The Extended-Cycle Birth Control Pill: Understanding Ethinyl Estradiol and Levonorgestrel

August 28, 2023

Introduction to Extended-Cycle Birth Control Pills

Birth control pills have been a popular form of contraception for decades, allowing women to control their fertility and prevent unintended pregnancies. However, traditional birth control pills, also known as “21-day pills,” require the woman to take a pill every day for 21 days, followed by a 7-day break during which she will experience a withdrawal bleed.

An alternative to traditional birth control pills is the extended-cycle pill. These pills allow women to have fewer periods and can be taken for a longer period of time without a break.

What are Extended-Cycle Birth Control Pills?

Extended-cycle birth control pills are a type of oral contraceptive that are taken for a longer period of time without a break. These pills are designed to reduce the number of periods a woman experiences in a year.

There are two main types of extended-cycle pills:

  • Continuous dosing, in which a woman takes a pill every day without a break.
  • Extended dosing, in which a woman takes a pill for 84 days (or 12 weeks) followed by a 7-day break during which she will experience a withdrawal bleed.

How do Extended-Cycle Pills work?

The most common types of extended-cycle pills are those that contain a combination of the hormones ethinyl estradiol and levonorgestrel. These hormones work to prevent ovulation by thickening the mucus in the cervix and thinning the lining of the uterus.

When taken as directed, extended-cycle pills are highly effective in preventing pregnancy. They also offer a variety of other benefits, including:

  • Reduced number of periods: Because these pills are taken for a longer period of time without a break, they allow women to have fewer periods.
  • Reduced symptoms of premenstrual syndrome (PMS): Taking a pill every day can help reduce symptoms of PMS, such as cramping, mood swings, and acne.
  • Reduced risk of ovarian and endometrial cancer: Long-term use of birth control pills has been linked to a reduced risk of these types of cancer.

It’s important to note that extended-cycle birth control pills do not protect against sexually transmitted infections (STIs) and it’s recommended to use condoms for protection against STIs.

Extended-cycle birth control pills are a safe and effective option for women looking to reduce the number of periods they experience in a year. These pills work by preventing ovulation and can offer a variety of other benefits, including reduced symptoms of PMS and a reduced risk of certain types of cancer. Women should discuss with their healthcare provider whether extended-cycle pills are a good option for them and what type of extended-cycle pill would be best.

How Ethinyl Estradiol and Levonorgestrel Work in Extended-Cycle Pills

The most common types of extended-cycle pills contain a combination of the hormones ethinyl estradiol and levonorgestrel. These hormones work together to prevent ovulation and provide contraceptive protection.

Ethinyl Estradiol

Ethinyl estradiol is a synthetic form of the hormone estrogen. It works by thickening the mucus in the cervix, which makes it difficult for sperm to reach and fertilize an egg. Ethinyl estradiol also works to prevent ovulation by inhibiting the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. These hormones are responsible for stimulating the ovaries to release an egg each month.

Levonorgestrel

Levonorgestrel is a synthetic form of the hormone progestin. It works by thinning the lining of the uterus, making it difficult for a fertilized egg to implant and grow. Levonorgestrel also works to prevent ovulation by inhibiting the release of LH and FSH from the pituitary gland.

How Ethinyl Estradiol and Levonorgestrel Work Together

When taken together, ethinyl estradiol and levonorgestrel work to prevent ovulation by thickening the mucus in the cervix and thinning the lining of the uterus. This makes it difficult for sperm to reach and fertilize an egg, and also makes it difficult for a fertilized egg to implant and grow in the uterus.

It’s important to note that extended-cycle pills containing these hormones are not effective if a woman is already pregnant. They will not interrupt or harm a pregnancy that has already occurred.

Dosage and Administration

The exact dosage and administration of extended-cycle pills containing ethinyl estradiol and levonorgestrel can vary depending on the brand. It’s important for women to follow the instructions on the package and to consult with their healthcare provider for guidance on how to take the pill.

The hormones ethinyl estradiol and levonorgestrel work together to prevent ovulation in extended-cycle birth control pills. Ethinyl estradiol thickens the mucus in the cervix while levonorgestrel thins the lining of the uterus, making it difficult for sperm to reach and fertilize an egg, and also making it difficult for a fertilized egg to implant and grow in the uterus. It’s important for women to follow the instructions on the package of the extended-cycle pills and to consult with their healthcare provider for guidance on how to take the pill.

Benefits and Risks of Extended-Cycle Birth Control Pills

Extended-cycle birth control pills are a safe and effective option for women looking to reduce the number of periods they experience in a year. These pills work by preventing ovulation and can offer a variety of other benefits. However, as with any medication, there are also some risks associated with their use.

Benefits

  • Fewer periods: One of the main benefits of extended-cycle pills is that they allow women to have fewer periods. This can be especially beneficial for women who experience heavy or painful periods.
  • Reduced symptoms of premenstrual syndrome (PMS): Taking a pill every day can help reduce symptoms of PMS, such as cramping, mood swings, and acne.
  • Reduced risk of ovarian and endometrial cancer: Long-term use of birth control pills has been linked to a reduced risk of these types of cancer.
  • Ease of use: Extended-cycle pills are easy to use and do not require additional methods of contraception, such as condoms.
  • May improve menstrual-related conditions : Extended-cycle pills have been found to improve conditions such as heavy bleeding, dysmenorrhea and acne.

