Sex & fertility
Is Seasonale safe?
Q: What about Seasonale? Is it safe to have a period just four times a year?
A. Yes. Many studies have shown that manipulating cycles with hormones is generally safe. Pills, patches and rings that allow you to skip periods are new techniques for a method that has been used for years: bi-cycling or tri-cycling. It’s also called extended-cycle use, or doubling up packs. Seasonale is just an old pill (Nordette) with a fancy new package and clever advertising.
Menstruating a few times a year from this method is fine, though this may not be an attractive birth control strategy for everyone. The bleeding a woman has when on the Pill is not actually a real period — it is a hormone withdrawal bleed, brought on simply from taking a break from the hormones. It is essentially as safe to initiate a hormone withdrawal bleed four times a year as it is to bleed once a month from this effect.
Unexpected spotting or breakthrough bleeding can occur while bi-cycling or tri-cycling, especially early on. You may be better off using the Pill regularly for a few months before doubling up your packs. Monophasic pills (the same dose for each pill and each day for the entire pack) are the best kind for extended-cycle use. For example, Ortho Cyclen is better than Ortho Tri-Cyclen if you’re going to double up.
Some women take active pills (those that contain hormones) as long as they can until they have spotting or bleeding, and then take five days off before restarting. If you like this method, talk to your gynecologist about getting started with extended cycling. Remember that Seasonale is not the only option if your insurance doesn’t cover that brand.
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Original Publication Date: 11/01/2005
Last Modified: 08/17/2009
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician