Is it safe to take the contraceptive pill without breaks?

If you’re thinking of starting the progestogen-only contraceptive pill, you’re probably wondering whether or not it is safe to take every day without a break. If that’s the case, we’ve got you covered. Read on for a little more insight into exactly what happens to our bodies when we take this kind of contraception, and why it’s OK to take it continuously. 

Hormonal contraceptive pills are designed to slot into your daily routine, and started or stopped based on your needs. Progestogen-only pills (otherwise known as mini pills) like Hana® can be purchased over the counter or online, so there’s no need for a doctor’s appointment and they are easy to access. 

Hana® is over 99% effective at helping to prevent pregnancy when taken correctly. This means taking Hana® at the same time every day, without a break between packs.

There are a lot of questions out there about whether or not it’s safe to have back to back hormonal contraception – especially given that some contraceptive alternatives suggest or require that you have a break for a bleed. In actual fact, the concept of a withdrawal bleed was created because it was thought women and people with uteruses wanted a monthly bleed, not because they physically needed to have one. Withdrawal bleeding does not provide any health benefits, and isn’t medically necessary. 

As Hana® (and some other progestogen-only pills) can be purchased over the pharmacy counter or online, there is no GP appointment required. There is, however, a pharmacist consultation. The pharmacist will ask you a series of questions or, if you’re ordering online, you will fill in and submit a questionnaire. From there, a pharmacist will review your answers and advise whether or not this contraceptive pill might be suitable for you. 

If you’re interested in learning more about the role of the pharmacist when purchasing Hana® or reading about the extensive training that pharmacists go through to be able to sell contraceptives, you might like our recent interview with Deborah Evans.

Contraceptive pills like Hana® work in two ways. They prevent ovulation, so no egg is released during your cycle, and also thicken the mucus around your cervix, which makes it harder for sperm to get through.

Because all contraceptive pills contain synthesised versions of naturally occurring hormones, the hormones that are already in your body can have a reaction. Sometimes this means experiencing one or more side effects, while other times users won’t notice any major changes. With Hana® and other progestogen-only pills, there can be a change in menstrual cycles.

We asked Deborah Evans, a pharmacist with over 30 years of experience, about the potential change in your bleeding pattern. “Any hormonal pill could potentially affect your periods. For some women, their bleeding might stop altogether. For others, that bleeding might slightly increase. And for some others – and quite commonly – they might just have some spotting. It tends to all settle down after three or four months.” 

If you’re concerned about an irregular bleeding pattern or have any questions about how your menstrual cycle could be affected or when it will return, you should always consult a medical professional.

We understand that you might be thinking about the long term effects that taking hormonal contraception could have on your body. When asked about what impact a progestogen-only pill could have on your future fertility, Deborah said “there is no evidence to suggest that the progestogen-only pill has any impact on future fertility.”

Like all medications, contraceptive pills can sometimes induce side effects. These might include hormonal skin spots, breast tenderness, decreased libido, altered mood, irregular menstruation, nausea and headaches – but any side effects usually subside within a few months. As with menstrual changes, some women and people with uteruses may experience one or more of these, and some may not. The full list of side effects is noted in the patient information leaflet.

Progestogen-only pills like Hana® work by preventing ovulation (which means that no egg is released during your cycle) and thickening cervical mucus so it’s even harder for any sperm to get through. Because you take the mini pill every day, it means you don’t have to worry about a contraceptive option in the moment, and there’s one less thing to interrupt you when you’re getting down to it.

For the mini pill to be most effective, you need to make sure you’re taking it every single day – it doesn’t matter what time of day you take it, as long as it’s the same time every day.

Sometimes life can get in the way of our routines, no matter how strict we are about sticking to them. In the event that you’re occasionally delayed taking your progestogen-only pill, you do have a 12 hour window before it is considered a ‘missed pill’.

Desogestrel (the active ingredient in Hana) does not “build up” in the body or cause the body to create resilience. If you choose to, you can take the progestogen-only pill up until you reach menopause.

If you’re questioning your commitment and are unsure whether or not you’re ready to sign up for anything long term, fear not. Hana® and other contraceptive pills can be taken for as little or as long as you like. We asked Deborah about how easy it would be to come off a progestogen-only contraceptive pill and she said: “Very straightforward. You simply stop taking the pill.” 

So when you’re ready to stop taking it (if you’ve decided to start trying to get pregnant, for example), you just stop taking it. It obviously differs from person to person, but your fertility should quickly return to normal. If you’re coming off the pill and don’t want to get pregnant, you should consider using a barrier method of contraception like condoms.

Some people like to keep their pill where they know they’ll see or find it every day – like on their bedside table, in their makeup bag or by the bathroom sink (see patient information leaflet for storage instructions). If you are concerned about forgetting to take your pill, it might be a good idea to set an alarm on your phone for the same time every day to remind yourself.

Again, if you’re using a desogestrel-based pill, like Hana®, you are still protected if you manage to take your pill within 12 hours of when you normally would take it. In this instance, just carry on taking the remainder of your pill packet as you normally would.

If this 12 hour window has passed, it counts as a ‘missed pill’. Don’t panic – take your missed pill as soon as you are able, even if this means you take two pills in one day. Carry on with the rest of the pack of pills as normal, and to be safe we advise that you use additional protection (like condoms) for 7 days after the missed pill has been taken.

If you’ve missed a pill we recommend using a barrier method of contraception to ensure you’re covered against unwanted pregnancy for a week afterwards. That being said, we know that accidents can happen. Emergency contraceptive pills like ellaOne® can also be bought online or over the counter, and can be taken up to five days after unprotected sex.

As always, if you have any specific questions, speak to a medical professional, like a pharmacist or GP.

Deborah Evans does not endorse any medical brands or products

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

ellaOne® 30mg film-coated tablet contains ulipristal acetate and is indicated for emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure. Always read the instructions on the package leaflet carefully.

References

https://www.medicalnewstoday.com/articles/withdrawal-bleeding#is-it-necessary

https://www.hana.co.uk/wp-content/uploads/2021/04/Hana-Package-Leaflet-May-2021.pdf