A relatively common concern of my patients is missing their menstrual cycles (AKA missed periods) when they are taking their birth control pills, the patch or the birth control ring (Nuvaring). This can be a bit unnerving for patients as it creates the concern that they might be pregnant or that there is something wrong with them.
What Missed Periods on Birth Control Means
Generally speaking, missing your menstrual cycle while you are taking your birth control pills is a common event, especially with the extremely low dose pills that are now available. If you do miss one or more menstrual cycles, be sure to check a pregnancy test to confirm that you are not pregnant. If it is negative and you were having normal and regular cycles prior to starting the pills, you can rest assured that there is nothing wrong with you unless you have had a recent uterine surgery or a severe uterine infection… and these are both things you would have been aware of if they had occurred.
How Birth Control Hormones Affect Menstruation
The reason that many women miss their menstrual cycles while taking the birth control pill, patch or ring is due to the low doses of hormones in these methods and the dominant effect of the progesterone in them. As you probably know, almost all pills, the patch and the ring contain estrogen and progesterone. Progesterone’s effect is to shrink the menstrual tissue layer of the uterus and the estrogen component provides a minor balancing stimulatory effect so that the menstrual tissue does not break down and cause bleeding on the days that you are taking the pills, also known as breakthrough bleeding. Progesterone’s “shrinking effect” on the menstrual layer is why most women experience lighter and shorter cycles while using these methods of birth control. In some cases, especially with very low dose pills, the menstrual tissue has such minimal stimulation for growth and development that there is no tissue to lose as a menstrual cycle when the end of the month of use is reached. This results in a missed menstrual cycle.
Next Steps After Missed Periods
So, if you have experienced a missed menstrual cycle while using birth control pills, the patch or the ring, and you are not pregnant– do not fret! You are fortunate to be experiencing one of the beneficial and harmless effects of these methods. Your menstrual cycles should return to your normal experience once the birth control method is stopped. Contact us today if you are experiencing a missed period when taking birth control pills and we’d be happy to schedule a consultation.