What Actually Happens When You Skip a Period With Birth Control?

Where does the blood go? Experts explain.

People who menstruate often wish they could reschedule their period. Wanting your flow to show up any other time has inspired plenty of people taking birth control to hack their packs by skipping the seven days of placebo pills.

That's the appeal of a birth control pill like Seasonale, which postpones menstruation so it only happens every three months. It's also why birth control manufacturers continue to innovate: There's a pill called Amethyst (among other generic names) that delivers active hormones every day, stopping periods for an entire blissful, cramp-free year.

But as ideal as that sounds, is it safe to use extended or continuous oral contraceptives? What does that do to your body? Here's what to know about skipping your period with birth control.

How Does Skipping a Period on Birth Control Pills Work?

When you take that traditional seven-day break from hormones on the pill, you're not really getting your period because you're not ovulating. Instead, you're having what's called a "withdrawal bleed" triggered by that brief hormone-free pause.

Sure, birth control manufacturers may have thought this bleed would make the pill feel more natural. But it's not actually a natural (or necessary) thing, Maria Sophocles, MD, medical director of Women's Healthcare of Princeton in New Jersey pointed out.

Is There a Purpose for Bleeding Once a Month While Taking Birth Control?

In a short answer, no. It turns out there was never a health-related reason for women on the pill to even have a monthly bleed. Birth control researcher Elizabeth Micks, MD, an assistant professor at UW Medicine and the director of research in the division of family planning, explained that there's absolutely no safety or medical difference between taking a birth control break every 21 days to get your period or sticking with it every day so you skip your period entirely—according to a July 2014 Cochrane Database of Systematic Reviews article she co-authored.

Back when the pill was first invented, "the belief at the time was that women needed to be able to have a regular cycle to feel healthy," Dr. Micks said. "It is my understanding that the pill was never developed [cyclically] for health reasons, but because it would be more acceptable to women and their partners, which is, I think, something people don't realize." In fact, the pill could have been created in the beginning to make you bleed "once a week, once a year, or anything in between," Dr. Micks added.

So, Is the Blood Just Sitting Inside Your Body When You Don't Take the Placebo Pills?

No—it isn't. This is because the synthetic hormone progestin in the birth control pill prevents the buildup of blood. "This keeps the uterine lining very thin," Dr. Micks explained. When the placebo pills roll around, "there's really nothing that needs to be shed because you've been on progestin the whole cycle."

The Pros and Cons of Skipping Your Period

Sometimes, having your period can be an inconvenience, so skipping it can make life a little easier. "It's not always fun to have a period and be traveling, or having an 80-hour workweek, or being a professional athlete, or even being regularly sexually active," Dr. Sophocles said.

Skipping the manmade withdrawal bleed might also be good for some individuals. Extended and continuous birth control methods have long been used to treat issues like heavy periods (as noted in a May 2021 study published in The European Journal of Contraception & Reproductive Health Care), menstrual migraines, and endometriosis.

However, healthcare providers are increasingly focusing on what their patients really want out of their oral contraception—whether it's fewer periods, more flexible bleeding patterns, or just solid pregnancy prevention. That last one is a big deal. Since no hormonal method is 100% effective, getting your period once a month is the reassurance many women are glad to have so they know they didn't accidentally conceive.

By continuing your pill pack and skipping that monthly bleed, "you may not be sure if you're pregnant or not, which is kind of an anxiety-provoking way to exist," Dr. Sophocles said. If you're the kind of person who needs that reassurance, a continuous or extended-use birth control may not be for you, Dr. Sophocles added.

If you do decide to try an extended or continuous method, know you might also experience some spotting, also known as breakthrough bleeding, until your body settles into a routine. Of course, if a cyclic method with a regular bleed still sounds best to you, that's totally okay too. "It's really nice to have options," Dr. Micks said.

Overall, if reading this has convinced you to set your own period schedule, talk to your healthcare provider about the best hormonal birth control method for you and which ones might give you your ideal bleeding pattern—and fewer worries about your body.

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