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What Happens When You Take Your Contraceptive Pill Back To Back?

Of the reported 3.5 million UK women who use the pill, I’d wager a huge amount of cash (alright, £50) on half of them not being able to solidly answer most questions on the seven-day pill break. Or, most pill-related issues, for that matter.

According to the CEO of leading sexual health charity Family Planning Association, I should probably wager a bit more money; “We used to have a helpline, and one of the biggest questions was about the pill,” Nakita Halil told me. "Missing a pill is such a common worry, and it’s worth mentioning that we’ve got a really clear chart on our site (and lots of contraceptive pill information.)"

When it comes to the seven-day pill break, I just do it without thinking, until I realised the other week that I couldn’t remember the last time I’d had a break and became convinced I was going to die.

I texted three female friends and received the following answers:

“I don’t know but your body will really need a period, take a break from the pill! NOW!”
“I think the seven-day break is fine to miss but I don’t know probably take it now just in case”
“Are you going to Becca’s later?” (She hadn’t registered my text)

Deciding never to speak to my friends (one of whom just bought a house) about contraceptive health again, I then turned to a professional who a) knows what she’s talking about and b) doesn’t speak in the same language as that effing pamphlet that comes with my Yasmin. It might as well be directions to the nearest petting zoo for all the help it provides during a 3am ‘I haven’t bled in a year’ panic.

“By the time you’ve taken seven pills, your ovaries have basically gone to sleep and stopped producing eggs,” explains Dr. Helen Webberley, the dedicated GP for Oxford Online Pharmacy and an expert in sexual health. Thank god. “If you stop taking the pill for more than seven days, the ovaries start to wake up again. There’s no harm in keeping them asleep, or rather, missing your break.”

Nakita agrees: “It’s absolutely fine for you to miss the break, it won’t harm you at all.”

And you can miss it more than once, too! It turns out that, when the combined pill was created, the manufacturers wanted to closely mimic women’s menstrual cycles to make us all feel a bit more normal. So the suggested pattern of 21 days on, seven days off, is just that: a suggestion. Patterns are crucial in helping your brain remember to take the pill (as is a daily alarm on your phone), but you can settle into whatever pattern you like.

'You only need seven days of consecutive pill taking before you can legitimately take a break and remain protected.'

Dr. Helen Webberley, Oxford Online Pharmacy

“You only need seven days of consecutive pill taking before you can legitimately take a break and remain protected – so you could do seven days on seven days off if you really wanted to,’ says Dr. Webberley. ‘Or four weeks of taking it and a week off. Some people don’t want a period that often, so the healthcare professionals now often suggest cycling three packets – nine weeks on and one week off.”

That last one is especially helpful if you’ve got a new squeeze, and would prefer your nights to remain crimson-free until you're comfortable enough to ask if you can put a towel down.

But why do you need that seven days off at all? Why can’t us pill-lovers just continue to live in period-free, pill-popping harmony?

“Because of the hormones, the ovaries are asleep and they don’t produce eggs, but the lining of the womb every month still gets ready for a fertilised egg,” explains Dr. Webberley. “When it doesn’t get one, it comes away like during a period, but it’s just lining. And it starts to trickle away in a non regulated fashion.”

Basically, your uterus needs a cleanup, and if she doesn’t get it, then she’s going to start letting a load of your endometrium out when you’re least expecting it.

The good news is that, if you don’t mind the odd bit of breakthrough bleeding flash-mobbing your pants, you could theoretically stay on the pill forever until one of the side effects gets you. Just kidding; though the risks are minimal, they are present.

However, if you’re a diehard pill-fan, there is an alternative that doesn’t even involve a seven-day break.
“The progesterone pill, where you don’t have any breaks, used to have a bit of a bad reputation because of its unreliability – if you missed one, you had to take the missed pill within a couple of hours for it to remain effective,” says Dr. Webberley. “But now, new formulas like Cerazette, and Cerelle, are a lot more reliable and just as safe as the combined pill, plus they don’t contain the oestrogen that causes those side effects present in the combined pill. Yes they are small risks, but they are definitely there.”

So no seven-day break, no periods, and no blood clots, heart attacks or strokes? Sounds ideal. But, as we all know, there is no ultimate wonder-pill for all women. What works for me might make you grow a moustache and get found underneath tables crying into the carpet because you saw a dog.

“There are fifteen other methods of contraception available,” Nakita reminds me. “Do your research and make sure you’re on the one that’s best for you.”

And which would a top medical professional recommend? For Dr. Webberley, it’s the coil: “It’s a really underused method of contraception, because there’s no hormones involved and you don’t have to take a pill every day. It’s great if you’re not looking to have children for a few months, or even a year.”

For now, though, I'm staying on the pill and embracing the fact that I don’t need to worry about skipping my break. The real take-home message, though, is: If you have any questions, don’t text your friends in a panic. Head to the FPA or speak to someone who knows what the hell they’re on about.