From the Guidelines
Yes, a patient can continue taking Opill (norgestrel), an over-the-counter progestin-only birth control pill, during their period. Opill should be taken at the same time every day without breaks, including during menstruation. Unlike combination birth control pills that often include placebo pills during the period week, Opill comes in packs of 28 active pills that should be taken continuously. Missing pills or taking them inconsistently can reduce effectiveness. Some patients may experience irregular bleeding or spotting while using Opill, which is normal. The continuous use of progestin-only pills works by thickening cervical mucus to prevent sperm from reaching an egg, thinning the uterine lining, and sometimes preventing ovulation. For maximum effectiveness (about 93% with typical use), it's essential to start the next pack immediately after finishing the current one, without any breaks, regardless of menstrual bleeding 1.
Key points to consider:
- Opill is a progestin-only pill, and its use during menstruation does not require any adjustments.
- Patients should be advised to take Opill at the same time every day, without interruptions, to maintain its effectiveness.
- Irregular bleeding or spotting are common side effects of Opill, but they do not necessitate any changes in the treatment regimen.
- The patient's goals and preferences should be taken into account when managing bleeding irregularities, and treatment options may be considered if necessary 1.
It is crucial to prioritize the patient's health and well-being, and to provide guidance on the proper use of Opill to minimize the risk of unintended pregnancy and other complications. By following the recommended guidelines and taking Opill as directed, patients can effectively prevent pregnancy while minimizing the risk of side effects and complications 1.
From the Research
Continuation of OTC Oral Contraceptives During Period
- Patients can continue to take OTC oral contraceptives during their period, as the primary concern is the management of menstrual bleeding and contraception 2, 3.
- Extended-cycle and continuous use of oral contraceptives have been shown to be safe and effective, reducing total bleeding episodes and problems with bloating and dysmenorrhea 2, 4.
- Women may experience more unscheduled spotting and bleeding in the initial cycles, but these problems decrease with longer use 2, 4.
- Amenorrhea, or the absence of menstruation, may be beneficial and suit the lifestyles of many women, and can be achieved through extended and continuous regimens of combined estrogen and progestin contraceptives 3, 4.
Safety and Efficacy
- Numerous studies have demonstrated that extended-cycle and continuous OC use are safe and effective, with comparable efficacy and safety profiles to traditional cyclic dosing 2, 4.
- The risk of venous thrombosis is increased with estrogen-containing methods, such as combined oral contraceptive pills, but progestin-only and nonhormonal methods are associated with rare serious risks 5.
- Optimal contraceptive selection requires patient and clinician discussion of the patient's tolerance for risk of pregnancy, menstrual bleeding changes, other risks, and personal values and preferences 5.
Management of Menstrual Bleeding
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce menstrual blood loss and are more effective than placebo, but less effective than either tranexamic acid or danazol 6.
- NSAIDs are a viable option for managing heavy menstrual bleeding, but may have adverse events, and individual NSAIDs (such as naproxen and mefenamic acid) have similar efficacy in reducing heavy menstrual bleeding 6.