Contraceptive Pearl: Continuous Use of Contraception

Why have a period? Hormonal contraception products allow for plenty of flexibility. The hormone-free week was originally designed to reassure users by producing the usual monthly period. However, the withdrawal bleed is not medically necessary. It can be skipped for convenience (honeymoon, vacation, etc.) or to treat menstrual symptoms.

Many birth control pill packs contain 21 active hormone pills and 7 spacer pills. Most people have a withdrawal bleed during the hormone-free week. To avoid the withdrawal bleed, pill users should skip their spacer pills and go directly to the next pill pack. Patch users should apply a new patch each week (skipping the patch-free week). Ring users should insert a new ring every month (skipping the ring-free week).

Cost-conscious hint: The ring contains 35 days’ worth of hormones, so it can be changed every calendar month rather than every 4 weeks. The patch can be changed every 9 days rather than every week. The ring and patch are expensive, so these extra days of protection are worth a lot!

People who shift to continuous-use contraception may have spotting during the first month or two.

We appreciate your feedback! Please write us at with any questions, comments or additional resources to add to our list.


Helpful Resources

Skipping Periods on Birth Control

Understanding Menstrual Suppression  (Patient fact sheet from the Association of Reproductive Health Professionals)

A Quick Guide to Skipping Periods with Birth Control (Patient information from Bedsider)



Edelman A. Menstrual nirvana: amenorrhea through the use of continuous oral contraceptives. Curr Womens Health Rep. Dec 2002;2(6):434-438.

Edelman AB, Gallo MF, Jensen JT, Nichols MD, Schulz KF, Grimes DA. Continuous or extended cycle vs. cyclic use of combined oral contraceptives for contraception. Cochrane Database Syst Rev.2005(3):CD004695.

Miller L, Verhoeven CH, Hout JI. Extended Regimens of the Contraceptive Vaginal Ring: A Randomized Trial.Obstet Gynecol. Sep 2005;106(3):473-482.

Stewart FH, Kaunitz AM, LaGuardia KD, et al. Extended use of transdermal norelgestromin/ethinyl estradiol: a randominzed trial. Obstet Gynecol. 2005 Jun;105(6):1389-96. 



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

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