Can I take the combined oral contraceptive pill without a seven-day pill-free gap?
From the medical point of view, there is no benefit in having the gap, and if you are taking a fixed, rather than a phasic pill, you can take the combined oral contraceptive pill back-to-back without pill free days. This may avoid a bleed during a social event or a vacation. The bleed that occurs during the gap we call a withdrawal bleed and not a period. The pharmaceutical companies produce the packaging with the combined oral contraceptive pill-free interval as women understandably feel that it is normal to have a monthly bleed. The only real advantage is that it provides an indication that there is no pregnancy. The phasic pills do not readily lend themselves to a pill-free interval although your doctor can usually provide appropriate advice (2)
If a pill is missed less than seven days before the combined oral contraceptive pill-free interval, the combined oral contraceptive pill-free interval should be avoided (18). The pill-free interval can be avoided for social convenience such as a vacation. Some women have cyclical symptoms around the time of the combined oral contraceptive pill-free interval. If there are problems with headaches, heavy or painful periods the combined oral contraceptive pill can be taken back-to-back. We generally recommend three packets at a time leading to a withdrawal bleed every ten weeks. The combined oral contraceptive pill is a treatment option for endometriosis and we may recommend avoiding the combined oral contraceptive pill-free interval for several months (21).
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