Period-havers of the world, unite! You have nothing to lose but your tampons!
The birth control pill works by preventing ovulation. Over the course of a natural cycle, your levels of estrogen will rise, thickening the lining of the uterus and eventually leading to ovulation; if the egg is not fertilized, you will shed your uterine lining and the unfertilized egg (the period). When you take the pill, your hormone levels are steady all month, so your uterine lining doesn’t thicken.
That means that technically you don’t have a period when you’re on birth control– even if you take placebo pills. Instead, you have withdrawal bleeding, which is the body’s reaction to not having the hormones it has the other three weeks in the month.
There is no evidence that skipping withdrawal bleeding will harm your health or make it more likely that you will get pregnant (or, for that matter, reduce fertility if you decide you want to have children). The most common side effect of skipping withdrawal bleeding is breakthrough bleeding or spotting, which usually stops as your body gets used to to its new, period-free routine. You might also find it harder to notice if you get pregnant; however, you can choose to have withdrawal bleeding every few months, have withdrawal bleeding that lasts only a day or two, or take a monthly pregnancy test.
The only reason birth control pills come with a placebo pack is historical. One of the inventors of birth control hoped that simulated periods would make hormonal birth control more acceptable to the Catholic Church and that women would find having a simulated period comforting.
If you want to stop having periods using the pill, you have two choices. First, you can get a birth control like Seasonale designed to reduce the number of periods you have. Second, you can start a new pack of birth control pills immediately after finishing the three active weeks in your old pack.
Thing of Things 
Now I am a cis male, and thus lack the relevant plumbing to know for certain, but the thought of bleeding from my genitals on a monthly basis (with associated costs of sanitation) is not the kind of prospect I associate with ‘comfort’. Also, how many deaths due to toxic shock from tampons could have been prevented?
Sometimes, you just have to kick down Chesterton’s fence, bull or not, just to run away from the pope. 😉
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For me, anyway, it’s because I’ve gone my whole pubescent and post-pubescent life associating menstruating with not being pregnant. The comfort in this sense is having a very visceral reminder that I am not, in fact, pregnant.
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I’m a cis woman, so I’ve had plenty of experience with periods and I also can’t really imagine how anyone could find them comforting. For me, the knowledge they provide that I’m not pregnant is pretty much worthless because I’ve never had a pregnancy scare, and if I did I’d take a pregnancy test.
For me, periods are strongly net-negative utility events, so I take continuous birth control. The idea of going back to bleeding every month makes me feel sick to my stomach. Periods are painful and unnecessary, at least for me. People who want them should of course continue having them, but I don’t really understand this preference.
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I wish your conclusions about breakthrough bleeding had applied to me when I tried this. Instead, my body became increasingly strict about the timing of my medication, and I would get a period when I was even a day late between doses. Once, when I was only a few hours late, it decided to give me a heavy, excruciating period that lasted a month. (Before I started taking pills I had a heavy, painful flow, but it was always regular and only lasted a week.) After that incident I switched to depo.
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Period II: Revenge of the Endometrium
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Followed by Period III: Now With Zombies, in which it manages to return from the dead after two years on T, and Our Hero’s only choice is to attack his ovaries directly with scalpels.
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I was a bit surprised by this post, word on the street in France (even more than 10 years ago) was that the pills sold in the US were often continuous, resulting in no periods, with contrasted reactions of “must be so nice” and “how do you know you did not get pregnant then”.
But then a quick search showed me that the FDA approved those only very recently 2007 according to webmd).
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Option #3 for people who would like not to have periods/have less periods: get a hormonal IUD. It varies a bit from person to person, but lots of people end up with very light periods/no period after having one for a month. Also it lasts five years, does not need to be refilled, does not require you to take a pill at the same time every day
(Disadvantage: the first two weeks or so of having it you get constant breakthrough bleeding as your uterine lining thins out. Very annoying.)
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I have been taking my pills in three month no-period runs for years. (My doctor prefers me not to take them indefinitely just to provide a sort of quarterly check-in with ny body and she is generally pretty sound so I have stuck to that) It is the best, though!
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Also: if you are a person whose drg plan will prevent you from refilling three weeks earlier than the full three months, there are brands that have more active pills (like Seasonale). I am on (the generic version of) Yaz, which has 24 active/4 placebos, as opposed to the usual 21/7. If I take all the active pills ans then take a full week off, I am only running out 5 days early instead of three weeks, which is enough wiggle room for most plans I think?
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It’s also possible to purchase birth control pills at online pharmacies.
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Oh interesting! I think that is less relevant to me as a Canadian, which is probably why I didn’t know. Cool!
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If bleeding on birth control is a withdrawal symptom and not a period, is it correct that the bleeding provides no additional evidence for non-pregnancy? In that case, the reaction of “how do you know you did not get pregnant then” (as in thirqual’s comment) would be nonsense.
Like Lambert, I am a cis male and am interested in whether there are reasons aside from skye’s (visceral reminder that you’re not pregnant) that someone would like to have withdrawal bleeding. My naive take is, Actual Periods: okay, maybe a little gross, but also kind of cool and anyway not nearly as gross as people with periods usually think it will seem to me. Withdrawal Bleeding: Yeah, kinda gross, and also, maybe don’t?
People should definitely have withdrawal bleeding if it makes them feel good, but it’s very surprising to me that such a preference might be common.
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You do not get withdrawal bleeding if you’re pregnant, because the uterine lining won’t shed if you’re pregnant.
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Oh, thanks! I didn’t realize that the withdrawal bleeding still consists (partly?) of the uterine lining–this seems odd because the lining doesn’t get thickened while on birth control. Also because I don’t know anything.
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From my observation of conversations between people with the relevant plumbing, regular menstruation seems to often be viewed not only as evidence of lack of pregnancy, but also as lack of evidence of any number of medical conditions that can result in irregular menstruation and/or amenorrhea. Given that combined oral contraceptives can be used to treat irregular menstruation, I suspect that having periodic withdrawal bleeds doesn’t give much evidence there, but it might still give some (although probably less than actual menstruation does) with regards to conditions that cause amenorrhea.
And, of course, even if it doesn’t actually give evidence, it may still make women feel more comfortable if they believe (or alieve) that it gives evidence.
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The first link is broken, alas! I wanted to read further!
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I am not sure if my personal experience is directly applicable to your post, but while I was taking oral contraceptive medication and skipped a period, the next time I chose to have it, I was in an excruciating amount of pain (more so than if I had followed the 28 day cycle) My medical practitioner suggested for me not to skip periods, but I can’t remember the exact medical reasoning for it…but it was definitely not for comfort or assurance that I was not pregnant. Also when I came off the contraceptive medication I encountered a lot of issues and know a lot of women who suffered complications for the same reason. I am sure that my experience and the experience of some of my female friends cannot speak for everyone, but nonetheless it might be something relevant to consider.
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