Does the Pill Stop Your Period?

There are two main types of oral contraceptive pills (OCPs).

1. Combination pills: These are the most common type of OCPs and contain both estrogen and progesterone. There are several types of combination pills.

• Monophasic pills are used in one-month cycles and provide the same level of hormones throughout the month.
• Multiphasic pills are used in one-month cycles and provide different levels of hormones during the cycle.
• Extended-cycle pills are used in 13-week cycles. Active pills with hormones are taken for 12 weeks and inactive pills are taken during the last week of the cycle. As a result, periods occur only three to four times per year.

2. Progestin-only pills or mini pills: These contain progestin without estrogen. These pills are a suitable option for women who breastfeed, smoke, have a history of blood clots, are older than 35 years old or who can’t take estrogen. These pills may cause irregular periods and, at times, stop them.

Combination pills containing estrogen and progestin prevent pregnancy primarily by stopping ovulation (release of the egg from the ovaries). Progesterone causes thickening of the cervical mucus, which makes it difficult for the sperm to swim through the cervix to reach the egg, thus preventing fertilization. The hormones also prevent pregnancy by causing changes in the lining of the uterus (endometrium), making it impossible for the fertilized egg to become implanted in the uterine wall.

The progestin-only pill prevents pregnancy typically by thickening the cervical mucus to stop the sperm from reaching the egg and thinning the endometrium to prevent the implantation of the fertilized egg. In addition, progestin-only pills may prevent ovulation (40 percent).

The regimen depends on the type of pill

• Combination oral contraceptive pills (OCPs): Combination pills come in packs of 21-, 24- or 28-day cycles. The first pill must be taken on the first day of a woman’s period. One pill has to be taken every day at the same time. The last seven pills in the packet are a different color. They are either vitamin pills or empty pills. These pills, when taken, allow bleeding to occur.
• Progestin-only pills or mini pills: Progestin-only pills come in a 28-day pack and must be started on the first day of a woman’s period. One pill must be taken every day at the same time.
• Stopping the period: It's possible to prevent a period by continuously using any birth control pill. This means skipping the placebo pills and starting right away on a new pack. You must consult a doctor before doing this. Amethyst is a combination birth control pill that is the first birth control pill approved by the U.S. Food and Administration (FDA) for continuous use for 365 days without placebo pills.
• Missed dose: Individual brands of OCPs come with specific directions to be followed if one or more doses are missed. A backup method of birth control has to be used for seven to nine days or until the end of the cycle to prevent pregnancy.

When oral contraceptive pills (OCPs) are taken as prescribed, they are 99 percent effective in preventing pregnancy. When OCPs are missed for one day or not taken at the same time every day, they are 91 percent effective.

Conditions that reduce the effectiveness of OCPs include

• Forgetting to take OCPs for two or more days
• Diarrhea or vomiting for more than 48 hours (two days)
• Taking medications such as certain human immunodeficiency virus (HIV) medicines, certain anti-seizure medicines, the antifungal griseofulvin, the antibiotic rifampin and St. John’s wort

Condoms have to be used as a backup during these conditions. Different birth control methods have to be considered. These medications have to be taken long term.

The benefits of oral contraceptive pills (OCPs) include

• 24/7 protection against pregnancy
• Better than most birth control options
• Reversible (Upon stopping OCPs, the cycle will return to normal and a woman can become pregnant.)

OCPs prevent or lessen

• Heavy periods
• Menstrual cramps
• Premenstrual syndrome (PMS)
• Acne
• Anemia
• Bone thinning
• Cysts in the breasts and ovaries
• Endometrial and ovarian cancers
• Risk of certain cancers
• Risk of ectopic pregnancy

The downside of oral contraceptive pills (OCPs) include

• OCPs don’t offer protection against sexually transmitted infections (STIs) including human immunodeficiency virus (HIV). Condoms need to be used along with the daily pill to protect against STIs.
• The pill should be taken every day at the same time.
• OCPs are not recommended for people who have migraines with aura, high blood pressure, high cholesterol or diabetes, breast cancer, cancer of the reproductive organs, heart attack, kidney disease, liver disease, stroke or certain forms of lupus.

The hormones in oral contraceptive pills (OCPs) may cause minor side effects in some people when starting OCPs. Side effects usually disappear in two to three months of taking OCPs. Common side effects include

• Irregular menstrual bleeding
• Spotting
• Headaches/migraines
• Nausea
• Breast tenderness
• Mood changes
• Decreased libido
• Bloating or weight gain
• Increased blood pressure

An increased risk of blot clots, especially with the use of combination pills, can lead to rare and serious side effects including stroke, heart attack, deep vein thrombosis, pulmonary embolism and liver or gallbladder disease.

If persistent side effects are present, the doctor may recommend a different type of contraception or a different type or brand of OCPs.