Birth Control Pills and Period: Your Questions Answered
Birth control pills, also known as oral contraceptives or “the pill,” are one of the most common forms of hormonal birth control. Birth control pills have been studied for over 50 years, and were approved by the FDA for contraceptive use in 1960. Your menstrual cycle will change depending on the type of birth control pill you choose because each variety contains different quantities and types of hormones that work together to prevent pregnancy. Understanding your options will help you determine the nature of your period while on birth control pills.
How do Birth Control Pills Work?
There are dozens of varieties of birth control pills available with a prescription from a healthcare provider. All birth control pills contain varying levels of hormones, which are released into a woman’s body to prevent pregnancy. The hormones in birth control pills stop ovulation, which prevents the release of an egg and thickens the mucus surrounding the cervix. By stopping the release of an egg, birth control pills usually make your period more predictable, and can affect the flow and side effects associated with your period each month.
No brand of birth control pills protects against sexually transmitted diseases (STD’s), and thus you should use an appropriate barrier form of birth control (such as female or male condoms) to protect yourself against the spread of infections and diseases.
Birth control pills are taken on a daily basis to ensure the consistent release of hormones. Each birth control type and brand comes with different side effects. To know which pill is right for you, it is important to understand how the various kinds of birth control pills are designed to interact with your body.
Types of Birth Control Pills
There are two main types of birth control pills:
- Combination pills
- Progestin-only or “minipills”
Combination pills contain both of the hormones progestin and estrogen. This variety of birth control pills is very common and is available three main forms:
- 28-day packs – 21 “active” pills (contain hormones) and 7 “inactive” or sugar pills (do not contain hormones)
- 21-day packs – all “active” pills (contain hormones)
- Extended cycle packs – usually contain 84 “active” pills and 7 “inactive” pills
The levels of hormones contained in these pills vary throughout the month to help your body prevent pregnancy most effectively.
When Do You Get Your Period on Birth Control Pills (Combination Pills)?
When using either the 28- or 21-day packs of combination birth control pills, you will still have a monthly menstrual cycle (even though these birth control pills stop ovulation). Different brands of birth control pills offer different quantities of hormones, and can affect the flow, timing, and side effects associated with your monthly period.
If you take a “28-day pack,” your period will come during the final week of the cycle, when you are taking the four to seven “inactive” pills (depending on which brand you use). That is to say, when you are taking the pills that do not contain hormones, your body will mimic the bleeding associated with a menstrual cycle. If you are taking your pills consistently and correctly, you will still be protected against pregnancy during this time.
The advantage of the 28-day pack is that you will develop the habit of taking a pill every day at the same time, with no break. Some women find this helpful because they don’t have to keep track of when they took their last active pill and when they should begin the next month’s pills.
If you use a 21-day pack system, you should take all of the pills in the pack. As opposed to the 28-day pack, the 21-day system contains only active pills. For the final week of the cycle, you do not take any pills, which allows breakthrough bleeding for the four to seven days after you finish your pack. A disadvantage of this system is that you may forget when you took your final pill from the previous month, and thus may get mixed up when it is time to start taking pills for the following month. This can compromise your defense against pregnancy if you miss any days of your birth control pills.
A common question associated with oral contraceptives is: Do birth control pills stop your period? An explanation for extended-cycle combination birth control pills best answers this question.
Since birth control pills were introduced to the public, women have chosen to stop their periods completely by skipping the “inactive” sets of pills and continuously taking the pills containing hormones. This essentially convinces the body that a woman is pregnant, which negates the normal menstrual cycle. This process is known as “continuous menstrual suppression” and has been used to avoid bleeding for a variety of reasons.
In 2003, the first Pill geared towards this use was made available to the public. Seasonale is an “extended-cycle” birth control pill. Extended-cycle oral contraceptives suppress menstruation by continuously releasing hormones into the body for 84 days, followed by seven days of inactive, or placebo pills. On this schedule, a woman will only bleed four times a year. Many women find that this is as close to having no period on birth control pills as you can get.
If you are looking for other birth control pills that stop periods, your doctor will most likely recommend an extended-cycle regimen. One disadvantage to this method is that women who become pregnant while taking extended-cycle birth control pills may not realize that they have conceived until much later than those who are on a monthly schedule.
A conversation with your healthcare provider can help you decide which brand and schedule of oral contraceptives is right for your body and lifestyle. Some of the most common brands of combination birth control pills are:
- Seasonale (Extended-Cycle)
- Seasonique (Extended-Cycle)
- Lybrel (Extended/Continuous-Cycle)
When Do You Get Your Period on Birth Control Pills (Progestin-Only or “Minipills”)?
Doctors may recommend progestin-only birth control pills for women whose bodies do not react well to estrogen. The only active ingredient in minipills is noroethindrone (a type of the hormone progestin), and works similarly to the combination of hormones in the birth control pills described above. These pills, like their combination counterparts, are designed to thicken the mucus lining of the cervix, thus preventing sperm from fertilizing an egg.
These types of birth control pills stop ovulation, but not as effectively as combination pills because they lack estrogen, which in turn slightly increases the risk of becoming pregnant. Depending on the type of minipill your doctor prescribes, your period may be longer or shorter than normal, or may stop completely. If you experience a heavy menstrual flow for more than a week, you should contact your healthcare provider immediately.
Progestin-only contraceptive pills only come in packs of 28 pills. Every pill contains hormones, which means there are no placebo pills. In the case of Progestin-only pills, it is important to take your pills at the same time every single day. Progestin is metabolized faster than estrogen, which means that your body will need another dose within 24 hours to ensure your protection against pregnancy.
Because of the way that progestin interacts with your body, women experience various types, flows, and cycles of menstruation while taking progestin-only birth control pills. The variations in a woman’s period while on birth control pills that only contain progestin are across the board. Most commonly, women will have very light but regular bleeding, which should regulate after the first two months of treatment. Some women experience light, but irregular bleeding. In one study, as many as 20% of women had no period on birth control pills of this variety. It is hard to tell how your body will react until you try this method, and any abnormalities in cycle should go away after one to two months.
Progestin-only pills contain lower levels of hormones than combination pills. If you find that your body is sensitive to hormonal fluctuations, you may find that this variety is most compatible with your body. Talk with your physician to determine if Progestin-only birth control pills may be right for you. The most popular brands of progestin-only birth control pills are:
Missed Period on Birth Control Pill
Other common questions related to birth control pills are concerns about missed periods. When a woman takes hormonal birth control pills, it is not uncommon to experience a missed or very light period, especially at the beginning of treatment. You are most likely not pregnant if you are consistent in taking your pills and have missed only one or two periods.
However, if you miss periods for more than three months, you should take a pregnancy test and contact your doctor to discuss expectations of your birth control pills and which brand is best for your body.
Some women also experience periods abnormal from any they have had before, characterized by intense pre-menstrual syndrome (PMS), heavy bleeding, or severe cramping. If you are concerned about these symptoms, consult with your doctor. Many women try several brands of birth control pills before they find the best fit. Many doctors recommend allowing at least three months for your body to adapt to a new brand of birth control pills before you change your regimen.
How PlushCare Works
In today’s age of unpredictable waiting rooms and swamped doctors, online services like PlushCare save you time and stress. All of our visits with patients are confidential and convenient and require as little as a phone or video consultation.
We are able to help with various concerns, including birth control, and work with local pharmacies to make sure you get your prescription quickly and efficiently. Our team of medical professionals has extensive experience consulting with patients about their birth control options, including starting and prescribing birth control pills, changing birth control methods, and understanding how birth control interacts with your body. Book an appointment with a PlushCare here.
Read more in our Birth Control series: