What is extended and 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.

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

You will need to see your health care provider for extended and continuous use because:

• you need a prescription for hormonal birth control
• only some birth control products with estrogen and progestin can be used safely in a continuous or extended way (e.g., some birth control pills, birth control patch, and the birth control ring)

Your health care provider will tell you how to use this method of birth control.

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

• There’s about an 85% chance of getting pregnant after one year of having unprotected sex.
• Extended and continuous use of birth control has the same effectiveness as traditional use of birth control.
• 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 92% to 97% 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.
• Use a condom every time you have sex (vaginal, oral, anal) to lower your risk of STIs and HIV.

What are the benefits of extended and continuous use?

• You may have fewer periods or no period at all.
• It may help you manage your period symptoms (e.g., cramping).

What are the side effects of extended and continuous use?

The short-term effects are the same as for traditional use of your method of birth control (see the information for your product). The long-term effects are not known.

The most common side effect with continuous and extended use is spotting or bleeding between periods. This will get better over time. If this doesn’t improve, talk with your health care provider.

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

• If you have taken your birth control for at least 21 days and you continue to have spotting: Consider a short hormone-free break of 3 – 7 days. The break cannot be longer than 7 days.
• Restart your birth control after the break (even if you are still spotting or bleeding).

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

Can hormonal birth control cause blood clots?

In rare cases, women using the birth control pill, patch, or ring can get a blood clot in the blood vessels. The risk is higher depending on your:

• Age
• Weight – if you’re obese
• History (or family history) of blood clots, heart attack, or stroke
• History of smoking (especially people older than 35 who smoke)
• history of migraines with aura or other nervous system problems affecting speech, vision, movement, or sensations
• risk factors for heart disease (e.g., high blood pressure, diabetes, high cholesterol)

The risk for a blood clot is higher during pregnancy and right after having a baby than when taking the pill. Your health care provider will help you to decide if hormonal birth control is right for you.

What symptoms do I need to watch for?

Go to the nearest emergency department or call 911 if you have:

• very bad pain in your abdomen, chest, or legs
• numbness in your face, arms or legs (often only on one side of the body)
• trouble breathing
• a very bad headache
• eye problems (e.g., sudden blurry vision or loss of vision)
• sudden problems with walking or balance
• sudden confusion or trouble understanding what people say to you

What if I forget or am late for my birth control?

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

• follow the directions for the method of birth control that you are using (e.g., pill, patch, ring, injection)
• contact your health care provider or Health Link at 811

Think about getting emergency contraceptive to help prevent pregnancy if you:

• took your birth control late during the first 21 days since your last hormone-free break
• took more than a 7-day break at any time

Did You Know

• You have the right to make the decision to have sex or not.
• Plan ahead and decide to protect yourself to lower your risk of pregnancy, STIs, and HIV.
• Many sexual health clinics offer some types of birth control for no cost for those who qualify.
• Talk to your health care provider to see if hormonal birth control is right for you (e.g., just had a baby, breastfeeding, medical problem).
• It is important to talk with your partner about how you can protect each other.
• It is safe not to have a period every month. With hormonal birth control, the lining of your uterus doesn’t build up. It gets thin and doesn’t need to be shed.
• Some medicines can affect how hormonal birth control works. If you are using hormonal birth control, talk to a pharmacist or health care provider before you take other medicines (prescription or over-the-counter).

Do a pregnancy test if you have:

• not been using your birth control product the right way
• unexpected changes in vaginal bleeding
• symptoms of pregnancy (e.g., sore breasts, feel tired, or feeling sick to your stomach)

Continuous or extended use of birth control is not expected to affect fertility. However, long-term effects are not known.

For More Information

• Health Link – Health Advice 24/7: 811