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Stopping birth control pills every two years?

Has 1 years experience. Specializes in Step-down, cardiac.

My brand-new, 2011-edition pharmacology text says, "Many health care providers prefer to have patients discontinue birth control pills for 3 of every 28 months. This allows the body to return to a normal cycle."

Is this true? I've never heard of stopping birth control for several months (I took the pill for ten years myself, and no one ever suggested stopping every two years). It seems like it would be just inviting unintended, unwanted pregnancies. Are nurses and doctors advising stopping pills for several months nowadays?

canesdukegirl, BSN, RN

Has 14 years experience. Specializes in Trauma Surgery, Nursing Management.

Hmmm...very interesting. I don't know the answer to that. I have a Mirena IUD, and that stays in for 5 years.

carolmaccas66, BSN, RN

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

When I worked in gynaecology I remember some of the doctors advising girls/women re this, after they'd had surgery. I don't know if it is just an old-fashioned reasoning that doctors are taught, because if you take the pill continuosly for years, you will still usually have breakthrough bleeding anyway as the endometrium builds up and must be shed. There are a lot of young - and older women - out there who are mightily confused re their pill. If you do a little research, some doctors think it's better to have a break, to see if the body reacts normally (ie: has a normal period, the lining gets shed etc) and to give the woman a break from the pill and others don't advise being on any oral contraceptive for more than 2-3 years due to the risks of clots and cancer (to name a few). Nobody really knows the long-term effects of oral contraceptives, so some say it's best to have a break, but the pill is associated with certain cancers - if you've had breast cancer or cervical cancer for example, you are advised not to take oestrogen. Women also need to be off oral contracetives for a certain time period, for certain tests such as FSH, LH and breast examinations, to get good results.

An interesting question.

PAERRN20

Has 3 years experience. Specializes in ER.

I know this isn't really evidence based, but I stopped birth control pills recently to make sure my cycle came back normally. Many women have abnormal cycles and that is why they take oral contraceptives to regulate the cycle.

I am not ready for a child right now, but maybe in 2-3 years. I had abnormal cycles before I took birth control and I want to know if my cycle is going to return now, rather 2 years from now when I want to get pregnant. I guess that could be the logic for stoping occasionaly.

They probably have concerns that some women will have difficulty getting pregnant when they eventually do get off the pill. It isn't everyone but I have known women that weren't very old and it took them longer than usual to get pregnant and they were on the pill for 10+ years.

metal_m0nk, BSN, RN

Specializes in ICU.

Might have to do with studies that show that prolonged use increases the risk of breast and cervical cancer.

Might have to do with studies that show that prolonged use increases the risk of breast and cervical cancer.

Maybe, but would stopping the pill for just 3 months every 28 months significantly affect those risks? I would think the cancer risks would be the same as if it was taken continuously, but I really have no idea.

They probably have concerns that some women will have difficulty getting pregnant when they eventually do get off the pill. It isn't everyone but I have known women that weren't very old and it took them longer than usual to get pregnant and they were on the pill for 10+ years.

There is no evidence to support the claim that birth control causes infertility or difficult conception as far as I've seen.

lifelearningrn, BSN, RN

Has 6 years experience. Specializes in School Nursing.

My horrible cycles returned as soon as I quit taking the pill (after about 10 years of use). Mine are every 18 days, sometimes shorter, rarely longer. It sucks! I've heard of many people getting pregnant right off the pill. It was almost a year for me, but just as my periods came back quickly, so did my endometriosis..

KatieMI, BSN, MSN, RN

Has 7 years experience. Specializes in ICU, LTACH, Internal Medicine.

"My brand-new, 2011-edition pharmacology text says, "Many health care providers prefer to have patients discontinue birth control pills for 3 of every 28 months. This allows the body to return to a normal cycle."

What textbook it is?

Anyway, it is not about cervical cancer (there's no evidence of any increasing or decreasing of its risk and taking pills in non-high risk populations); it is hardly can be about breast cancer (if there is an additional risk of it because of pills, it appears to be rather small) and not at all about uterine or overian cancers (against which pills provide some degree of protection). If there's a question about "nature" and such stuff, then three months of freedom after 28 of suppression is not enough for the system to reload itself anyway. The hormones are deposited in body fat and eliminated very slowly (weeks/months)

It was a rather ancient method of treatment of so-called "female functional infertility" and irregular cycles (all tests are OK, but either no evidence of ovulation in three subsequent cycles, or cycles are irregular and all that was considered to be the reason for inability to concieve): patients were given a year of pills and then stop abruptly and "resume active attempts". The expected result, in otherwise healthy young patient would be increase of axis activity and multiple ovulations, or at least ovulation in every cycle for a while. It worked in many cases, so maybe some practitoners still use pills for this purpose. But if patient doesn't plan to get pregnant, then such tactics will only expose her to high and unnecessary risk of unwanted pregnancy.

