Not Your Mother's Birth Control Pill Placebo Interval
MONTREAL — Limiting the hormone-free portion of OC regimens can reduce side effects and may improve contraceptive effectiveness, according to two studies presented at the World Congress on Fertility and Sterility.
“For a lot of women, the hormone-free days are when they have their PMS, their pain, and their heavy bleeding. That's also when many women have their headaches, and sometimes that's when their acne flares. It's amazing that the 7-day hormone-free interval [HFI] has lasted this long,” said Dr. Patricia Sulak, a researcher, consultant, or speaker for Berlex Inc., Barr Laboratories Inc, and Wyeth, all of which market OCs.
In a separate presentation, Angela Baerwald, Ph.D., of the University of Saskatchewan reported evidence of follicular development, endometrial development, increased serum estradiol, and even ovulation during the HFI in women compliant on certain OC regimens.
“The loss of endocrine suppression during this interval provides the rationale for a reduction in the traditional 7-day hormone-free interval and/or the use of continuous hormonal contraception,” she said.
Most Pill brands have a 7 day placebo interval--an interval when no pills, or no hormone-containing pills are taken.
Contrary to popular belief, during this time your body doesn't take a "hormone break". Before the placebo week, your body's hormone levels are low, and more importantly, they're steady. And the same is true for the Pill hormones--steady levels. As soon as you withdraw the Pill hormones, during the placebo week, your body revs up its hormone production, and the levels start to fluctuate.
The problem is that these fluctuations can cause side effects like headaches, pain, or PMS. They can also allow an egg to start maturing inside the ovary (this increases the likelihood of an inadvertent pregnancy).
Reducing the number of placebo days offers a solution to these problems. Two Pill brands, Minesse and Mircette, already have a shortened placebo interval built-in (4 days and 2 days, respectively).
Of course, you can shorten the hormone-free pill interval even if your Pill brand is a 7 placebo days one. You do this by starting a new pill pack sooner. For example, instead of waiting for 7 days between pill packs, or taking 7 placebo pills, you start the new pack after 3 or 4 days (or after taking only 3 or 4 placebo pills).
Bottom line: Because the duration of the placebo interval was arbitrarily selected (it's 7 days because of "designer" reasons, not medical or health ones), its length is not written in stone. You can adjust it--2, 3, 4, etc. days--to fit your unique needs.