Skipping periods on the Pill
Let's talk about periods and the pill, and whether or not it's ok to skip your period...
Skipping periods on the pill is a really common discussion with our Women's Health GPs at FitRight HQ.
Dr Sophie Genoni answers the most common questions she gets about skipping periods, and why this might be encouraged for some women.
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    How does the Pill work to skip periods?

    The Pill (Combined Oral Contraceptive Pill) is a combination of oestrogen and progesterone. These are the same hormones involved in women's natural reproductive cycles, but given at a constant dose rather than the usual fluctuating levels.

    In a natural menstrual cycle, ovulation occurs around the middle of the cycle, which causes oestrogen and progesterone levels to increase. If fertilisation of the egg does not occur, these hormones decrease towards the end of the cycle which triggers shedding of the endometrial lining, which is what a period is.

    The Pill comes with 21 days of active tablets and 7 days of placebo tablets (and some newer formulations coming with 24 days of active tablets and 4 days of placebo tablets). For the first 21 days of the packet, a constant hormone level is delivered. During the 7 days of placebo tablets, no hormone is delivered. These tablets are essentially just a sugar tablet, but are in the packet as a reminder to keep you in the habit of taking a daily tablet. The sudden drop in hormone with these tablets is what triggers shedding of the endometrial lining.

    Although this feels exactly like a period, it's actually called a 'withdrawal bleed' as it occurs by a different mechanism to a normal period.

    Why do they include a withdrawal bleed on the Pill packets?

    When the Pill was first introduced, it was thought that a period was required because it was more 'natural'. We now know there is no medical need for this. The endometrial lining does not build up if it is not shed this way, in fact the Pill helps to thin and stabilise the endometrial lining. It also does not impact long term fertility to skip periods.

    Why should women skip their periods?

    Women don't need to skip their periods, however there may be reasons they wish to and reasons their doctor may recommend skipping their periods, including:

    • Less periods - less inconvenience and less money spent on sanitary products

    • Less blood loss can prevent iron deficiency from developing or help with managing iron deficiency

    • Managing painful or heavy periods

    • Managing pre-menstrual symptoms

    The Pill is actually more effective if periods are skipped, as there is less chance of ovulation spontaneously occurring when the hormonal tablets are continuously taken, compared to if the placebo pill is included.

    How long can I skip my period for?

    This will vary between women. Some women may notice they have breakthrough bleeding (light spotting) after skipping their period for a certain amount of time. Often with a longer duration on the Pill, periods become easier to skip and women can go longer between periods.

    How do I skip my periods?

    Your doctor may advise a particular method for skipping periods that is relative to your situation. However, there are generally a couple of ways to skip periods:

    • Menstrually signalled extended use - this basically means continuously taking the hormonal tablets until you get breakthrough bleeding, and then have placebo tablets for 4 days to shed the lining and start again.

    • Tricycling - this is essentially skipping 3 periods in a row by completing 3 packets of the hormonal tablets before having placebo tablets for 4 days to shed the lining and start again.

    Want to make a booking with one of the Women's Health GP's at FitRight HQ? They love taking the time to discuss women's health topics like Contraception, Perimenopause, Sexual Health, Preconception and more!

    You can book a 45 minute initial appointment online here or call FitRight HQ 08 6444 7994.


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