Is It Safe to Skip Periods on the Pill?What Studies Show

On the combined pill, you usually have bleeding like a period during the pill-free break or the dummy pills.¹ Many women wonder whether they can skip it, for a trip, a wedding or simply every month.

What the trials found

A Cochrane review gathered 12 randomized trials comparing the usual monthly pattern with extended or continuous use, meaning more than 28 days of active pills in a row.²

• Pregnancy protection was similar.²
• Safety was similar.²
• Checks of the womb lining were normal with both patterns.²
• In 11 of 12 studies, bleeding patterns were the same or improved over time with extended use.²

The reviewers rated the evidence as good quality.²

Fewer period symptoms

In trials that measured symptoms, women on extended or continuous pills did better on:²

• Menstrual pain
• Headaches
• Bloating
• Tiredness
• Genital irritation

A separate review found continuous use may relieve period pain more than the standard pattern.³

The catch: spotting

Breakthrough bleeding or changes to bleeding are common in the first few months of any pill.¹ A shorter break or no break is one option a clinician may suggest.¹

How to do it safely

1. Ask first. Taking pills this way is called a tailored regime, and a doctor, nurse or pharmacist can explain how it works with your pill.¹
2. Expect some spotting at first, and note it on a calendar.
3. Keep taking pills on time and follow your pill’s missed-pill instructions.
4. See a clinician for heavy or lasting bleeding.

See also best painkillers for period cramps and periods after stopping the pill.

Try: “My periods on the pill bring bad cramps and headaches. Could I run my packs together, and what should I expect?”

Period, Handled covers cramp options in Chapter 7, “Cramps That Stop You,” in a section called “What the Trials Support.” Its Period Scorecard logs bleeding days, pain and spotting, so you can see whether a new pill pattern is working. See the book.