Risks

  • Blood clots: As with any hormonal contraceptive, there is a small risk of blood clots. Women who smoke or have a history of blood clots should not use extended-cycle pills.
  • Migraine headaches: Extended-cycle pills may worsen migraine headaches in some women.
  • Nausea and vomiting: Some women may experience nausea and vomiting when taking extended-cycle pills.
  • Breakthrough bleeding: Some women may experience breakthrough bleeding or spotting while taking extended-cycle pills.
  • Does not protect against STIs: Extended-cycle pills do not protect against sexually transmitted infections (STIs) and it’s recommended to use condoms for protection against STIs.

Extended-cycle birth control pills are a safe and effective option for women looking to reduce the number of periods they experience in a year. These pills offer a variety of benefits including reduced symptoms of PMS, reduced risk of ovarian and endometrial cancer, ease of use, and may improve menstrual-related conditions. However, there are also some risks associated with their use, such as blood clots, migraine headaches, nausea and vomiting, breakthrough bleeding. It’s important for women to talk to their healthcare provider to weigh the benefits and risks and determine if extended-cycle pills are the right choice for them.

Comparison of Extended-Cycle Pills to Traditional Birth Control Methods

Extended-cycle birth control pills are an alternative to traditional birth control pills, also known as “21-day pills,” which require the woman to take a pill every day for 21 days, followed by a 7-day break during which she will experience a withdrawal bleed.

Here is a comparison of extended-cycle pills to other traditional birth control methods:

Extended-Cycle Pills vs. Traditional Birth Control Pills

  • Number of periods: Extended-cycle pills allow women to have fewer periods compared to traditional birth control pills.
  • Ease of use: Both extended-cycle pills and traditional birth control pills are easy to use and do not require additional methods of contraception, such as condoms.
  • Effectiveness: Both extended-cycle pills and traditional birth control pills are highly effective in preventing pregnancy when taken as directed.

Extended-Cycle Pills vs. Birth Control Shots

  • Number of periods: Extended-cycle pills allow women to have fewer periods compared to birth control shots, which may stop periods altogether.
  • Ease of use: Extended-cycle pills are taken orally on a daily basis, while birth control shots are given by a healthcare provider every 3 months.
  • Effectiveness: Both extended-cycle pills and birth control shots are highly effective in preventing pregnancy.

Extended-Cycle Pills vs. Birth Control Implant

  • Number of periods: Extended-cycle pills allow women to have fewer periods compared to birth control implant, which may stop periods altogether.
  • Ease of use: Extended-cycle pills are taken orally on a daily basis, while birth control implant is inserted under the skin by a healthcare provider and can stay there for up to 3 years.
  • Effectiveness: Both extended-cycle pills and birth control implant are highly effective in preventing pregnancy.

Extended-Cycle Pills vs. IUD

  • Number of periods: Extended-cycle pills allow women to have fewer periods compared to IUDs, which may also reduce or stop periods.
  • Ease of use: Extended-cycle pills are taken orally on a daily basis, while IUDs are inserted by a healthcare provider and can stay in place for up to 5-10 years.
  • Effectiveness: Both extended-cycle pills and IUDs are highly effective in preventing pregnancy.

Extended-cycle birth control pills are an alternative to traditional birth control pills and other contraceptive methods, such as birth control shots, implant, and IUDs. Extended-cycle pills allow women to have fewer periods compared to traditional birth control methods and are easy to use. However, the best method of contraception will vary for each individual and it’s important to consult with a healthcare provider to determine the best option for you.

Patient Education and Considerations for Using Extended-Cycle Pills in Obstetrics and Gynecology Practice

Extended-cycle birth control pills are a safe and effective option for women looking to reduce the number of periods they experience in a year. However, it’s important for healthcare providers to properly educate patients on the use of these pills and to consider certain factors before prescribing them.

Patient Education

  • How to take the pill: It’s important for patients to understand the proper way to take the pill, including the specific dosage and administration for their particular brand of extended-cycle pills.
  • Effectiveness: Patients should be informed that extended-cycle pills are highly effective in preventing pregnancy when taken as directed. However, they do not protect against sexually transmitted infections (STIs) and it’s recommended to use condoms for protection against STIs.
  • Possible side effects: Patients should be informed of the possible side effects of extended-cycle pills, such as nausea, headaches, and breakthrough bleeding.
  • Missed pills: Patients should be instructed on what to do if they miss a pill and provided with a plan for addressing missed pills.
  • When to contact a healthcare provider: Patients should be advised to contact their healthcare provider if they experience any unusual symptoms or side effects while taking extended-cycle pills.

Considerations Before Prescribing

  • Medical history: Healthcare providers should review the patient’s medical history, including any history of blood clots, migraines, or other conditions that may contraindicate the use of extended-cycle pills.
  • Smoking: Women who smoke should not use extended-cycle pills as they are at an increased risk of blood clots.
  • Drug interactions: Healthcare providers should be aware of any drugs the patient is currently taking that may interact with extended-cycle pills.
  • Other contraceptive options: Healthcare providers should discuss other contraceptive options with the patient and determine the best option for the individual.

Extended-cycle birth control pills are a safe and effective option for women looking to reduce the number of periods they experience in a year. However, it’s important for healthcare providers to properly educate patients on the use of these pills and to consider certain factors before prescribing them. Patient education and proper consideration can ensure that extended-cycle pills are used safely and effectively. It’s important for patients to discuss with their healthcare provider whether extended-cycle pills are a good option for them and what type of extended-cycle pill would be best.

Sources & references used in this article: