I’ve been doing the 21/7 method for 10 years now, and recently I was thinking about how they drill into us that we need to take it exactly the same time every day, or it’ll be less effective. Or when we miss it, it’ll be less effective. Make sure to use condoms for a week if we miss it more than twice. All that jazz. Women are told to opt for different methods of contraception if they aren’t able to commit to taking it 100% regularly.
From what I know, the pill works by keeping the hormone cycle steady, to prevent an egg from maturing. After 24h, there is a spike in some hormone which the pill normally keeps steady (I think it’s progesterone but not 100% sure), so we take the pill, and the hormones remain in tact.
Surely then by not taking it for 7 whole days would mess the entire thing up. How come the risk of pregnancy stays low after 7 days, if missing it for 1 day can increase it?
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The active pills keep you at a hormone level where you don’t ovulate. Its not exactly mimicking any given part of the cycle, more kind of negating it mostly, just using hormones that are (fairly close to) those your body uses to regulate it naturally.
The time off the pills is to allow a period, which in this case is a withdrawal bleed from the estrogen – this is kinda like a normal period, but actually closer to the mini period baby girls sometimes get after birth when they lose exposure to their mum’s estrogen.
The timing is just marketing and comfort really – there’s no reason the 21/7 is better, its just fairly average cycle length so that’s what the makers settled on. It used to be thought to be important for health reasons to have the bleed, turns out that doesn’t seem to be the case. Only downside of skipping the break seems to be breakthrough bleeding, so often people just find the timing of breaks that works for them and go with that – someone might need one 2 monthly to avoid spotting, someone else could go 6 months without issues.
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