Extended or Continuous Use of Birth Control

Using birth control pills or the vaginal ring to have fewer or no periods

Why choose to have fewer or no periods?

Some girls and teens choose to use the hormonal therapy in the pill or ring to have fewer or no periods. They may do this for many reasons, including:

  • Having fewer or no periods at all
  • Avoiding heavy, painful or irregular periods
  • Eliminating or reducing pelvic pain or ovarian cysts
  • Treating a medical condition or problem that is worse while on their period

Is this safe?

Yes. The hormone – called progestin – that is in the pill and ring keeps the lining of the uterus very thin. Because the lining does not build up, there is no medical reason to have a scheduled period.

How does skipping periods work?

When using the pill or the ring in the regular way, there is a break from the hormones during the placebo pills or during the ring-free week. The hormones that were keeping the lining of the uterus stable are gone during this time, so the lining of the uterus sheds or bleeds.

By skipping the “breaks” (that is, skipping the placebo pills and staying on active pills, or by not having a ring-free week) the lining of the uterus will be more stable and no scheduled bleeding will occur. However, you might still have unscheduled or unplanned bleeding – see “What else do I need to know” below.

How do I get started using birth control?

If using the ring

Start a new ring and note what day of the month it is (the first day of the month might be easiest to remember). This is your change date. Keep the ring inside until the same date of the next month; then take the old ring out and put a new one in.

  • For example, you may decide that your change date is the first of every month. You would take out the old ring and put a new one in on January 1st, February 1st, March 1st.

To have a period every three months, use three rings in a row for three months. Then take the ring out for five days (a “ring-free” break), during which time you will have your scheduled period. Be sure to put a new ring in after the five days off.

You can use a new ring every month and not have any “ring-free” breaks. This is called continuous use and can work well for some teens. The ring has enough hormone to last at least five weeks, but you want to be sure not to go any longer than this, especially if you are relying on it for birth control. It is best to change out the ring on your change date.

Read more about the ring: Getting Started with the Vaginal Ring.

If using birth control pills

You can switch to a pill brand that is designed in an extended or continuous fashion. For example, Seasonique (period every 84 days) or Lybrel (no scheduled periods). Just take one pill each day.

You can also have less frequent periods with regular monthly pills.

  • First, figure out which pills are the placebos. There are usually seven of them at the end of the pack, and they are a different color than the active pills. Ask your health provider or your pharmacist if you are not sure!
  • Second, decide how often you want to have a period:
    • To have a period every 63 days, take 63 active pills in a row. This is the number of active pills contained in three packs of most birth control pills. Take one active pill each day, skipping the placebo pills and going right into a new pack of pills. After 63 days of active pills, take five days off. During this time off the pill, you will most likely have your “scheduled bleeding” or your period.
    • To have a period every 84 days, take 84 active pills in a row, then take five days off.
    • To have no scheduled bleeding, take an active pill every day. This is called continuous use and can work well for some teens.

Read more about the pill: Getting Started: Birth Control Pills

What else do I need to know about birth control?

IT IS VERY LIKELY THAT YOU WILL HAVE SOME UNEXPECTED BLEEDING OR SPOTTING. This is annoying but it will get better.

Here is what you can do:

  • Be prepared. Have a tampon or pad ready to use.
  • Don’t be alarmed. Call us if you have concerns or questions.
  • Know that IT GETS BETTER but it may take three, six or even 12 months. The longer you stick with the new way, the less unexpected bleeding you will have.

If you are forgetting your pills/ring or using them late, call your doctor to talk about other ways for you to have less bleeding.