Continuous Birth Control

Extended Cycle Birth Control Pills

Birth control

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There are many types of birth control pills available on the market today. Continuous birth control pills (also known as extended-cycle pills or continuous-cycle pills) are the newest evolution of the birth control pill. Continuous birth control pills are a type of combination pill, meaning that they contain both estrogen and progestin. Continuous cycle pills contain more pills per pack, which means that they can:

  • Shorten your monthly periods.
  • Lower the frequency of your period.
  • Completely eliminate periods.

Types of Extended-Cycle Pills

There are three categories of extended-cycle pills:

  • 91-Day: These continuous birth control pills include the pill brands: Seasonale, Quasense, Seasonique, and LoSeasonique. Each pack contains 84 active/hormone pills—this equals 12 weeks of continuous birth control. The pack also has seven inactive pills (in Seasonale and Quasense, these are placebo pills. In Seasonique and LoSeasonique, these are low-dose estrogen pills). When you use a 91-day continuous-cycle pill pack, your period (or withdrawal bleed) usually occurs during Week 13. This means that you only have a period every three months (that's just four periods a year). Plus, the lower dose of estrogen in the last week of the pills help to make your period lighter and shorter, most women say that their period only lasts about 3 days.
  • 365-Day: The only continuous birth control pill FDA-approved for 365 days of use is Amethyst (this is the generic version of Lybrel, which is no longer being made). These continuous pill packs come with 28 active/hormone pills. Over 12 months, this equals one pill for each day of the year. There are no placebo pills. While using this extended-cycle pill, you should not have any periods for the entire year.
  • Mini Continuous-Cycle Pills: Because these extended-cycle pill packs have more hormone pills than the typical 28-day pill packs, they are also considered to be continuous birth control. You may also have fewer hormone fluctuations on these pills because they contain more hormone pills. These mini extended cycle pills include:
  • 24-Day: These are the pill brands Yaz, Beyaz, and Safyral. Each pack has 24 days of active pills and only four placebo pills.
  • 26-Day: This includes the pill brand Lo Loestrin Fe. This pill brand pack contains 26 days of estrogen/progestin pills, two days of estrogen-only pills, and two days of placebo pills. Studies show that these extra two days of estrogen can lead to lighter and shorter periods.

How It Works

Continuous-cycle birth control works the same way as other hormonal contraception that contains estrogen and progestin (such as combination oral contraceptives, NuvaRing, and the Patch). If you don't have a prescription for one of the extended-cycle pill types listed above, you can also use your regular 28-day combination pills or combination hormonal contraception as continuous birth control.

Safety

Research shows that continuous-cycle pills are safe to use. Experts assert that there's no biological need to have a monthly period if you are using hormonal contraception. Especially as when you use hormonal birth control, you're not getting a true period, but rather what's termed a "pill bleed" or "withdrawal bleed."

Continuous birth control pills have the same side effects and risks as your regular 28-day birth control pill packs—this is because they contain the same types of hormones. Continuous pills also offer the same high effectiveness.

One 2018 study found no clinically significant difference in the risk of venous thromboembolism (blood clots) with the continuous-cycle pills versus traditional cycle pills.

Benefits

Extended-cycle pills offer you the same non-contraceptive benefits that hormonal contraception does. But continuous birth control pills may be able to do even more: If you have period-related issues, continuous cycle pills can greatly improve your quality of life. They give you the control to lower the number of periods you have as well as how long your periods last. This could provide a lot of relief if you suffer from:

  • Menorrhagia (heavy bleeding)
  • Long and/or frequent periods
  • Dysmenorrhea (painful periods)
  • Uncomfortable menstrual-related bloating, breast tenderness or mood swings
  • PMS or PMDD
  • A disability that makes it difficult to use pads and/or tampons
  • A health condition that becomes worse during your period (like anemia, endometriosis, or migraines)

Even if you do not have difficult symptoms during your period, you may still want to choose to use continuous birth control for the following reasons:

  • Having shorter, fewer, or no periods is more convenient
  • To save money on the cost of pain relievers, pads, liners and/or tampons (every dollar counts!)
  • As part of a greener, more environmentally-conscious lifestyle (you'll have less waste because you won't be using period products every month).

A Word From Verywell

As with other hormonal contraceptives, you will need a doctor’s prescription to get continuous birth control pills. If you have certain health conditions, extended cycle pills may not be the safest contraceptive method for you to use. And, even though these pills are effective at preventing pregnancy, continuous birth control pills do not provide you with any protection against sexually transmitted infections.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lo Loestrin Fe prescribing information. Irvine, CA: Allergan USA, Inc.; 2017. 

  2. Nappi RE, Kaunitz AM, Bitzer J. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians. The European Journal of Contraception & Reproductive Health Care. 2016 Mar 3;21(2):106-15. doi:10.3109/13625187.2015.1107894

  3. Li J, Panucci G, Moeny D, Liu W, Maro JC, Toh S, Huang TY. Association of risk for venous thromboembolism with use of low-dose extended- and continuous-cycle combined oral contraceptives: A safety study using the Sentinel Distributed Database. JAMA Internal Medicine. 2018 Nov 1;178(11):1482-8. doi:10.1001%2Fjamainternmed.2018.4251