Is it okay to skip my period on the pill? (And other VIP period questions)

So, you’ve been prescribed oral contraceptive pills (aka, ‘the’ pill). Questions we get asked a lot around here are: how often can I take a break from the pill? Can I skip my period on the pill? Am I protected during a 7-day pill break? 

First things first, that ‘period’ you get in between pill packets may feel like a period, but it actually isn’t one. Your body's hormone levels drop when you start taking hormonal contraceptives; the lining of your uterus starts to shed, and you get a withdrawal bleed.

These withdrawal bleeds are not a ‘real’ period(1) as they can’t be used to indicate whether you’re pregnant or not—women who take combined hormonal contraception (CHC) can experience withdrawal bleeding when pregnant (2) (yes, really). 

So, how should you take your pill and is it safe to take your pills back-to-back? 

Yes, it’s completely safe. Back in the day, we were told we should finish the hormone pills in the pack and then we should bleed. Fun fact: this advice was actually partly down to the pope.

Today, The Faculty of Sexual and Reproductive Health (who set the ground rules for everything contraception-related in the UK) has explained that withdrawal bleeding isn’t actually medically necessary (3). Basically, it’s up to you.  

We know a lot of women and people with cycles feel they may ‘store up’ their period so when they do take a break from the pill, they’ll have one huge bleed. Never fear, this isn’t true, as taking a continuous dose of hormones means your womb lining never builds up in the first place. 

Read on for the different ways you can take your oral contraceptive pills to work out which is best for you.

The ‘standard’ regimen

This means you take a break after you’ve taken hormone pills for 21 days. Enter withdrawal bleeding. 

• Pros: It’s great if you like experiencing regular bleeding and you want to follow a strong routine. 

• Cons: Well, if you don’t like withdrawal bleeding, this way means you get one once a month—and any side effects that come with it, i.e. cramps. 

The ‘tailored’ regimen

This is when you extend the number of days you take your hormone pills. You either skip taking your hormone-free pills or avoid your pill breaks. By doing this, you can avoid your withdrawal bleed.  

• Pros: It’s completely safe, you bleed less (and you won’t suffer any side effects you experience with hormone withdrawal, i.e. cramps). You may even be more protected against pregnancy(4) because you reduce the likelihood that an egg will mature in your ovaries. If an egg doesn’t mature, it can’t be released for fertilization.  
   

• Cons: There is the potential for breakthrough bleeding. Some people prefer to experience a regular monthly bleed. 

There are different ways you can ‘tailor’ your pill routine, such as: 

The ‘tailored’ regimen: Tricycling

You take all 3 sheets of hormone pills in your pack back-to-back, i.e. you run your pill packets for three months without taking a break (63 active pills). When you do take a break, you take either one cycle’s worth of hormone-free pills or you stop taking your pill for 4 to 7 days.

Heads up: Most women will experience withdrawal bleeding during this break.

The ‘tailored’ regimen: Flexible

You take your hormone pills back-to-back until you have an unplanned breakthrough bleed. When this happens, you either start taking hormone-free pills or stop taking pills for 4 to 7 days. 

Heads up: Remember to restart the hormone pills again, even if you're still bleeding.

The ‘tailored’ regimen: Continuous

You take your hormone pills every day without a break, even if you start to notice breakthrough bleeding. You don’t take any hormone-free pills at any point in your cycle, and you take no breaks. 

Heads up: There is no official withdrawal bleed, but you might still experience some breakthrough bleeding (spotting). This usually settles within a few months.

The ‘tailored’ regimen: Extended

You take a hormone pill every day for 84 days and then take a break from your hormone pills for 7 days. During this break, you may experience a withdrawal bleed. 

Heads up: You’ll need to remember to take your pill every day for 84 days, so make sure this is practical for you and your lifestyle.

VIP period questions that you’ve asked us

Which pill is best to stop periods?

Everyone is unique and therefore the type of hormonal contraception that will work best for you will depend on many different factors (we can help with this). There are 238 hormonal contraceptives right now, for example, each with different ingredients and hormone doses. BUT, tailoring your pill intake (i.e. by taking your pill packets back-to-back) means you’ll avoid the withdrawal bleed. 

Which are the best birth control pills to regulate periods? 

Again, the answer to this will depend on your unique genetic makeup and the way your hormones fluctuate (both naturally and when you’re taking hormonal contraceptives). If you’re looking to regulate periods, you can do so either by using the ‘standard’ regimen which can involve taking hormonal pills for 21 days before taking a break (this is when you’re likely to get your withdrawal bleed). Or if you’d prefer, you could opt for the ‘tailored’ regimen which means you can either skip taking your hormone-free pills or avoid your pill breaks. This can stop your withdrawal bleed entirely. 

What happens if you take birth control every day?

Well, you either won’t get withdrawal bleeding or you’ll experience some spotting. We follow The Faculty of Sexual and Reproductive Health’s latest guidelines(3), which state that women can take fewer (or no) hormone-free intervals to avoid monthly bleeds, cramps, and other symptoms.  And, it’s perfectly safe and healthy(3) to do so!

Why am I bleeding while on the pill?

As mentioned earlier, it’s not exactly a menstrual period, but a hormone withdrawal bleed. The drop in hormones(5) triggers your body to release blood and (ahem) mucus from your uterus’ lining. 

Is the oral contraceptive pill safe?

Combined hormonal contraception is generally safe. It’s associated with lower risks of cancers (colorectal, endometrial and ovarian) and a slightly increased risk of breast cancer (the risk returns to baseline after 5-10 years of stopping use). The number of side effects reported with extended or continuous CHC use is low and similar to when it’s taken according to the traditional regimen. Even if you don’t have a bleed in each cycle, your future fertility is not affected by tailoring your approach (98-99% of women who used a tailored regimen ovulated within 30 days).

How effective is the pill when taken perfectly?

Up until now, the medical system has focused on how effective the pill is in stopping you from getting pregnant. BUT there’s so much more to the pill than this and these figures aren’t a true reflection of our lived experiences on the pill. Yep, if used perfectly (i.e. according to instructions), less than one in 100 women will get pregnant in a year, and if used not-so-perfectly, about 9 in 100 women will get pregnant in a year. Plus, by taking fewer hormone-free intervals (or shortening them to 4 days), you can further reduce the chance of getting pregnant. 

Am I protected during a 7-day pill break? 

Yes, absolutely. As long as you’ve been taking your pill correctly and starting your hormonal contraception on time, you’re protected during your week off. 

What happens if I accidentally take 2 birth control pills in one day?

Oops. No need to seek medical advice though. If you take a fair few more than that, you might feel a bit sick, actually be sick, or experience some bleeding. Your symptoms should pass, but if they’re severe, seek medical attention. If you take an extra pill(s), take the rest of your pack as normal.

Written by

Hermione Wright (she/her)

An NCTJ-qualified journalist, Hermione writes for national and local publications in addition to creating thought leadership for brands with a purpose. Passionate about telling the stories that matter, she helps our community make their own clued-up choices about their healthcare.

Medically reviewed by

Dr. Arushee Prasad, GP, MBBS (she/her)

Dr Arushee Prasad is a GP for NHS England with an MBBS in Medicine and Surgery, and an MRCGP from the Royal College of General Practitioners. Passionate about digital health and algorithmic medicine, Arushee was previously an Algorithmic Medical Doctor for Docly.

Scientifically researched by

Hannah Durrant (she/her)

Hannah is a Biomedical Content Writer at Tuune, with a BSc in Biomedical Sciences from University College London. She is passionate about bringing together the scientific community and the general public by disseminating modern science via digestible, engaging and thought-provoking content.