Extended Pill Taking - The “21st Century Way To Take The Pill”

This leaflet should be read together with the latest FPA advice: https://sexwise.fpa.org.uk/contraception/combined-pill-coc

What does this mean?

  • Pills come in a 3 week pack, which is usually followed by a 7 day break.
  • Not taking the pills for 7 days weakens the contraceptive effect which means that an egg might be released and you may be at risk of pregnancy (especially if you miss any pills in the pack before or after).
  • Women have a “withdrawal bleed” in those 7 days which is not a natural period but a fake one which happens simply because you’ve stopped the hormones for a few days.
  • This bleed is not necessary. Contraception is very safe these days so women do not need a monthly bleed to know they are not pregnant.
  • It is quite common for women to miss out their 7 day break to avoid having a bleed - such as when going on holiday.
  • It is perfectly safe to carry on taking the pill for longer than 3 weeks.
  • This means less or no monthly bleeds - whatever suits you and your lifestyle.


  • Fewer or no monthly bleeds
  • Less side effects (period pain, bloating, headaches, PMT)
  • Avoids bleeding on special occasions (eg holidays)
  • Less need for tampons/ sanitary towels


  • You might sometimes get irregular light bleeding or spotting
  • Some people prefer having a monthly bleed

How do I do this?


What to take

Pill-free break

Extended use

3 packs of pills taken back to back (tri-cycling)

4-7 days off after finishing the 3rd pack then re-start. You are still protected from pregnancy during this 4-7 days

Continuous use with

shortened pill-free


Pills taken continuously for at least 21 days until bleeding or spotting occurs for 3–4 days in a row

4 days off then re-start (even if you are still bleeding). You are still protected from pregnancy during this 4 days

What if I miss a pill?

You can miss up to seven pills and still be protected against pregnancy, even if you had sex in that week (as long as you’ve taken at least 7 pills correctly beforehand).

If you have missed up to 7 pills:

  • Restart your pills straight away.
  • No need for emergency contraception. No need to use extra protection (eg condoms).
  • Continue with the next strip without any more breaks in pill taking.
  • You should then restart the pill and use condoms or avoid having sex for seven days.
  • Do a pregnancy test after 3 weeks.

If you miss seven or more pills: you might need to discuss emergency contraception. Please contact or attend the clinic.

What if I am sick (vomiting or diarrhoea)?

  • No extra precautions needed unless this lasts for 7 days.
  • If it lasts 7 days, contact or attend your surgery /clinic as you might need emergency contraception.
  • Continue pill-taking.

Printable version

Adapted by Carrie Lenton, Mar 2019. Original versions developed by John Guillebaud/ Anne MacGregor and Emma Huskins. With thanks.