Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Recommended OCPs?

31 July, 2019


Hi! I’m wondering if you are able to help me out. Are there any oral contraceptive pills that you recommend for frum women who want to prolong their time between Mikva visits? For example getting their periods 4x yearly instead of 12. Which pills best eliminate staining and breakthrough bleeding?

I was very happy myself on Yasmin for many years but my practitioner switched me to something else with lower estrogen that was terrible and now I’m on a third medication that’s not working out either. It’s been so frustrating and I’m not sure who else to turn to.

Thank you so much!


Because each woman is unique, there is no one oral contraceptive pill (OCP) that works well for all women. Generally speaking, a higher estrogen level will be associated with less breakthrough bleeding over time, but may also have more side effects.

It is normal to experience staining for the first 1-3 months as your body adjusts to a new type of hormonal birth control. If you continue to experience difficulties beyond that point, we suggest you go back to your practictioner to discuss why you were switched off Yasmin, what other possibilities might be worthwhile, and how best to extend your cycle.

In theory, one can extend the active pills of many combination OCPs for as long as three months in order to get a period only four times a year. This is fairly straightforward with monophasic pills, where all 21 pills in a package have the same formulation. It is more complicated with triphasic pills, where the dosages of estrogen and progesterone vary over the course of each cycle. The longer a woman continues active pills without a break, the higher the chance of breakthrough bleeding. For a more detailed discussion, please see our article on Extending or Manipulating Cycles.

It is also important to review the laws of stains, as by reading our articles on Stains and Toilet Paper, since not all stains make a woman niddah. If staining is interrupting the seven clean days, please get back to us or a halachic authority about possible leniencies.

Please feel free to get back to us with any further questions.

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