Hi Alice,

I'm interested in the 72-day forms of birth control pills. However, the only brand I can seem to find information about is Seasonale. Aren't there more options out there for my sexual needs? Thanks.

Dear Reader,

You bet your buttons there are more options out there! As you mention, Seasonale is one brand name for the “combination pill” which is a formulation of estrogen and progestin — the same hormones used in many of the 21-day or 28-day cycle birth control pills. However, unlike those monthly cycle pill packs, you would take “active pills” (containing the hormones) every day for 84-days (twelve weeks) followed by a week of “inactive pills” (placebo) with Seasonale (and the brands Jolessa and Quasense). This would provide protection against pregnancy while allowing you to only have your menstrual period about once every three months. Looking for other hormonal options? Seasonique and Camrese are two brand names of low-dose estrogen pills for extended birth control (BC) and work on the same time frame as the Seasonale, Jolessa and Quasense: 84 days of active pills, followed by a week of the inactive pills during which you’ll have your period. Another option is Quartette, which has a consistent dose of progesterone and a gradually increasing dose of estrogen over the 84-day interval, with the thirteenth week of hormone being only low dose estrogen (and then your period arrives). Finally, if a period every three months is still more frequent than you’d like, there is Amethyst to consider: this is a low dose of estrogen and progesterone that you take daily for one whole year — because there’s no break in the hormone, there’s no period, period!

So, what might you expect as possible side effects with these extended-cycle BC pills? Mostly, you can anticipate the same ones associated with single month cycle oral contraception: breakthrough bleeding (bleeding or spotting between periods), breast tenderness, nausea, headache, mood changes, leg cramps, acne, bloating, weight change, and dark spots on the face. Of these, breakthrough bleeding is the most common, and it’s more common with extended-cycle oral BC use than with the conventional 21- or 28-day formulations. The chances of breakthrough bleeding increase if you miss taking a daily pill, and also may occur if you have nausea or diarrhea, or start a new medication or supplement.

To some, a monthly period is a welcomed reassurance that their body is working properly and that they're not pregnant. But, having less frequent or fewer periods may appeal to those who have:

  • Heavy menstrual bleeding
  • Long or very painful periods
  • Significant bloating, breast tenderness, or mood swings in the ten days prior to menstruating
  • Difficulty using sanitary napkins or tampons
  • A health condition worsened by menstruation, such as endometriosis, anemia, asthma, migraine, or epilepsy
  • An upcoming event during which menstruation would be inconvenient or undesirable (e.g., vacation, a honey moon, the first week of a new job, or final exams)

It’s worth noting that there aren’t adverse health risks associated with period skipping or your ability to get pregnant in the future. On the other hand, there are some people for whom oral contraception (extended-cycle or otherwise) is not recommended: if you have diabetes, you have a clotting disorder or a history of heart attack or stroke, you are obese, if you have high blood pressure, you have regular migraines, you have unexplained vaginal bleeding, or a history of breast, uterine, or liver cancer. People over the age of 35 who smoke cigarettes are also recommended to use birth control that’s not hormonal because of the risk of heart attack, blood clots, and stroke. Lastly, extended-cycle BC options aren’t the only ways to avoid your period; there are a number of additional methods that may reduce the frequency of menstrual periods or at least make them lighter. Read Can I reschedule my period? for more information on using other hormonal methods of BC to reduce the number of times per year you menstruate. Chatting with your health care provider will help you figure out what option might be best for you and your sexual needs.

Here’s to punctuating your calendar a little less frequently, if that’s what you’re after!

Alice!

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