Birth control pills: Should you take the 7-day break or not?

Birth control pills, commonly known as contraception pills, are a daily medication that alters the body’s hormonal balance to prevent pregnancy. Hormones are chemical substances that control how the body’s organs work. In this case, the hormones that the pills contain specifically regulate the ovaries and the uterus. Most birth control pills are combination pills that include both estrogen and progesterone hormones, which work together to prevent ovulation. Ovulation is the release of an egg from the ovaries, and without ovulation, fertilization and pregnancy cannot occur. While pills can be the best bet for individuals who are sexually active with no intention of getting pregnant, people may get confused about taking a 7-day break from pills after consuming them for 21 days straight.

Health Shots got in touch with Dr Archana Dhawan Bajaj – Gynecologist, Obstetrician, and IVF Expert, Nurture Clinic, New Delhi, to understand whether one should take a 7-day break from contraceptive pills or not.

Birth control pills with a 7-day break and without a break!

There are numerous types of pills, but the most widely used packs have 21 tablets—one to be taken each day for three weeks, with a seven-day break from pills at the end of the month, when a woman will usually bleed.

Some brands make it easier for women by including 28 tablets—21 active ones and seven inactive ones—instead of the usual break between packs of pills, though they should still expect some monthly bleeding.

What is the 7 day break rule for the pill?

A 7-day break from birth control pills refers to the typical practice of taking a 7-day pause or “break” from active hormonal pills in a birth control pill pack. During this break, you usually don’t take any active pills but may take placebo pills, often called “sugar pills” or “inactive pills”, that are included in the pill pack.

The purpose of the 7-day break is to allow for a withdrawal bleed, which is similar to a menstrual period. The withdrawal bleed occurs as a result of the sudden drop in hormone levels when you stop taking the active pills.

However, some newer types of birth control pills, such as continuous-dosing pills or extended-cycle pills, are made to be taken continuously without a pause. You don’t take any inactive pills throughout the month when you take these pills, which normally come in packs of 84 or 91 active pills. With this kind of medication, you continue taking the daily active medications without the 7-day break.

Are you protected on 7 pill-free days?

Dr Bajaj says, “During the 7-day break from birth control pills, the chances of pregnancy during this break are relatively low, but it is not eliminated. Sperm can survive in the reproductive tract for up to five days, so if you have unprotected intercourse during the break or shortly before it, there is a possibility of pregnancy. However, if you have been taking your birth control pills correctly and consistently leading up to the break, the risk of pregnancy is still relatively low.”

Combination birth control pills are generally designed to provide continuous protection if taken correctly. This means that even during the placebo week, you’re still protected against pregnancy as long as you start the next pack on time.

Progestin-only pills, sometimes called the mini-pill, have a narrower window for effectiveness. It is crucial to take these pills at the same time every day to maintain their contraceptive effect. If you’re using progestin-only pills, it’s especially important not to exceed the recommended 24-hour window for taking each pill to ensure continued protection.

For both types of pills, it’s important to follow the instructions provided by your healthcare provider or the specific instructions given with your birth control pills to ensure proper use.

Also read: 5 things that may happen when you take birth control pills too often

Is it wise to take a 7-day break from contraceptive pills?

According to Dr Bajaj, “There is no medical advantage of taking the 7-day break. Eliminating the break and continuously taking active pills may offer some benefits. Continuous use of birth control pills without the 7-day break has been found to reduce the occurrence of breakthrough bleeding, a common side effect of the pill. Additionally, continuous pill use may be beneficial for managing certain medical conditions such as endometriosis, polycystic ovary syndrome (PCOS), or heavy menstrual bleeding.”

Ultimately, the goal is to find a birth control method that suits your individual needs, provides effective contraception, and minimizes any associated side effects or risks. Your healthcare provider will be able to guide you in making an informed decision about the best option for you!