FIRST available in the US in 1960 and introduced to Britain the year after, the combined oral contraceptive pill (COCP) is undoubtedly on of the greatest breakthroughs in modern medicine. Since that time, the mantra “21 days on, seven days off” has been held as gospel by several women and indeed by many prescribers.

However, this is all about to change with the Faculty of Sexual and Reproductive Health stating that for some women the seven day pill-free interval could be dropped, with advice that it confers no health benefit, and that continuous use of the pill may even reduce the number of unwanted pregnancies.

It is thought that the 21/7 day cycle was designed to mimic a natural menstrual cycle, and hence appeal to religious leaders; which sadly it didn’t. Indeed the natural cycle can be anywhere between 14 to 35 days, and some women may only have a period a handful of times per year.

The withdrawal bleed, when contraception is stopped, is often anxiously anticipated as a demonstration that the user is not pregnant. Yet it is only a sign of the contraceptive hormones leaving the body.

There are advantages to taking the combined pill continuously. Firstly, the lack of a period will appeal to many women who find their monthly bleed disruptive and often painful. In addition, the drop in hormone levels in the pill free break have often been blamed for side effects including mood disruption and headaches. But perhaps the greatest benefit from forgoing the seven day break may be a reduction in the number of unwanted pregnancies.

The combined contraceptive pill is sited as being 99 per cent effective if instructions are followed to the letter. In the real world this is about 90 per cent. The riskiest time for missing a pill and falling pregnant is either at the start or end of this long hormone free period.

Combined oral contraception, as the name suggests, involves two hormones, oestrogen and progesterone. It works in three ways. Firstly, it prevents an egg being released from the ovaries every month. By thickening the composition of mucus at the neck of the womb, sperm are less able to swim into the womb itself. If despite the above measures a sperm and egg combine, the pill thins the lining of the womb, making implantation of the fertilised egg less likely.

The combined pill is one of the most commonly prescribed medications for young women first requiring contraception, and for many it will be entirely suitable long term, even up to the menopause.

It offers both short and long-term benefits including alleviating the pain associated with periods, lightening the volume of blood loss, as well reducing the risk of some cancers. If you are on the combined pill using the traditional 21/7 method and would like to omit the break, it would be worth discussing this with your doctor.

Many will have experience of patients using three packs without a break, and some will have been advocating continuous use long before these new guidelines.