P.S. i take low-dose pills for 20+ years with break only for baby, and never, ever was told to have a break. I don't have any additional risk factors, though.

Tree5981, ADN, BSN, MSN

Has 8 years experience. Specializes in oncology, med/surg, ortho.

I've been on birth control for 12 years and took a break and it returned to my normal painful cycle in about 6 months. But i've also never been told to take a break with my birth control from my healthcare provider. . I have however been told that if i don't switch the brand of my pill every couple years then i won't be able to have children! i was like what!??:eek::eek:. (i switched gynos real quick!) Turns out there is no proof of that either. I think for people who have dysmenorrhea or endometriosis it actually has many benefits to take birth control. Like the others have stated there is no proof that it effects your ability to have children.

I have however been told that if i don't switch the brand of my pill every couple years then i won't be able to have children! i was like what!??:eek::eek:. (i switched gynos real quick!)

Having to switch brands every couple of years would be really unfortunate for those women who had to trial several different brands of pills before they finally found one that relieved their dysmenorrhea. :eek:

metal_m0nk, BSN, RN

Specializes in ICU.

"My brand-new, 2011-edition pharmacology text says, "Many health care providers prefer to have patients discontinue birth control pills for 3 of every 28 months. This allows the body to return to a normal cycle."

What textbook it is?

Anyway, it is not about cervical cancer (there's no evidence of any increasing or decreasing of its risk and taking pills in non-high risk populations); it is hardly can be about breast cancer (if there is an additional risk of it because of pills, it appears to be rather small) and not at all about uterine or overian cancers (against which pills provide some degree of protection). If there's a question about "nature" and such stuff, then three months of freedom after 28 of suppression is not enough for the system to reload itself anyway. The hormones are deposited in body fat and eliminated very slowly (weeks/months)

It was a rather ancient method of treatment of so-called "female functional infertility" and irregular cycles (all tests are OK, but either no evidence of ovulation in three subsequent cycles, or cycles are irregular and all that was considered to be the reason for inability to concieve): patients were given a year of pills and then stop abruptly and "resume active attempts". The expected result, in otherwise healthy young patient would be increase of axis activity and multiple ovulations, or at least ovulation in every cycle for a while. It worked in many cases, so maybe some practitoners still use pills for this purpose. But if patient doesn't plan to get pregnant, then such tactics will only expose her to high and unnecessary risk of unwanted pregnancy.

P.S. i take low-dose pills for 20+ years with break only for baby, and never, ever was told to have a break. I don't have any additional risk factors, though.

Didn't the WHO, after reviewing all of the available literature, declare combination oral contraceptives a Group 1 carcinogen?

I think I remember reading something about that not long ago...

I am on Depo Provera for almost 3 years to treat my endometriosis and I LOVE not getting my periods. My only regret is that I didn't go on it sooner.

It does say in the pamphlet that I shouldn't be on it for more than 2 years unless recommended by a doctor but, I think that's because of the increased risk of osteoporosis.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

I take BCP, skip the placebo week and start a new pack. I've been doing this for several years, with no adverse effects.

Wow, I can't believe I've never heard or read that before! Thankfully, the article states:

"They regularly review

the safety of COCs and assess the balance

of risks and benefits of COC use and they

have determined that for most healthy

women, the health benefits clearly exceed

the health risks."

KatieMI, BSN, MSN, RN

Has 7 years experience. Specializes in ICU, LTACH, Internal Medicine.

Didn't the WHO, after reviewing all of the available literature, declare combination oral contraceptives a Group 1 carcinogen?

I think I remember reading something about that not long ago...

:):):twocents:

Just for clarification:

http://ntp.niehs.nih.gov/index.cfm?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932

http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s084ster.pdf

only estrogen is declared to be a "known human carcinogen", and that's why postmenopausal estrogen replacement therapy was outlawed. Before this, diestilbestrol was taken off for the same reason. There were 3 studies about causative correlation between breast cancer and combination oral contaceptives, and the relative additional risk was found to be "small", about 5 additional tumors/1000 women/lifetime; I guess that other risk factors add much more.

After all, breast cancer can be screened early enough to cure. Ovarian and uterine cancers (which are prevented by taking oral contraceptives with up to 50% decreasing risk for ovarian cancer) are much more difficult to find and much less likely even to be put into good remission.

carolmaccas66, BSN, RN

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Yes I know what the endometriosis sufferers have gone through. As soon as I stop my pill (I had to have a series of blood tests done not long ago and had to cease the pill for a month b4 hand), and all my bleeding, pain, etc (well more like haemorrhaging), came back full force. I don't like taking the OCP and have tried every other available alternative for endometriosis but the OCP seems to work best. I could not go to work or function without it as the pain is horrific.

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