Why the 7-day contraception pill break is optional

For many of us, oral contraceptives, often known as “the pill,” have become a standard part of our everyday lives. It’s used most commonly to prevent a pregnancy although there are many other reasons you may take the pill, for example, to improve period cramps. The standard regime for taking the combined pill is to take a pill for 21 days then stop for 7. The progesterone only pill is taken daily with no break as it’s standard guidelines.

For the combined pill, during this 7-day break from taking the pill, you would normally have a small bleed, similar to a menstrual bleed. However, the guidelines have recently changed as scientific research confirms the 7-day break is now optional. Let’s find out why and what that means for you.

The Birth of The Pill

The journey began in the 1950s when the pill was developed to manage the menstrual cycle in women. It underwent human trials and in 1960 the first birth control pill was approved by the U.S. Food and Drug Administration (FDA). Initially, the pill was only prescribed on the NHS to married women for the moral objection to having sex outside of marriage. Years later, parliament approved the NHS Family Planning Act which allowed unmarried women access to the pill. This was a revolutionary step towards women’s reproductive autonomy, marking a new wave of independence and empowerment. 

Why the 7-day break?

One reason the pill break was invented was to try and get the Catholic church, typically anti-contraception, to embrace the pill. As the 7-day pill break mimics the natural menstrual cycle where a woman would bleed, this would appease the Catholic church and meant more women could have access to the oral contraceptive.

It’s also known that when the pill was first formulated, the levels of hormones in the pill were much greater in dose (often 100 times more) than the oral contraceptive pill we know today. Many women would report feeling so awful that the break was advised simply to have a break from the surge of hormones in a womans body. In addition to this, historically women would experience anxiety about taking the pill and be unsure as to whether they were pregnant or not. The pill break and bleed would help to reassure women that they were not pregnant. Fast forward to today, we know this is medically incorrect as the bleed during a 7-day pill break is not a normal menstrual bleed and would not be an accurate indicator they weren't pregnant.

The optional pill break

Over the last 10 years or so, research has now proven it is safe and still just as effective to continue taking the pill and opt not to have the 7-day pill break and therefore miss out on the pill break bleed too. The research has shown that from a medical point of view, there’s no requirement to have the break nor to have the bleed. In fact, as the pill has developed over time with a much lower dosage and is much more tolerable for many women, there is no significant benefit from either the pill break or bleed. This means the 7-day break from the pill is optional and you can safely continue taking the contraceptive pill every day if you wish to do so.

What does this mean for you?

Yes, you’ve read it correctly, this means you can take the oral contraceptive combined pill continuously back-to-back every day and not have a bleed every month. As long as you take the pill correctly at the same time every day, it’s just as effective. This is because during the usual 7-day pill break, there’s a withdrawal of hormones which allows for the lining of the womb to shed (your period-like bleed). But, when you continue taking the pill and opt not to have the 7-day break, the womb lining doesn’t change so there’s no blood to release. Make sure to inform your prescriber if you intend to take the pill continuously to ensure they prescribe the correct quantity and offer you the right guidance during your annual review.

If this is news to you, we’d love to hear from you. Reach out to us on our socials or contact our clinical team at




More from our advice centre