Do I really need to have a monthly ‘period’ if I take the combined contraceptive pill?

The traditional way of taking the combined oral contraceptive pill (COC) is a cycle of 21 active, hormone-containing tablets followed by 7 days without – often referred to as the pill-free interval. Some brands of COC do include pills that are taken during this time but these are inactive pills that do not contain any hormone. During the pill-free interval, the drop in hormone level caused by stopping the active pills causes a ‘withdrawal bleed’. Strictly speaking this is not a period but women will often call it that. The active pills are then restarted after 7 days and the cycle starts again.

This 4 week pattern was developed when the pill was first introduced (back in the 1960s) to try and mimic a woman’s natural cycle as it was felt this would make the pill more acceptable to women and, some may say, more acceptable to the church! Unfortunately the latter didn’t happen but the 4 week cycle remained. However, there is actually no medical reason that the pill has to be taken in this way, with no health benefit gained from having a bleed!!

For some years now, the Faculty of Sexual and Reproductive Healthcare (FSRH) has advocated that women should be advised of the different ways they can take the COC to suit their needs.

So, if you are someone who likes to have a bleed each month (although, to be honest, why would you?) then taking the COC in a 4 week cycle is perfectly fine. But, if like most of us, you’d much rather not, then there are different ways you can take the pill.

There are a number of different regimes that can be used. Some women choose to take it every day, some women may take 2 or 3 packets in a row and then have a break, and some may just want to put 2 packets together to prevent a ‘bleed’ occuring for a special event such as a holiday.

So, if you are sick and tired of your monthly bleed (not to mention the cost of sanitary wear!) then I would recommend speaking to your own GP or sexual health clinic about the different ways you could take the pill. But please note, not all regimes are suitable for everyone, so seek advice before making changes yourself.

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