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Knowing how your menstrual cycle works is the first step to making informed choices about birth control and figuring out if having your period less often is right for you.
Menstrual Period
When you’re not using hormonal birth control, you experience a menstrual cycle each month that helps prepare your body for pregnancy. Each month during your menstrual cycle, surges of hormones cause your ovaries to release an egg (ovulation) to be fertilized. Elevated hormone levels also cause the lining of your uterus to build up. If the released egg is not fertilized within a few days, your body sheds the built-up layers of the uterine lining and the unfertilized egg – and the process begins all over again. This normal shedding is what you know as your “menstrual period”.
Pill Period
When you are using any type of hormonal birth control (estrogen and progestin), the bleeding you experience isn’t the result of a menstrual cycle. That’s because normal hormonal birth control prevents you from ovulating (releasing an egg). So without an egg, your body doesn’t prepare for pregnancy. As a result, the lining of your uterus doesn’t build up much, and since there is no unfertilized egg, there’s no physical need to shed the lining every month. The bleeding that you typically experience on the days that you are not taking hormone (e.g., the sugar pills, or the days between pill packs) isn’t the same as a normal menstrual period – it’s a “pill period” (also called a “withdrawal bleed”) caused by discontinuation from the hormones that are in your “active” pills. A pill period is generally lighter and shorter than a regular menstrual period.
Having your period less often*
Now that you understand the difference between a normal menstrual period and a pill period, it’s easier to understand why it is okay to have fewer period days each year, and that it’s okay to use approved products to lengthen the time between your scheduled periods. Because there’s no egg released each month, the uterus doesn’t need to build up a lining to prepare for pregnancy, and there is no egg to be expelled. Clinical trials have shown that the 21/7, 24/4 and 84/7 regimens provide similar efficacy and side effects. And because the lining of the uterus remains thin, even if you have your “period” less often, you should expect it to be lighter and shorter than a normal menstrual period.
*Combination oral contraceptives are designed in a way that you should not expect to have your period while taking active therapy and expect to have your period while taking placebo pills. Some women may find that their periods are actually shorter than the number of placebo days, while some women may find that they are still menstruating for the first couple of days after they resume taking active therapy. Some women may also find that they have some bleeding or spotting when they take active pills. This is generally transient and is not part of your planned or scheduled period. Some women may also find that their period stops all together (amenorrhea). Women who experience amenorrhea are still protected from pregnancy and their periods typically return to normal once they stop taking therapy.
