Birth Control Pills - When Should I Expect My Period?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on May 11, 2025.

• Combination Birth Control Pills
• Extended- or Continuous-Cycle Pills
• Progestin-Only Pills
• Spotting and Irregular Bleeding

Many women using birth control pills will find that over time their periods may become more regular, lighter, and less painful. In fact, many women use birth control pills to help regulate their periods and ease cramping and premenstrual syndrome (PMS). You can even use the pill to safely skip your period altogether if you prefer. But sometimes breakthrough bleeding or spotting can still occur.

Combination Birth Control Pills

If a combination birth control pill (estrogen + progestin pills, usually in a 21- or 28-day pack) is started for the first time on the Sunday after your period begins, your period should occur about 25 days later.

Ask your healthcare provider which day is the best to start your specific pill pack. If your period begins on a Sunday, you can start the pill pack on that Sunday.

• In general, about 3 days after finishing all of the 21 active tablets in a 28-pill pack, most women will start their period. If you use a 28-pill pack, you'll get your period during the week you take the reminder (hormone-free) pills. Most pill packs have hormone-free pills for 7 days, but sometimes there are less.
• If you use a 21-day pill pack, you'll still get your period the week you do not take any pills. Remember that the 21-day pack has no reminder (hormone-free) pills.

Extended-Cycle or Continuous Cycle Combination Birth Control Pills

If you take extended cycle (i.e., Seasonale, Seasonique) birth control pills you will only have four periods per year. If you take continuous dose birth control pills (i.e., Amethyst) you will eliminate your periods completely. However, breakthrough bleeding or spotting may occur with extended- and continuous-dose birth control pills. Spotting may last for up to 3 to 6 months, but will usually subside over time.

• Extended cycle pills like Seasonique typically have 12 weeks of active combined hormone pills (an estrogen and progestin) that you take continuously for 12 weeks, followed up by 1 week of reminder pills (91 pills total).
  • You take one pill each day. You’ll only have your period once every three months (4 times per year). Each period is likely to last about 3 days.
  • You may also have unplanned bleeding or spotting between your periods, which usually decreases with time. If the spotting continues for more than 7 consecutive days or if the bleeding is heavy, call your healthcare provider.
  • You are protected from pregnancy even the week that you take the reminder (inactive) pills. Your reminder pills may contain iron or other supplements.
• Continuous cycle pills like Amethyst usually contain 28 days of active combined hormonal pills (an estrogen and progestin).
  • You take one pill each day for 28 days in a row; there are no inactive (reminder) pills.
  • As soon as you finish one pack, you start the next pack the following day. You do not take a break in-between packs.
  • Your periods will most likely stop, but you may have unplanned bleeding or spotting when you first start to use Amethyst. Do not stop taking your pills if you have spotting. The number of days each month with unscheduled bleeding and spotting usually decreases over time for the majority of women taking Amethyst. 

Progestin-Only Birth Control Pills ("Mini-Pills")

With progestin-only pills, all 28 pills have a progestin-only hormone (contain no estrogen) and come in a 4-week (28-day) pack. Progestins include drugs like norethindrone.

The new over-the-counter (OTC) birth control pill Opill is also a "mini-pill" progestin-only pill. In July 2023 the U.S. Food and Drug Administration approved Opill, the first nonprescription, over-the-counter (OTC) birth control pill. Opill is available without a prescription in stores and online as of March of 2024. Check with your pharmacy if you have questions.

Learn more: What is Opill, where can I get it and how much does it cost?

Take one pill every day in the progestin-only pack to be protected from pregnancy. You must take progestin-only pills within the same three hour time period every day to be protected from pregnancy. This is very important. Missing this timeframe can increase your chances for pregnancy.

• For example, if you normally take your pill at 8 PM, taking it after 11 PM the next night may put you at higher risk for pregnancy.
• Take every progestin-only pill in a pack to be protected from pregnancy — there is no hormone-free week or reminder pills.
• You may get a period in the 4th week, off-and-on bleeding or spotting throughout the month, or no period at all.

Slynd (drospirenone, 4 mg) is a progestin-only oral contraceptive pill with a dosing regimen that contains 24 active and 4 inactive tablets and also allows a 24-hour missed pill window.

• This regimen allows an improved bleeding profile and contraceptive efficacy for up to 24 hours in the event of a delayed or missed pill. However, it’s best to take it around the same time each day if you can to help you stay on schedule.
• Slynd (pronounced "slind") is the first birth control pill with this unique regimen.
• As a progestin-only option without estrogen, the safety profile of Slynd was demonstrated for higher-risk populations like smokers, older women, and subjects with a Body Mass Index (BMI) >30.
• Slynd was first approved in 2019.

Related: Lists and Types of Birth Control (Contraceptives)

Irregular Spotting or Bleeding

Irregular spotting or bleeding can occur during the first few months of taking any type of birth control pill. Spotting is more common with:

• progestin-only pills (the ‘mini-pill’) compared to combination pills (with both estrogen and progestin)
• a "monophasic" pill (same hormone dose every day) compared to a "triphasic" pill (different dosages over the cycle).

Spotting can occur if you forget a pill or take it late, especially with the progestin-only pill.

But we get it - life is busy and it's easy to miss a pill. You may want to use a smart phone app, a calendar or other reminder tool to help you stay on track with your pills.

If you are concerned about spotting, irregular bleeding or an irregular cycle, contact your healthcare provider right away for further advice.

This is not all the information you need to know about birth control pills and does not take the place of your doctor’s directions. Discuss any medical questions you have with your doctor or other health care provider.

See also

• Birth Control Pills: Benefits, Risks & Side Effects
• Birth Control Pills: Why do I get breakthrough bleeding?
• Emergency Contraception: What You Need to Know
• Emergency Contraceptives: Morning After Pills & OTC Options
• Grapefruit and Birth Control Pills: Your Questions Answered
• Missed your birth control pill? Here's what to do
• Non-hormonal Methods of Birth Control
• What are the options for permanent birth control?
• Your Guide to Types of Birth Control Pills (Oral Contraceptives)

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer