Hormonal birth control is a widely used method for contraception and managing menstrual cycles. These medications introduce synthetic hormones into the body to alter natural reproductive processes. This article addresses common questions about using birth control while navigating your menstrual cycle.
Continuing Birth Control During Your Period
For most hormonal birth control methods, especially combined oral contraceptives, continue taking pills without interruption, even during the week bleeding occurs. A standard pack usually contains 21 active hormone pills and 7 inactive (placebo) pills. These inactive pills help maintain a daily routine. During the inactive pill week, or a hormone-free break with a patch or ring, a withdrawal bleed will occur.
You remain protected from pregnancy during this inactive pill week, provided active pills were taken correctly. Skipping inactive pills and immediately starting a new pack is an option to reduce or eliminate bleeding. This continuous use of active pills is effective and can lead to fewer or no bleeding episodes. Consult your healthcare provider to discuss if continuous use is appropriate for your specific birth control type.
How Birth Control Manages Your Cycle
Hormonal birth control works by introducing synthetic estrogen and progestin. These hormones prevent the ovaries from releasing an egg (ovulation), thereby preventing pregnancy.
The hormones also affect the reproductive system in other ways. They thicken cervical mucus, creating a barrier that makes it difficult for sperm to reach an egg. Additionally, these hormones thin the uterine lining (endometrium), making it less receptive for a fertilized egg to implant. These combined actions effectively prevent conception and manage the menstrual cycle.
Distinguishing Between Types of Bleeding
The bleeding experienced on combined hormonal birth control differs from a natural menstrual period. This “withdrawal bleed” occurs due to a temporary drop in hormone levels during the inactive pill week or hormone-free interval. Unlike a natural period, which follows ovulation and uterine lining shedding, a withdrawal bleed responds to hormone withdrawal. The uterine lining does not thicken as much on hormonal birth control, so withdrawal bleeding is typically lighter and shorter than a natural period.
“Breakthrough bleeding” or spotting is unexpected bleeding between scheduled withdrawal bleeds. This is a common side effect, especially during the first few months as the body adjusts. Breakthrough bleeding does not usually indicate that birth control is ineffective, but inconsistent pill-taking can contribute to it. If breakthrough bleeding is persistent or heavy, consult a healthcare provider to rule out other causes.
Ensuring Effective Birth Control Use
Maintaining birth control effectiveness requires consistent and timely use. For oral contraceptives, take a pill at the same time every day for optimal protection. Missing pills, particularly active hormonal ones, increases the risk of unintended pregnancy. If one combined hormonal pill is missed, take it as soon as remembered, even if it means taking two pills on the same day. If two or more pills are missed, follow specific instructions on the pill packaging or from a healthcare provider, often requiring backup contraception for several days.
Certain medications can also reduce hormonal birth control effectiveness. Some anti-seizure drugs, anti-HIV drugs, and the antibiotic rifampin are known to interfere. Herbal supplements like St. John’s wort can also diminish efficacy. Inform your healthcare provider about all medications and supplements you are taking to assess potential interactions. Always consult a healthcare provider for personalized advice regarding birth control use and any effectiveness concerns.