Oral contraceptives – skipping periods when taking the Pill

  • This fact sheet is a guide to taking the Pill continuously. Your doctor may have recommended that you take the Pill continuously to reduce the number of menstrual periods you have each year, or to try to stop your periods completely.

    Reducing the number of periods may be recommended if you have heavy or painful periods, or symptoms such as seizures, dizziness, asthma, headaches or mood disturbances that worsen with your menstrual cycle.

    Skipping periods may also be an option for people with an intellectual or physical disability who find it difficult to manage their periods.

    Using the Pill to skip periods is safe and won’t cause long-term problems.

    What is the Pill?

    The Pill, also known as the oral contraceptive pill (OCP), combined oral contraceptive pill (COC) or birth-control pill, is a daily medication that contains hormones to change the menstrual pattern and to prevent pregnancy.

    Most pill packets have 21 hormone pills (active pills), and seven sugar pills (hormone-free pills). Some newer types of the Pill have 24 hormone pills and four sugar pills. A menstrual period (sometimes called a withdrawal bleed if you are on the Pill) usually starts a couple of days after taking the sugar pills. This is a result of the fall in hormone levels. Sugar pills have no active ingredients; they are simply included to help you stay in the habit of taking one pill every day.

    Continuous use of the Pill

    The Pill is usually taken so that a menstrual period happens every month, copying the pattern of a normal menstrual cycle. This is called cyclical pill use.  

    Continuous use of the Pill is when the sugar pills in the packet are skipped. This means that your period will also be skipped.

    How to start taking the Pill continuously

    If you are not already taking the Pill, it is usually best to start the first month by taking all the pills in the first packet, including the sugar pills. You can expect to get a period this time around. Following this period, only take the hormone pills and skip the sugar pills. Move straight onto the next packet after you have taken the last hormone pill in a packet.  

    When you take the Pill, it is important to try and take it at the same time every day.

    If you are already taking the Pill in the normal cyclical way, you can change to continuous usage by simply skipping the sugar pills when you get to them and moving straight to the hormone pills in the next packet.

    Breakthrough bleeding

    Sometimes breakthrough bleeding can occur, even though you are taking the Pill continuously. If the bleeding is light or just ‘spotting’ that lasts for two or three days, keep taking the hormone pills daily as you have been. 

    If the light bleeding continues for more than three or four days, or is more like a moderate or heavy period that lasts for more than a day, a four-day break from the Pill is recommended. This involves taking no pill (or taking sugar pills for four days). During this time, you should experience a proper period. Start taking the active pills again after four days. Do not use this technique more than once in any four-week cycle. If you miss two or more active tablets, the pill is much less effective as a contraceptive.

    You can use pain relief (e.g. Ponstan, Naprogesic, ibuprofen etc.) if you have any period pain during the breakthrough bleeding.

    Usually the episodes of breakthrough bleeding become less and less frequent, until eventually you may only have one or two periods per year, or none at all.

    What to do if you forget a pill

    If you forget to take a pill, take it as soon as you remember. If this is within 12 hours of the usual dose time, it is considered a late pill. Late pills are still effective as contraceptives.

    If it is more than 12 hours after the usual dose time, take the forgotten pill as soon as you remember, even if this means taking two pills on the same day. The Pill is less likely to protect you from pregnancy if it’s more than 12 hours late.

    Continue to take the Pill daily at the usual time after a late or forgotten pill.

    When to see a doctor

    If you are taking the Pill continuously to skip periods, go back to your GP or gynaecologist if:

    • your breakthrough bleeding is still heavy, and taking four-day breaks from the Pill hasn’t helped – your doctor may prescribe tranexamic acid (Cyclokapron) for you if the bleeding is very heavy
    • you are having trouble remembering to take your daily Pill, or you have had more than one four-day pill break in a month – your doctor may recommend some other contraceptive or period management options that might suit you better
    • you are concerned for any reason.

    Key points to remember

    • Using the Pill to skip periods is safe and won’t cause long-term problems.
    • Continuous use of the Pill means skipping the sugar pills, which means you will not get your period.
    • If you get moderate or heavy breakthrough bleeding, or prolonged lighter breakthrough bleeding, have a four-day break from the active pills then restart them.
    • If you forget to take a pill, take it as soon as you remember.

    For more information

    Common questions our doctors are asked

    Is taking the Pill continuously effective for contraception?

    Yes. If you can successfully skip a period, then you know that your ovaries are ‘switched off’, and that you have good contraception in place.

    Is the Pill only for contraception?

    No. Many people find that there are added benefits to taking the Pill. It can make your periods less painful and lighter, which can lower your risk of anaemia (low levels of iron). The Pill can reduce the severity of acne, the risk of ovarian cysts, problems with fibroids, and it can help with endometriosis. The Pill can also give some protection against developing ovarian cancer, endometrial cancer, bowel cancer, and osteoporosis.

    Are there any risks associated with taking the Pill?

    The Pill may cause some weight gain, headaches and mood changes in some women. Health risks are rare, but the Pill is not suitable for people who have some types of migraine, a history of blood clotting, liver problems, high blood pressure or severe heart problems. It is extremely important not to smoke cigarettes if you are taking the Pill.

    Will the hormones in the Pill affect my fertility in the future?

    No. Your fertility will not be affected by taking the Pill continuously or cyclically. After you stop taking the Pill, you are no longer protected from becoming pregnant.

    Is it safe or ‘natural’ to skip my periods?

    Yes. Skipping periods is quite safe. Pregnant women do not have a period for nine months and breastfeeding women may not have a period for up to two years, depending on how often they breastfeed their baby. It is quite natural to skip periods. It is common for those who have many babies and who breastfeed their babies for extended lengths of time to have less than 50 periods in their lifetime. Some specialists recommend having a period at least once every three months, in order to shed the lining of the uterus, but you should discuss this with your doctor.


    Developed by The Royal Children's Hospital Gynaecology department. We acknowledge the input of RCH consumers and carers.

    Reviewed March 2018.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit  www.rchfoundation.org.au.


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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.