Extended cycling for oral contraceptive pills OCPs (1005)

Key points below

What is extended cycling?

Extended cycling with oral contraceptive pills (OCPs) is a way to stop having your period every month.  It gives a longer length of time between periods.  You should always talk to your health care provider before starting the extended cycling.

What do I need to know about it?

OCPs are the female hormones, estrogen and/or progesterone. They are taken daily to control your cycle. They control how often and when you have your period. They can also prevent pregnancy if they are taken correctly. If you can take OCPs on a regular cycle, you can use extended cycling. 

Most pill packs have 28 pills. There are 21 active pills and 7 inactive sugar pills. You should have a period during the week you are taking the inactive pills. With extended cycling, you don’t take the sugar pills in the pack. You keep taking the active pills in the next pack and skip the sugar pills. You can go two or more months without a period.

Why would I do this?

Every woman’s period is different. Some get severe pain, heavy bleeding, headaches, mood changes and acne. Women with some types of medical problems, like seizures or asthma, may notice their condition gets worse with their period. Not having a period every month gives them a better quality of life. Extended cycling can also be used when having your period may be hard or inconvenient.

What are the side effects of OCPs?

Side effects may include nausea, vomiting, headaches, sore breasts, and vaginal spotting or bleeding and mood changes. Side effects may lessen after the first few cycles.

What are the risks of taking of OCPs?

OCPs may cause blood clots.  Symptoms of a blood clot may be painful leg swelling, sudden or severe chest pain or shortness of breath, severe headache or loss of vision. Smoking while taking OCPs increases the risk of blood clots and heart attacks. 

Call 911 or go to the emergency room immediately if you are worried you have a blood clot.

Special directions

Your health care provider will help you decide when to start your pills. Normally, you can start as soon as you pick up your pills. Take your pill at the same time each day. Pick a time that is easy for you to remember, such as when you brush your teeth. Setting a cell phone alarm can help remind you to take your pill. If you have side effects such as headache and nausea in the beginning, it may help to take the pill at night.

Extended cycle for ___ packs with 28 day pack:
1. Take one pill each day for the first 21 pills. Throw out the fourth week pills.  Those are the sugar pills that are a different color. Do this for the first ____ packs. Immediately start the next pack of pills. 
2. On the ___ pack of pills, take one pill each day using the entire pack including the sugar pills.
3. Repeat steps one and two above.

Extended cycle for ___ packs with the 21 or 28 day pack:
1. Take one pill each day for first whole 2 packs of pills.  Immediately start the next pack of pills. 
2. After finished with __ packs of pills take the sugar pills or take seven days off and then start the next pack of pills.
3. Repeat steps one and two above.


Call your doctor, nurse, or clinic if you have any questions or concerns or if you:

  • Are bleeding longer than ten days or you are soaking more than one pad or tampon per hour. 
  • Have special health care needs that were not covered by this information.