Continuous Pill Taking

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What is continuous pill taking?

• This is a way of taking the pill leaving out the regular pill free break – i.e. not in the usual 21 tablets then stopping for 7 days way (21/7 for short).
• This is an “off licence” prescription. Yet it is supported by medical authorities in the UK and by WHO: there’s lots of evidence for it making your pill much safer, contraceptively. We have known for some time that the routine of not taking tablets for 7 days weakens the pill’s main effect of stopping your ovaries from releasing an egg: so it makes egg-release more likely when pills are missed. Since it’s quite common to forget 1 or 2 pills, ordinary women find the method lets them down about 10 times more often than if “over 99% effective” was true, in the real world.
• It also means you don’t have to have regular monthly bleeds, which have no known benefits.
• A non-phasic 20 mcg oestrogen pill is used - your healthcare provider will be able to tell you this.

What are the benefits for me?

• As just said, it makes the pill more effective as a contraceptive.
• It reduces problems such as period pain, PMT, migraine and other headaches, and more.
• It’s convenient for when you want to avoid bleeding e.g. for holidays and special occasions.

How do I take the pill continuously?

• Start your pill on the correct day of the week (as shown on the strip).
• Take one pill at about the same time each day, at a time that is easy for you to remember
• Take all the pills in that strip, and then start the next strip without a break.
• Keep taking the strips without a break

How long can I take the pill continuously?

• Indefinitely – until either you choose another method or your surgery/clinic advises this.

Isn’t it better for me to have “periods” every month?

• Modern contraception is very safe and women do not need to bleed every month to know that they are not pregnant.
• The “period” on the pill is completely artificial and is just your womb’s response to stopping the pill (and therefore the hormones) for a few days. It is called a “hormone withdrawal bleed”.
• Continuous pill-taking just stops you having that completely unnecessary regular bleed.

What happens if I get bleeding while taking the pill continuously? 

• Irregular bleeding and/or ’spotting’ during the first months of continuous pill-taking can occur, but most women find this becomes acceptable as it lessens over time.
• If the bleeding becomes troublesome to you, e.g. by continuing for more than a few days, stop the pill for 4 days. No need to contact the surgery or clinic first. Also:

1. Unless you also missed other tablets for any reason in the previous week, no need to take extra precautions.
2. Then restart your pill taking the correct pill for that day, leaving out the 4 unused pills.
3. Continue as before.

Having this 4-day break usually works to stop or improve the bleeding, but if it carries on and does not resolve, you should seek advice from your surgery/clinic in case you need a check up to exclude other causes of bleeding e.g. Chlamydia.

What is an “off licence” prescription?

• All medicines have a product licence. The licence tells us under which conditions the medicine can be prescribed for patients.
• If expert medical opinion is that a medicines can be used also in different ways or under different conditions, this is called prescribing “off-licence”.
• Prescribing off-licence is as safe as taking the pill in the standard way because we still follow medical guidelines.