From a medical standpoint, it is not necessary for women using birth control pills to have a monthly period. The pills keep the lining of the uterus from cycling as it normally would. The lining stays thin, which prevents pregnancy and eliminates the need for monthly shedding of the this tissue. A variety of birth control pills on the market enable women to have periods every 3 months, freeing them from inconvenient monthly periods.
Types of Birth Control Pills
The only types of birth control pills that would allow for a scheduled, predictable period every 3 months are combined oral contraceptive pills. In general, combined oral contraceptive pills contain two types of hormones, forms of estrogen and progesterone. These hormones work to thin and stabilize the uterine lining. When a woman takes placebo pills, or has hormone-free days, her body allows her to have a period.(ACOG)
If a woman continuously takes oral contraceptive pills that contain hormones, she will not have a period. Some birth control pill manufacturers package their birth control pills in such a way that a woman will take 84 active, hormone pills and then 7 inactive placebo pills. This allows her to have a period every 3 months, and is known as a continuous cycle or seasonal cycle birth control. As long as a woman is on combined hormonal contraception, it is safe for her to not have a monthly period.
Continuous cycle birth control pills come in dosages that are similar to formulations of regular birth control pills. Typical regimens contain 20 to 30 mcg of ethinyl estradiol and 90 to 150 mg levonorgestrel. A few brands vary the dose of ethinyl estradiol throughout the month at very low levels. This may help reduce the risk of breakthrough bleeding, or spotting, that can occur as a woman's body adjusts to the continuous cycle birth control regimen.
Women can "stack" -- or take active pills continuously -- any type of monophasic combined oral contraceptives. (FP #3) A package of monophasic pills has two types of pills: active and placebo. A woman can simply skip the week of placebo pills at the end of her usual pack of pills and begin the next month's active pills. Although birth control pills are considered safe and confer some noncontraceptive health benefits to women with long-term use, there are risks associated with using any form of birth control pills. Women should consult their doctors before altering their pill regimens.