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More and more women who are taking the birth control pill are taking it on their terms, designing cycles that work best for them. What was once reserved for special vacations or honeymoons is now getting much more common.
Birth control pills use estrogen and progestin to block ovulation. There are 21 active pills, followed by seven placebo pills. Most women have bleeding during the last week, the week off hormones. It was designed in the '60's to mimic a natural 28-day cycle. But gynecologist Dr. Kirtly Parker Jones says, "Natural isn't always wonderful, as all of us who have periods know."
She says times have changed and women today are more comfortable with the idea of not having a monthly period. In fact, many prefer it.
"So, in 2002, the idea of having a period every month if you didn't want one on the birth control pill, means we can prearrange the way pills are given, so women don't have to have a period every month," she says.
Doctors can rearranging the pills to find a cycle that works best for each woman. And it's not just a matter of convenience, either.
"The upside is particulary women who have very painful periods, horrible things like seizures or headaches that happen when they have their periods, or other things which are rare, can postpone having their periods so that they might have one every six, or nine, or 12 weeks, or never."
Hormones in the pill keep the uterine lining very thin, so nothing builds up over time. However, because the lining is so thin there may be unexpected spotting, what's called breakthrough bleeding.
"So I tell my patients who want to stretch out the time between their periods that they just take their active pills, the ones with hormones, continuously. But if they start to have spotting, they should just go off a week and then go back on," the doctor says.
And that's key, because women who don't re-start their pills on time may ovulate, and run the risk of an unwanted pregnancy.
While this can be done with most types of pills or even the birth control patch or vaginal ring, it's best to talk to your doctor first to see what schedule is right for you.
