Seasonique Birth Control Pills

What you should know about the pill that gives you four periods a year

Close up of a contraceptive blister

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Seasonique is an extended-cycle, or continuous birth control, that gives users only four periods per year, or one a season, as the name implies. If you experience painful or heavy periods, PMS or PMDD, or menstrual migraines⁠—or you just wish your period didn't need to come every single month, Seasonique may be a birth control method to consider.

If you're thinking about making the switch, here's what you should know about Seasonique effectiveness, uses, and side effects.

How Seasonique Works

Seasonique is an FDA-approved continuous cycle birth control pills containing estrogen (ethinyl estradiol) and a progestin (levonorgestrel).

Like other birth control pills, Seasonique prevents pregnancy by preventing ovulation so that an egg is not released to be fertilized. Combination birth control pills also cause the cervical mucus to be thicker (making it more difficult for sperm to pass through the cervix) and change the lining of the uterus so that, if fertilization does occur, implantation is unlikely.

Unlike 28-day combination birth control pills that include 21 days of hormones and seven days of placebo pills, each package of Seasonique contains 91 pills. The first 84 pills contain 30 micrograms (mcg) of ethinyl estradiol and 0.15 mcg of levonorgestrel, while the last seven days of the three-month pill pack contain a low-dose of 10 mcg ethinyl estradiol.

The extended hormone dosing is what leads to periods only occurring only quarterly.


Like other combination birth control pills, Seasonique is 91% effective with typical use and 99.7% effective with perfect use. This means that, of every 100 women who use these birth control pills for one year, less than one will become pregnant with perfect use; nine will become pregnant with typical use.

Possible reasons for failure include:

  • Missing pills
  • Medications, including certain antidepressants and antibiotics
  • Being overweight or obese


There are a number of reasons some people prefer or can benefit from continuous cycle birth control over cyclic pills.

Painful Periods

Women who have dysmenorrhea (painful periods) would only have to cope with related symptoms a few times a year if they took Seasonique. This may be particularly helpful for those who have painful cramps due to endometriosis.

Heavy Periods

Heavy periods, referred to as menorrhagia, are not only limiting physically but can contribute to anemia in some women. Periods are typically lighter and shorter while using Seasonique.

Menstrual Migraines

Combined birth control pills can trigger migraines for some women. Having fewer periods could help those who have estrogen withdrawal headaches. It's also thought that having stable estrogen levels, which continuous pills allow for, may reduce migraines that are brought on by hormonal fluctuations.


Menstrual periods and the symptoms associated with them are a common barrier to physical activity in women. A 2018 study of recreationally and competitively active women found that 74% had intentionally manipulated their period at least once in the previous year. A pill that allows for fewer periods may make athletic participation easier for some women.


Research shows that women were even more likely to manipulate their periods due to holidays and special events than for sporting events.

Safety and Side Effects

It has been known for a long time that occasionally skipping periods with birth control pills is safe, and there are currently no known risks associated with only having four periods each year.

Overall, Seasonique is as safe and effective as other forms of birth control pills.

That said, the side effects of Seasonique are similar to any other birth control pills too, and it should not be used by women who have:

  • Heart disease
  • A history of blood clots
  • Diabetes with complications
  • Estrogen-dependent cancer
  • Liver disease
  • Kidney disease
  • Had a stroke

Additionally, Seasonique should not be used by women who could be pregnant. Women who smoke or are over age 35 should also carefully weigh the risks with their doctors and strongly consider other options.

Despite having fewer periods, spotting (breakthrough bleeding) is more common with continuous birth control. Fortunately, this side effect often decreases with time.

A Word From Verywell

Deciding what form of birth control to use is a deeply personal decision. Always consider your own lifestyle and health, and talk with your doctor about pros and cons specific to you, before making a switch.

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