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Dr. Kate,
I'm currently on a 21/7 pill, and it's working beautifully for me, but I have a question about the placebo week's effect on the body. After reading the post about the different lengths of placebo weeks, I'm wondering: Is a placebo week even necessary? Is that withdrawal bleed an actual period? Would you recommend skipping the placebo week several months in a row, or is it healthier or safer to take that week and have the subsequent withdrawal bleed each month? Okay, that was three questions! Puzzled by Placebos Dear Puzzled, I'll take your second question first. The withdrawal bleeding is just that--your body's reaction to the withdrawal of hormones; it's not a true period. Once you start manipulating your cycles with hormones (that sounds so diabolical!), you no longer have what gynos consider "periods"--just regular, hopefully scheduled, bleeding. So the placebo week isn't truly necessary. When the pill was first manufactured in the 1960s, its creators came up with the 21/7 pattern to mimic the natural cycle, hoping it would be more acceptable to both women and the Catholic Church. The pope didn't buy it, as we know, but many women have felt reassured by seeing bleeding every month. But as I've posted before, that bleeding isn't necessary for good health. In the end, it's totally fine to skip the placebo weeks whenever you want (it's not healthier or safer, it's simply another option), with a few caveats:
This also works for the Nuvaring: you can follow one ring directly with another, and skip the "ring-free" week. Have any of you had luck skipping the placebo week of your birth control? 9 CommentsLeave a comment |
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I was taking Lybrel for five months, but I would be spotting almost all month. I hated it because I never knew when it would happen either. Finally I switched to Yaz which only gives me a four day period which is still pretty light.
What happens if you skip the placebo week on triphasic pills? Do they become less effective?
another caveat is if you are on a progesterone only pill ("mini pill"), there is no placebo week - all the pills are active. I didn't know that until after about the 4th time I had just gone ahead and not taken the last week of pills like I always had with my triphasic pills in the past. This would be a good thing to share with women when prescribing this med because who actually really takes the placebo pills?
Thanks for a clarifying post. One question: I'm on the Pill, and I always greet withdrawal bleeding with a sigh of relief--it means I'm not pregnant! But if the bleeding isn't a true period, does it really tell me that I'm not pregnant?
All questions answered :) --
If you skip the placebos in a triphasic pack, you're just more likely to have spotting - it's not any less effective.
EXCELLENT point about no placebos in a Micronor (progesterone-only) pack - thank you!
Yes, your withdrawal bleeding DOES reassure you that you're not pregnant. If you were pregnant, you would most likely not bleed at all. So you can still celebrate!
I've been skipping my period for years while on the pill. It's fantastic!!! Once I did it on the triphasic and got lots of break through bleeding so changed to the monophasic. However, I have been breakthrough bleeding a lot more recently. I went to my gyno and she changed me to a different pill which is apparently better for the uterine lining and so prevents/lowers breakthrough. I haven't gone back onto the pill yet because she told me I need to give my uterus a rest for a few months to repair.
I'm on continuous use Nuva-Ring. It's wonderful and I hardly spot, except if I have grapefruit (or the juice), I have my regular PMS symptoms (migraine, acne, bloating, large breasts, irritability, and cramps) and then I get my period! My doctor told me that being on continuous use would reduce my PMS symptoms... it eliminated it!
At the risk of sounding stupid, what about the 24/4 packs like Yaz? If you have sex the last 4 active days of your pack, are you still protected?
If you haven't missed any pills in the pack, you're safe to have sex at any time. Think of it this way - as long as you're taking hormones, your ovaries stay turned off during the whole cycle, including the end of the active pills and the placebo time. And as long as you don't go more than 7 days without hormones, your ovaries stay off.