If you use the pill, chances are you know all about sugar pills.
They’re the inactive pills at the end of the packet (the last seven pills after the 21 active ones), and they’re there so you can have your ‘period’ at the end of the month, right?
Well, wrong, actually.
In news that surprised most people (myself included), apparently those sugar pills were originally included in a bid to appease the Pope. It’s been suggested that back in the 1950s, the founders of the pill designed it to mimic a woman’s natural monthly cycle so the Vatican would be more likely to accept this form of contraception….
But the truth is, you don’t actually have to take those sugar pills and have a bleed each month – here’s why.
So it’s okay to skip those sugar pills?
As mentioned before, sugar pills are completely inactive – meaning they contain no hormones. You therefore don’t need to take them in order to keep your contraception working.
However, if you want to have a break between pill packs (meaning you’ll have a withdrawal bleed, which is like having a ‘period’), then you can take those sugar pills if you wish. Some women like having a bleed, because it reassures them they’re not pregnant, or for other reasons.
But again, if you don’t want to have a bleed, you don’t need to use those sugar pills.
Obstetrician, gynaecologist and fertility expert Dr Alexander Polyakov agrees it’s totally fine to skip the sugar pills and just keep taking the pill. He says that when you’re on the pill, you don’t need to have a period “at all”.
However, if you skip those sugar pills every single month, you may get breakthrough bleeding (or spotting). For that reason, he usually recommends using the sugar pills and having a withdrawal bleed every 3-6 months.
What are the benefits of skipping sugar pills?
Apart from the obvious – not bleeding – research also found that women who continuously took the pill “fared better in terms of headaches, genital irritation, tiredness, bloating, and menstrual pain”.
There are other benefits to taking the pill all the time, with other research finding that continuous use of the pill can help patients manage their endometriosis better.
But what will happen to all that blood that builds up? Don’t I need to release it?
The thing is, that bleed you have when you’re on the sugar pills isn’t actually your period.
Instead, it’s known as a ‘withdrawal bleed’ because once you withdraw the active hormones of the pill, you will bleed.
Taking the pill causes the lining of your uterus to be thin, so it’s not like you get a massive buildup of blood if you keep skipping the sugar pills.
In other words, no; you don’t need to take the sugar pills because your body ‘needs’ a period.
What are the possible disadvantages of skipping sugar pills and simply using the pill continuously?
One possible disadvantage of continuous use of the pill is that, without having a break in your pill use, it may be harder to know if you are pregnant.
And, as Dr Polyakov mentioned, you may get spotting or breakthrough bleeding.
If that bleeding is light and doesn’t last longer than a couple of days, then continue taking the pill as normal.
However, if that bleeding is heavier or lasts longer, chat to your GP.
The good news is that, over time, the incidence of spotting or breakthrough bleeding reduces over time.
And, according to research, most women won’t have any bleeding after one year of using the pill continuously.
So let me get this straight – I really don’t need to use the sugar pills and can move onto the next pill pack if I want to, when it’s that time of the month?
You got it.
Dr Evelyn Lewin is a qualified GP who has completed a diploma in obstetrics and gynaecology. Along the way, she also had three kids and developed a massive coffee addiction (mmm, coffee). Nowadays, she works as a freelance writer.