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Sexual and Reproductive Health

Extended or continuous use birth control

What is extended or continuous use of hormonal birth control?

  • Extended use is when you take your birth control product for 2 or more cycles without stopping and then take a planned, hormone-free break. You will have your period during this break. By doing this, you will have fewer periods.
  • Continuous use is when you take your birth control product without stopping (without taking planned hormone-free breaks). You will have fewer or no periods.
Extended or continuous use of birth control prevents pregnancy as effectively as using hormonal methods in the typical way. People can choose to take their birth control using the extended way, continuous way, or typical way for medical or personal reasons.

With hormonal birth control, the lining of your uterus doesn’t build up and doesn’t need to be shed.  It’s safe not to have a period every month.

Which hormonal birth control products can I use for extended or continuous use?

Only some birth control products with estrogen and progestin can be used in a continuous or extended way, including some birth control pills, birth control patch, and the birth control ring. Talk to your health care provider to see if taking hormonal birth control in a continuous or extended way is right for you.

Learn more about the birth control pill, patch, and ring.​

How well does extended or continuous use of hormonal birth control work?

  • Extended or continuous use of birth control has the same effectiveness as the birth control method itself. Learn more about the birth control pill, patch, and ring.
  • With typical use (this means not following the exact directions, for example you might miss or be late with birth control) the birth control pill, patch, and ring are 91% effective.
  • With perfect use (this means you follow the exact directions all the time) the birth control pill, patch, and ring are 99.7% effective.
  • Most pregnancies happen because people forget to take their birth control.
  • Hormonal methods of birth control don’t protect you from sexually transmitted infections (STIs) and HIV.

What are the benefits of extended or continuous use?

  • You can choose to have fewer periods or no period at all.
  • It may decrease symptoms related to your period.
  • It may make your periods less painful and decrease pelvic pain.

What are the disadvantages of extended or continuous use? 

  • Having fewer periods might make it difficult to tell if you become pregnant.
  • It can cost a bit more.
  • You may have unpredictable spotting or bleeding.​

What are the side effects of extended or continuous use?​

The short-term effects are the same as for typical use of your method of birth control (see the information for your product). The long-term effects are not known. There is a chance (most likely in the first 3 months) that you might have increased spotting or bleeding between periods. ​

What can I do if I have spotting or bleeding between periods?

Spotting or bleeding between periods is a common side effect and should get better over time. If you have taken your birth control for at least 21 days and you continue to have spotting or bleeding that are a problem for you: ​

  • Consider a short hormone-free break of 3 to 7 days. If the break is longer than 7 days, you won’t be protected from pregnancy. Restart your birth control after the 3 to 7 day break (even if you are still spotting or bleeding).
  • Talk with your health care provider if it doesn’t improve.​

You must take at least 21 days of birth control in a row before you can take another hormone-free break. 

What if I forgot or am late with my birth control?

If you forget or are late with taking your birth control:

  • Follow the directions for the method you are using, or
  • Contact your healthcare provider or Health Link (811) for more information.

Think about getting emergency contraception if you:

  • Took your birth control late during the first 21 days of a new cycle, or
  • Took more than a 7 day hormone-free break at any time, or
  • Miss 7 days or less AND then miss more birth control in the next 21 days.

If your hormone-free break was longer than 7 days or you used emergency contraception, you will need to use an extra method of birth control (like condoms) or not have vaginal sex for the first 7 days of your new cycle before you are protected from pregnancy.

What else is important to know about consent, sexual activity, and birth control?

  • You have the right to decide to have sex or not. Talk with your partner or partners about consent.
  • There’s an 85% chance of becoming pregnant within one year, if no birth control is used for vaginal sex.  
  • Use a condom or barrier every time you have sex (oral, vaginal, anal). Condoms help prevent pregnancy, STIs, and HIV. 
  • You can lower your risk of HIV by taking an HIV prevention pill every day. Many Albertans can get it for free. Visit HIV PrEP to find out more.  
  • Transgender and gender diverse people who have a uterus can use hormonal birth control. It can help prevent pregnancy and make periods lighter and less painful.​

Where can I find more information?

​If you have questions, need to find a sexual health clinic near you, or want more information, call Health Link at 811 anytime, day or night, to talk to a registered nurse.​

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