Amethyst Continuous Birth Control Pill

Amethyst is a combination birth control pill. It is the generic version of Lybrel—Lybrel was the first extended-cycle oral contraceptive designed to supply you with an active dose of hormones every day. You take pills for 365 days and have no more periods. Lybrel is no longer available. Amethyst is manufactured by Watson Laboratories. Each pack of Amethyst contains 28 tablets (90 micrograms levonorgestrel/20 microgram Ethinyl estradiol). Amethyst is classified as a low dose, continuous, non-cyclic combination oral contraceptive.

Amethyst continuous birth control pills with packaging
Dawn Stacey

How It Works

Amethyst works just like other combination birth control pills. The main difference is that Amethyst supplies a steady, low dose of Ethinyl estradiol and levonorgestrel to be taken every day of the year. Unlike most other birth control pills, Amethyst does not contain any inactive tablets—so there is no placebo period. By taking this pill every day (as continuous birth control), you will no longer have your regular monthly period. 

Surrounding Debate

The idea of not having your period sounds pretty amazing. The "opponents" claim that it is unnatural or harmful to manipulate a woman's menstrual cycle by completely stopping her period. Well, my friends, these "opponents" need a quick reality check. You see, any woman who uses birth control pills (no matter which kind) is already manipulating her menstrual cycles. Few women naturally have a regular 28-day menstrual cycle; you're considered "regular" if you get your period every 24-38 days. The standard birth control pill manipulates a woman's cycle by causing it to be a perfect 28-day cycle.

Women who use birth control pills do not even have a "real" period What they actually experience each month is called withdrawal bleeding—this is what happens during the seven days that they are using the placebo pills. The bleeding tends to be shorter and lighter than a regular period because the uterine lining does not build up in women who use the pill—so there is less that needs to be shed. Basically, once the hormones are not taken (which is what happens during the fourth week of a typical pill cycle), the small buildup of the lining of the uterus is discarded. When you use Amethyst, you get continuous hormones (since there is no placebo period—there are 28 days of active pills), so you should have little or no uterine bleeding.

And now, get ready for this piece of information: the so-called period that occurs during regular 21- or 28-day combination birth control pill packs actually has no medical function other than reassuring you that you are not pregnant. The researchers who invented birth control pills back in the 1960s thought that women would be more likely to take them and the church would be more accepting of them if they "built-in" a period week (to more naturally mimic a woman's cycle).

We know that women have been choosing to skip their periods by manipulating their birth control for various reasons. Perhaps due to physically demanding jobs, upcoming honeymoons, vacations, and/or severe period-related symptoms. For decades, doctors have been showing women how to do this properly. Up until now, many pill users choose to avoid having a period by starting a new pill pack during the fourth week (when one's period usually occurs).

Advantages and Benefits

  • Medical authorities state that there are no health risks or medical reasons women need to have a monthly period.
  • Eliminating the menstrual week of a woman's cycle (as Amethyst does) can lead to a reduction or complete elimination of the symptoms associated with your period week such as: bloating, cramping, irritability, headaches, tender breasts, and other various aches and pains.
  • Eliminating periods through the use of continuous oral contraceptives has been shown to be an effective treatment for many health-related problems, such as endometriosis, anemia/menorrhagia, and epilepsy.
  • The use of Amethyst will also save women money. This is because you would no longer have to buy feminine hygiene products and/or period-related medications to treat headaches and other PMS symptoms. This also makes Amethyst more eco-friendly (for all of you wanting to lead a "greener" lifestyle, you know, reduce your carbon footprint).

Potential Risks

  • Many women welcome their monthly period—it provides reassurance about their continued fertility and femininity and lets them know they are not pregnant.
  • The continuous exposure to hormones associated with Amethyst has been a source of concern for some people. But, many doctors point out that seven additional days of low-dose hormone exposure per month is unlikely to significantly increase any risks beyond those already faced by women taking other types of combination birth control pills.
  • Since approximately 1% to 8% of oral contraceptive users become pregnant each year, young women who have never been pregnant and are taking Amethyst may not recognize pregnancy-related symptoms—if they become pregnant, since they cannot rely on a missing period to alert them of a pregnancy.
  • The low doses of hormones used in Amethyst may cause breakthrough bleeding (unexpected spotting). In one study, 49% of continuous oral contraceptive users had achieved amenorrhea by cycle two of use, and 88% had achieved it by cycle 12.

Side Effects

Amethyst has the same side effects as other combination hormonal methods. Serious complications are not common with oral contraceptive use.

All oral contraceptives, Amethyst included, carry a greater chance of negative outcomes in:

  • Women who smoke.
  • Women age 35 and older (should be monitored while taking Amethyst).
  • Women who are 35 or older and smoke.
  • Women who have conditions associated with a heart attack (such as high cholesterol, high blood pressure, diabetes, cardiovascular disease, and conditions that increase the risk of blood clotting).


Amethyst (just like other combination birth control pills) is 91% to 99.7% effective. This means that with typical use, only 9 out of every 100 women will become pregnant during the first year of Amethyst use. With perfect use, less than 1 will become pregnant during the first year of using Amethyst.

How to Obtain It

In order to obtain a prescription for the Amethyst, you will most likely need a medical evaluation, blood pressure check, and possibly a pelvic exam by a physician. Women can then have the prescription filled at a local pharmacy.


Amethyst may be purchased at a drugstore or clinic with a valid prescription. You should check with your health insurance policy as Amethyst should be covered with no out-of-pocket costs for all non-grandfathered insurance plans.

STI Protection

Amethyst will not offer you any protection against sexually transmitted infections.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Office on Women's Health. Menstrual cycle.

  3. Dhont M. History of oral contraception. Eur J Contracept Reprod Health Care. 2010;15(Suppl 2):S12-S18. doi:10.3109/13625187.2010.513071

  4. Hillard PA. Menstrual suppression: current perspectives. Int J Womens Health. 2014;6:631-637. doi:10.2147/IJWH.S46680.

  5. Edelman AB, Koontz SL, Nichols MD, Jensen JT. Continuous oral contraceptives: are bleeding patterns dependent on the hormones given? Obstet Gynecol. 2006;107(3):657-665. doi:10.1097/01.AOG.0000199950.64545.16. 

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