design of a birth control pack

Extended cycle birth control pill: Everything you need to know

The extended cycle pill, also known as a continuous-cycle pill, is a birth control pill with both progestin and estrogen. It safely and effectively prevents pregnancy and also extends your cycle, so you only have a period once every three or four months. Instead of taking placebo pills, like with a regular birth control pill, you continue taking the hormone pills so your cycle extends. 

If you take the extended cycle pill, add it to your Ovia profile so you never miss a day!

How the extended cycle pill works

The hormones progestin and estrogen help thin the uterus lining, thicken cervical mucus, and suppress ovulation. A thin uterus lining makes it difficult for a fertilized egg to implant, and thick cervical mucus prevents the sperm from reaching the egg. There are a few types of extended cycle pills, such as 91-day packs, 365-day packs, and mini continuous-cycle pills. 

The extended cycle birth control pill does not impact your ability to become pregnant in the future.

How often you need to do something

You need to take a pill at the same time everyday in order for it to remain effective at preventing pregnancy. Depending on the type of extended cycle pill, you may or may not have placebo pills in your pack. 

Benefits and drawbacks

Is an extended cycle pill right for you? Here are the main pluses and minuses.


  • Limits the number of periods you have each year to three or four
  • Doesn’t interfere with sexual activity
  • Could reduce menstrual pain and bleeding
  • Environmentally-friendly as you won’t need as many pads and tampons (less waste)
  • You can become pregnant as soon as you stop taking the pill
  • Doesn’t require partner involvement


  • Likely to have more spotting than a 28-day pill, though this usually eases after the first few months
  • Possible side effects such as breast tenderness, headaches, nausea, bloating, high blood pressure, and blood clots
  • Possible heavier periods although this is rare
  • Doesn’t protect against STIs 


Extended cycle pills are 99% effective in preventing pregnancy when taken properly at the same time every day. If you miss a pill, follow the instructions given by your pill’s manufacturer. You may need to use a backup birth control option for a couple of days, such as a condom.

Where and how to get it 

You need a prescription from your healthcare provider. Continuous-cycle pills can be bought at a pharmacy or from an online birth control service.  

Average cost

The cost of extended cycle pills can be anywhere from $0 to $50 per month, but is often covered by health insurance plans and government health care.

Who’s eligible

Most healthy premenopausal women can take the extended cycle pill. But be sure to check with your practitioner and discuss your health history. The extended cycle pill may not be best for those with a history of certain types of cancer, blood clots, liver disease, are in the first month of breastfeeding, have high blood pressure, heart disease, or uncontrolled hypertension. If you experience migraines with an aura or are a smoker over 35 years old the combination pill may not be a good option for you. You should also discuss allergies to medications along with any meds you’re taking to avoid complications.  

Want to learn about other types of birth control? Check out these posts.

Reviewed by the Ovia Health Clinical Team

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