Combined Oral Contraceptive Pills
Combined Oral Contraceptive Pills


Does it matter if I do not see a period whilst taking the combined oral contraceptive pill?

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Does it matter if I do not see a period whilst taking the combined oral contraceptive pill?

A withdrawal bleed ('period' whilst taking the combined oral contraceptive pill) does not have to occur with every pill-free interval. Provided you have taken the combined oral contraceptive pill correctly, a pregnancy is very unlikely. If you do not see a withdrawal bleed it usually means that the lining of your womb is not building up sufficiently to result in a bleed. This reflects the way that the womb is responding to the combined oral contraceptive pill and does not indicate what will happen when the combined oral contraceptive pill is stopped if you wish to have a baby. From the medical point of view there is no reason to change the combined oral contraceptive pill if the problem continues and there is no need to run any tests.

If you are unhappy that you do not see a withdrawal bleed, a different pill may suit you better. One of the phasic pills (Table 16.2) could be tried if you are on a monophasic variety

A girl of 13 had extremely heavy and painful periods which were controlled for two years with a monophasic pill (Microgynon). At the age of sixteen she returned to my clinic as she kept missing withdrawal bleeds. She had not started sexual activity but was worried that she would lose her fertility. We reassured her that medically there was no anxiety. After discussion she was started on a phasic pill (Trinovum) and withdrawal bleeds occurred.

Some women find that when they stop the combined oral contraceptive pill they do not see their periods. Until twenty years ago this was called 'post-pill amenorrhoea'. Research then showed that, with few exceptions, patients with amenorrhoea after discontinuing the combined oral contraceptive pill had infrequent or absent periods before they commenced the combined oral contraceptive pill. The pill had simply masked an underlying problem and was not the cause.


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