Short answer—yes. Do you think we would let it happen if we thought it wasn’t? I get this question a lot when I describe methods of birth control that may result in little to no period. “Isn’t that unhealthy? Doesn’t your body need to shed the uterine lining?”. It IS unhealthy if you are not on any form of hormonal birth control. However, under the influence of hormones from birth control pills, implants, IUDs, shots (you name it…), it is completely fine! So how is this the case? It’s slightly complicated, but let’s try and break it down.

  1. How? Birth control helps to prevent a uterine lining from growing. That’s part of how it works! Fertilized eggs want a comfy lining to call home. But without a desirable nesting spot, this is hard to do (and can help prevent an unwanted pregnancy). With the hormones used in birth control (either a combined estrogen and progesterone, or progesterone alone) the uterine lining is kept thin. A thin lining means… you guessed it, nothing to shed. So why do I have a period on birth control pills? Well, in our world, birth control “periods” are not quite the same as a natural period. In fact, we even have a different name for them. We call them “withdrawal bleeds”. These withdrawal bleeds occur because of a lack of hormone. Those different colored pills at the end of your pack? Those are hormone-free. When we take the hormones away, it sends a signal to your body that it’s time for a period. As a result, a “withdrawal bleed” occurs. Many women on birth control pills experience shorter, lighter periods (thank you, thinner uterine lining!) and sometimes no period at all, even with the hormone-free pills. This is ok! There just isn’t a lining there for it to shed. The second we take birth control out of the picture (excluding the depo-provera injection) your body resumes business as usual. A lining grows, a pregnancy doesn’t occur (but can, so be aware!), and a period follows.
  1. What about IUDs or other methods where you don’t have a withdrawal bleed? These methods are progesterone-only methods. Meaning there is no estrogen in them. Estrogen is a hormone that causes growth of the uterine lining, while progesterone keeps the lining in check (and helps it to shed). Remove the extra estrogen from the picture and… the progesterone wins this battle. With more progesterone in play, the lining of the uterus stays thin. And with IUDs (or implants), there is no removing of the extra hormone. That sucker is in there (which is a good thing!!). And again, this is all part of the magic of how birth control works. A thin lining means no comfy home for a fertilized egg. It also means no period. So we’ll chalk it up as a win-win.

I hope this answered some questions as to why it is OK to have no period while on hormonal birth control. Again, if you are not on any birth control and are not having a period, you need to be evaluated by your health care provider. What I write is not intended to be medical advice and should not be taken as so. Always, always discuss your questions and concerns with your OB/GYN. They know you and your individual concerns and can always give you the proper advice.