Emzzzz asked
My previous doctor said to take a 4 day break on my last birth control pill but I’ve recently changed my pill and want to have a 7 day break. Will increasing the monthly break increase my chances of getting pregnant? (I really don’t want that to happen).
Answer
A majority of oral hormonal birth control pills have a 28 day cycle that is based on the average menstrual cycle. This cycle includes 21 days of "active" hormone containing pills followed by a hormone free interval (HFI) for 7 days. The 7 day HFI pills are commonly known as placebo pills and are have no effect on your cycle. They are included to keep woman on schedule by consistently taking one pill daily.
Packs that have 21 pills have 21 active hormone pills, but no placebo pills. After the 21 days, you are instructed to skip 7 days of taking a pill. Afterward, you start a new 21 days of birth control pills.
Now, there are 24 day birth control products that contain 24 hormone containing pills and 4 non-hormone pills, like Loestrin Fe 24.
Most often, the length of your hormone free interval is is entirely dependent on the birth control product you are taking. Nevertheless, your doctor may recommend a shorter hormone free interval, regardless of the birth control pill product you are taking.
Shortening Your Hormone Free Interval
Your doctor had instructed you to have a hormone free interval of 4 days on your previous pill. This is most likely due to the product your were prescribed. Depending on what your new birth control pill is, you may be able to have a 7 day hormone free interval.
As long as you take your birth control pills consistently, at the same time and don't miss doses, you are well protected from pregnancy with a 7 day hormone free interval. However, a study by Spona et al reported that a decrease of the hormone free interval from 7 days to 5 days will decrease the risk of breakthrough ovulation when pills are forgotten. In order words, there is a little more room for error.
In addition, shorter hormone free intervals can decrease certain menstrual side effects such as:
- Breast tenderness
- Bloating
- Headaches or migraines
- Cramping
Take all of this into consideration when talking to your doctor about increasing your hormone free interval from 4 days to 7 days. According to common prescribing, you will be protected from unwanted pregnancy with a 7 day break from taking active hormone pills, as long as you take them as directed.
Make sure to check which birth control pill you are taking and the indicated hormone free interval time. If you want to utilize a different length hormone free interval than your birth control product directs, be sure to talk to your doctor.
