serious side effects or risks, but the creators of the pill created a monthly cycle, complete with a period, anyway. For the history behind the pill and periods, and details on how to skip your period, read on.

The History of Periods on the Pill

Since combined hormone birth control pills were first marketed in the 1960’s, they were sold in packs rather than in bottles of pills in the belief that women would need the daily reminder of having each pill in a slot labeled with a day of the week. They were packaged with 21 active pills and 7 placebo pills, because researchers who developed the pill thought that mimicking a 28-day menstrual cycle would make the pill more socially acceptable, both for patients and for regulators, physicians, and clergy. 

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Using an artificial period to make the pill seem “natural” might seem silly, until you realize that prior to the US Supreme Court’s Griswold v. Connecticut decision in 1965, states could outlaw contraception, and some did. And because that decision protected only married couples, single people didn’t have a Constitutional right to contraception until the Eisenstadt v. Baird decision in 1972!  So making the pill seem like it caused a normal menstrual period was likely a smart decision that helped hormonal birth control get FDA approval. (Want to learn more? Science reporter Michaeleen Doucleff wrote a detailed piece about this for NPR)

Advantages to Skipping Periods on Birth Control

So is it necessary to have periods? In a word, no. The bleeding that happens with combined hormone birth control pills (meaning those that contain both estrogen and progestin) is not really a period — the medical term for it is “withdrawal bleed.” You see, the hormones in the pill which suppress ovulation also cause the growth of the endometrium (the lining of the uterus) and when you stop taking these hormones during the placebo week this lining sheds and seems like a normal menstrual period. This isn’t necessary for health. 

Let me repeat: Taking a pill every day for months at a time is just fine. Decades of contraceptive use has shown that skipping periods on the pill is not only safe but can also have several advantages. For some women, the drop in hormones that accompanies the placebo pill week and period brings on bad menstrual migraines, mood swings, or endometriosis symptoms, and period skipping prevents them. For women who are anemic it can be beneficial to avoid the iron loss that comes with monthly bleeding, and skipping periods is great for women with bleeding disorders such as von Willebrand’s disease and hemophilia.

How to Skip Your Period on the Pill

It’s simple: You can prevent your period by skipping the placebo pills in a pack of birth control and starting the active pills of the next pack the day after finishing the active pills of your current pack, or by using a type of pill (like Amethia) packaged for having a period every three months. Note that triphasic pills (those that contain different amounts of hormone different weeks) do not work well for period skipping.

Although the patch and the ring aren’t FDA-approved for skipping periods, many women do use them this way. If you use the birth control patch apply a new patch for the last week of your cycle, when you would ordinarily go patch-free (but note that since patches contain a slightly higher dose of estrogen than pills, you should be sure to take a one-week break every three months). If you use the Nuvaring, leave your ring in for four weeks instead of three, then immediately replace it with a new ring. 

Note that if you use progestin-only pills you can’t skip periods in the same way, because there is no placebo week with these pills — you are already taking an active pill every day. But women on progestin-only pills (also called “mini” pills) usually experience much lighter periods, and sometimes stop getting periods altogether.

Spotting When Skipping Periods

One thing that some women find annoying about skipping periods is that the uterus may occasionally shed some of the endometrium, resulting in spotting/breakthrough bleeding. Even though this bleeding is harmless, the unpredictability of it can be inconvenient. If you’re using the pill to skip periods and spotting bothers you, you may want to take a few days off of the pill from time to time to have a “period”/withdrawal bleed. Just be sure not to take more than 7 days off of the pill — after that long you’ll no longer have contraceptive protection and there’s an increased chance you could get pregnant. 

For other women, having an occasional episode of bleeding isn’t bothersome, and for these women, taking the pill every day for months or even years at a time works great.

Safety of Skipping Periods With Birth Control

It’s not surprising that in one study, 53% of women surveyed reported wanting to skip their periods completely. Many women like to skip periods occasionally, for reasons such as to avoid needing to pack tampons on a vacation. One thing to know is that it may not work to try to skip when first starting a pill – most women need 2-3 months on a pill before skipping without spotting/breakthrough bleeding.

The only real risk to skipping periods is that it might take you longer to know if you do get accidentally get pregnant. When used correctly the pill is 99% effective at preventing pregnancy, so if you’re taking your birth control on time every day you shouldn’t have anything to worry about. And, the hormones themselves aren’t harmful early in pregnancy, but we want women who are pregnant or trying to conceive to take prenatal vitamins with folate to reduce birth defect risk and so it’s good to diagnosis pregnancy early.

The bottom line: There are no health risks associated with skipping periods on combined hormone birth control pills compared to having a week off the pills and bleeding every month, and more women would probably really like this option if they understood how safe it is. If you want to learn more, Nurx can help. Our medical team has lots of experience prescribing birth control to women who want to use it to skip their periods. They can help you find a method of contraception that’s right for your body and lifestyle.


About the Author

Dr. Julie Graves is a family medicine and public health doctor, as well as the Associate Director of Clinical Services at Nurx. She has more than 20 years of experience and has practiced medicine in Texas, Florida, Maryland, Wisconsin, Washington, DC, Sint Maarten, Germany, and even on a cruise ship. Dr. Graves also enjoys working in telehealth because it provides patients with convenience and comfort, enables them to ask questions at any time, and protects their privacy.

This blog pro­vides infor­ma­tion about telemed­i­cine, health and related sub­jects. The blog content and any linked materials herein are not intended to be, and should not be con­strued as a substitute for, med­ical or healthcare advice, diagnosis or treatment. Any reader or per­son with a med­ical con­cern should con­sult with an appropriately-licensed physi­cian or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.

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