How long should my contraceptive pill break be?
Gemma Dauncey scrutinises the current confusion of deciding on the right number of days between taking the contraceptive pill
It is fair to say that contraception has come a long way and, unlike past generations, we are no longer reliant on abstinence or coitus interruptus thanks to the NHS offering (hopefully) something for everyone. But despite medical developments, common understanding and knowledge about contraceptive methods is often limited and occasionally outdated. So do we actually know everything about the pill?
Although this common contraceptive has a reputation which proceeds it, including myths and fears about its hormonal impacts and unappealing side effects, there remains an air of mystery around its inner workings which for many can seem confusing and possibly off-putting. One topic which is subject to such confusion is the ‘pill break’- the gap you take between packets of the combined pill to simulate a period. Most people believe that that break should last for seven days, completing a twenty-eight day cycle which GCSE science textbooks say is the norm for menstruation. But recently ideas of continuous pill taking and shorter four-day breaks have been discussed outside the doctors office by news outlets, causing an array of confusion as everything people thought they knew about the pill is changing.
News outlets have been reporting the seemingly groundbreaking news that a seven day pill break on the combined pill may not be necessary
First of all it’s important to start with a disclaimer, whilst this article uses information from sources such as the NHS websites, FSRH (Faculty of Sexual and Reproductive Healthcare) recommendations, and a little real-life experience, it is important that you speak to a healthcare professional about any questions you may have or changes you may wish to make. This could be your GP or a member of the contraceptive services team at the Sidwell Street walk-in centre (who are very helpful). This is particularly important as the effects of the pill can vary significantly person to person and your reasons for taking the pill may also impact what you take and how frequently you take it (yes, there are reasons for taking the pill other than contraception, such as to help with period regulating and acne. Calm down dad’s-in-outdated-tv-shows who go crazy when they find out their 14 year old is taking the pill; you might not know the full story).
Recently, news outlets have been reporting the seemingly groundbreaking news that a seven day pill break on the combined pill may not be necessary. The FSRH have changed their recommendations as research suggests there are no particular benefits to the seven day break and that it is possible to shorten the break to three/four days or to not take a break at all. This can be particularly beneficial for those who struggle with remembering to take the pill as there is no disruption to routines and it could also help to prevent pregnancies, as risks surrounding missed pills are higher around the time of the break. Of course, by shortening the break symptoms like the ‘period-type’ bleed experienced between packets would also be lessened, benefiting those whose symptoms are particularly uncomfortable. As the bleeds are not necessary and (because they’re not an actual period) don’t show that you aren’t pregnant, the inconvenience of a monthly bleed could be avoided. There are also multiple variations to the pattern including taking three packs in a row followed by a short break, so talking to your doctor or whoever prescribed your pill may help you figure out a routine that works for you and your symptoms.
What is particularly interesting about this ‘revelation’ however, is that for some of us this information is not new. Having previously been recommended this by my doctor a year or so ago and having experienced taking back-to-back packets to avoid the break symptoms at particularly awkward times, the recent reports indicate that there is still considerable variation in what women know about their contraceptive methods. This is in part due to continuous pill taking being an “off licence” prescription, something recommended by doctors but not in the instructions provided by manufacturers. But it also is perhaps indicative of the mysteries which still surround contraception and the general acceptance of myths and pre-established ideas.
If continuous pill taking interests you, another option is the progesterone only or ‘mini’ pill which is taken non-stop, or there are packets of the combined pill which contain 7 placebo pills that can help with maintaining routine but still involve a break from the pill itself. There are lots of options when it comes to contraceptives, meaning it’s definitely worth talking to your doctor and doing some research to figure out these options, and maybe bust some myths at the same time.