What Is Continuous Cycle Birth Control?
Key takeaways:
Continuous cycle birth control is a type of birth control pill that can lower the number of periods you get. In fact, many women experience no periods while taking these birth control pills.
Continuous birth control pills aren’t known to raise the risk for serious side effects, such as blood clots or breast cancer. The risk of these problems is similar to that of other hormonal birth controls.
Breakthrough bleeding and spotting are common with continuous birth control. But it tends to get better after the first few months of taking it.
Do you wish there was a way to reduce the number of periods you get a year? Or better yet, do you wish you could make them stop? Besides being a monthly inconvenience, menstrual periods can often cause cramping, acne, and diarrhea. For some women, these symptoms can be severe.
Thankfully, there are options that can help lower your number of periods or even eliminate them. These are called extended-cycle or continuous cycle birth control pills. The main idea behind these birth control pills is to provide more consistent hormones with fewer breaks. And fewer breaks in your pack of pills means fewer periods.
It’s safe for most people to use birth control to skip their periods. But there’s information you should know before starting continuous cycle birth control. Here, we’ll give you the scoop on these birth control pills and what to expect if you take them.
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How does continuous cycle birth control work?
Continuous cycle birth control (often shortened to continuous birth control) is a type of combined oral contraceptive (COC). This means it has two hormones in it: a type of estrogen and a progestin. A progestin is a lab-made version of the hormone progesterone. These two hormones work together to prevent pregnancy. But birth control pills are also helpful for other reproductive health issues too, including acne and menstrual cycle regulation.
Many COCs come as a pack of 28 pills. Most of the pills are what’s known as active pills. This means they contain hormones. The last few pills in a pack are inactive, or placebo, pills. They don’t contain any hormones. Sometimes, the inactive pills have a low dose of iron. You don’t have to take the inactive pills. But, taking them can help you better remember when to start the active pills again.
While taking the inactive pills, you’ll likely experience bleeding. This is what you probably know as your period. But this bleeding is actually happening because your body no longer has a steady supply of hormones. Once the active pills are restarted, the bleeding should stop again. This withdrawal bleeding mimics a natural period for most women.
Continuous birth control has no inactive pills. All 28 pills in a pack include the two hormones. Because there’s no break in hormones, withdrawal bleeding doesn’t happen. But as we’ll detail later, you can experience spotting or breakthrough bleeding.
How long can you be on continuous birth control?
If you’re concerned the extra doses of hormones may have a higher risk of serious side effects, you can rest easy. Studies have found no significant differences in the risk of blood clots or breast cancer when it comes to different forms of COCs. The risks of these complications are similar for all types of COCs, including continuous cycle birth control. And those risks are relatively small.
How long you take continuous birth control is a personal decision. And it’s best to make this decision together with your healthcare provider.
How is continuous birth control different from extended-cycle birth control?
Both continuous birth control and extended-cycle birth control can help lower your number of periods.
As discussed above, continuous birth control has no placebo pills in the packs. The goal of these birth control pills is to stop your periods. An example of a continuous birth control pill is Amethyst (levonorgestrel/ethinyl estradiol).
Extended cycle birth control pills are a little different. These pills have 84 days of active pills that contain both hormones. This is followed by 7 days of either placebo pills or pills that only contain estrogen, depending on the brand. So when you’re taking extended-cycle birth control pills, you should only have a period once every 3 months.
Examples of extended-cycle birth control pills are Seasonale (levonorgestrel/ethinyl estradiol) and LoSeasonique (levonorgestrel/ethinyl estradiol).
What are the common side effects of continuous cycle birth control?
Hormonal birth control methods all have similar side effects:
Changes to your menstrual cycles
Breast tenderness or pain
Nausea
Headaches
Weight gain
Loss of sex drive
More or less acne
Breakthrough bleeding and spotting are common for extended-cycle and continuous birth control pills. This is especially true during the first few months after starting one of these medications. But after the first 3 to 6 months, this side effect usually happens less often or goes away.
Why does spotting or irregular bleeding sometimes happen when taking continuous cycle birth control?
Breakthrough bleeding and spotting can happen with all hormonal birth controls. Experts aren’t sure why this happens. Some possible explanations include:
The amount of estrogen in the birth control pill. Lower amounts of estrogen are linked to more breakthrough bleeding.
The way a person’s body breaks down the hormones in the pill. Everyone’s body reacts differently to birth control pills. This can cause side effects that vary from person to person.
Whether a person smokes. One study found that smokers are nearly 50% more likely to experience breakthrough bleeding or spotting compared to non-smokers.
If you’re experiencing breakthrough bleeding and it’s bothersome, speak with your healthcare provider. They may be able to offer suggestions or birth control changes to help manage this side effect.
Does continuous cycle birth control stop your period?
For many women, continuous birth control completely stops their periods. Studies have found that after a year of taking these birth control pills, between 58% and 88% of women reported having no periods.
Does continuous birth control stop ovulation?
Yes, it should. Like all COCs, continuous birth control should stop you from ovulating (releasing an egg). This is part of how birth control pills prevent pregnancy. Continuous birth control pills also help thin your uterine lining to prevent a fertilized egg from implanting. And they make your cervical mucus thicker, making it harder for sperm to enter your uterus.
But, missing pills or taking them late raises your risk of ovulating and potentially getting pregnant. So it’s important to take your continuous birth control pills at the same time every day. This will help them to be as effective as possible.
The bottom line
Continuous birth control pills are a safe and effective way to help cut down on the number of periods you experience. For many women, their periods stop altogether with these medications. While breakthrough bleeding and spotting are common side effects, they usually happen less frequently after the first few months of taking them. Speak with your healthcare provider to see if continuous birth control pills are a good fit for you.
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References
Actavis Pharma, Inc. (2021). Amethyst [package insert].
American College of Obstetricians and Gynecologists. (2018). Combined hormonal birth control: Pill, patch, and ring.
Centers for Disease Control and Prevention. (2017). Combined hormonal contraceptives.
Endocrine Society. (2022). Reproductive hormones.
Li, J., et al. (2018). Association of risk for venous thromboembolism with use of low-dose extended- and continuous-cycle combined oral contraceptives. JAMA Internal Medicine.
Mørch, L. S., et al. (2017). Contemporary hormonal contraception and the risk of breast cancer. The New England Journal of Medicine.
Nappi, R. E., et al. (2016). Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians. The European Journal of Contraception & Reproductive Health Care.
Schrager, S. (2002). Abnormal uterine bleeding associated with hormonal contraception. American Family Physician.
Wright, K. P., et al. (2008). Evaluation of extended and continuous use oral contraceptives. Therapeutics and Clinical Risk Management.
