For a tiny tablet, the Pill can raise a lot of questions. Do you really need to take it at the same time everyday? Is there are any truth to reports that it’s bad for you? And what do those sugar pills actually do?
In most combined pill packets, you’ll find seven sugar pills alongside the active hormone tablets. You’re instructed to take them during your period — but what happens if you don’t?
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According to Dr Deborah Bateson, Medical Director of Family Planning NSW, the sugar pills were originally included as a reminder.
“They were just a way of getting women into the habit of remembering to take their pill, they don’t actually “do” anything,” she says.
“Traditional pill packs contain 21 active pills and seven sugar pills, while newer types have 24 hormone pills and four placebo pills. In other countries, they just have 21 active pills and no placebo pills at all.” (Post continues after gallery.)
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“Their only purpose is a reminder. It’s not harmful to take them, and it’s not harmful NOT to take them. Some women take them, others pop them out each day and throw them away and some people ignore them altogether,” Dr Bateson adds. Either way, the important thing is that you return to the active pills after those seven days are up.
If you do choose to take the sugar pills, you will have a “withdrawal bleed”. You are still covered from pregnancy during this time, as long as you have not missed any of the active pills prior, and return to taking the active pills when those seven days are over.
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“When you’re on the Pill, you don’t actually get a period because you’re not ovulating. When you take the sugar pills, you have a drop in hormones which causes the withdrawal bleed, which is essentially a fake period,” explains Dr Bateson.
Dr Bateson says it’s also perfectly safe to skip the sugar pills (and so your “period”) for an extended length of time, if you desire.
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"Traditionally, women have been advised to take three months' worth of pills at a time, then have a withdrawal bleed and then continue that cycle. But really good safety data has found that it's safe to go longer and have an extended pill cycle of up to 12 months."
"It is possible for some women to still get breakthrough bleeding through this. If that's the case and you have four days of bleeding, take a break then restart but also talk to your doctor just to check everything."
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Despite what you might have been told, skipping your period like this doesn't cause any kind of "build up" inside your body. "There's nothing building up inside by not having a period. The pill thins out your uterus lining over time so there's actually not anything to have a period," says Dr Bateson.
"There are also no long-term effects of taking the Pill for an extended period, as long as you are eligible to take it (i.e you don't have any conditions or develop anything that requires you to stop). You can stay on it until you're 50 if you like." (Post continues after video.)
This includes having no effect on your future fertility, either.
Dr Bateson says for some women, it makes sense to skip the sugar pills and 'periods' altogether.
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"Really, if you're not trying to get pregnant, then there's no reason to have a pill-free break. A lot of women accidentally fall pregnant in that time, because they want a period to check things are okay," she says.
"However what's most important is that women know all about the choices they have when it comes to contraception, including long-acting reversible (LARC) methods to find the one that works best for them."
Do you take the sugar pills? Do you have any other questions you've always wondered about the Pill?
For more information, have a chat with your doctor or check out Family Planning NSW.
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