Beth Messenger for The Spinoff
There is a lot of confusion out there at the moment about the right way to take the contraceptive pill. Family Planning doctor Beth Messenger gives us the facts.
The Combined Oral Contraceptive Pill has been in the news lately with Britain changing its official pill guidelines to reduce the risks of unplanned pregnancies. The new British guidelines state that it is safe to take the pill continuously.
For many people who have always been told they must take their placebo or sugar pills each month, or should only 'skip' a bleed when absolutely necessary, this came as a shock.
It wasn't a shock to us here at Family Planning. For more than five years we have been encouraging people to take the contraceptive pill continuously.
- The shocking reason you take sugar pills with your contraception
- Oral contraceptive pill to be dispensed over the counter
- Nationwide shortage of contraceptive pill
And the reason is simple: continuously taking the pill is the best and safest way to avoid pregnancy while on the pill. What's more, there is no medical reason to have a period.
Usually, when you take the combined pill, you take 21 hormone pills, and then seven inactive non-hormone pills (also known as placebo or sugar pills) which causes you to get your 'period'. Some women will use a pill type that comes with just 21 pills, but the majority are using 28-pill packs – 21 hormone pills and 7 non-hormone pills.
When you take your pill continuously, however, you only take the hormone pills, skipping the inactive pills – meaning you also skip your 'period'. You can continue to take the hormone pills for as long as you like.
There are no side effects to not having a period. Because your hormone levels stay the same, blood does not build up in your uterus if you don't have a period. The longer you take the pill, the thinner the lining of the uterus becomes.
The seven-day 'period' you have when you take the placebo or sugar pills is not a real period. This 'period' was introduced in the 1960s to mimic a natural menstrual cycle. But it's not natural. It is simply withdrawal bleeding – your body reacting to not taking the hormones in the pill.
The fact that you can take your contraceptive pill continuously is not widely known and there's a reason for that. There are currently no official guidelines on contraception for people in New Zealand.
That means advice around contraception can differ between GP, after-hours services, and clinics. For example, the Ministry of Health's website advises women to take a seven-day break while on the pill despite the fact that it's really not necessary.
The Ministry has told Stuff that they are reviewing their advice.
So here's our official advice. If you want to take your pill continuously, you should.
- It gives you better contraceptive protection than regular use. That said, there are more effective ways not to have a baby such as a long-acting contraceptive like an IUD or implant.
- It lets you control your period. You can choose when you have your period, if you decide to have it at all.
- It can help women who have long, heavy or painful periods.
- Not having a monthly period can help women who suffer from endometriosis or anaemia. Talk to your doctor or nurse about this option.
- Taking the pill continuously could lower the risk of ovarian cancer.
Doing it is simple: Take the 21 hormone pills in your packet, then go on to the next packet, missing the placebo or sugar pills.
If you're worried about pregnancy, remember, the monthly period you have while on the pill is not proof that you are not pregnant. The only way you can know whether you are pregnant is to take a pregnancy test. As soon as you stop taking the pill, your fertility will return to normal. There is no difference to your fertility whether you take the pill continuously or with a break.
The side effects from taking the pill continuously are the same as taking the pill in the regular way. Serious side effects are rare, but important to be aware of.
Ultimately, whether you take the pill continuously or not should be up to you, not anyone else. And it's vitally important everybody has the information they need to make the right choices for their bodies.