This is one aspect – and it’s best to point this out right away – that is harmless from a health point of view, but that the woman should be well-informed of. Regardless of the type of pill (monophasic, biphasic or triphasic), the extended regimen can more easily cause occurrences of spotting (the minor bleeding that Federica mentioned), particularly in the first few months of treatment when the body has to adapt to the new regimen. Not all women want to deal with this. To reduce the incidence of this unexpected spotting, all you have to do is stop taking the pill for 4-5 days to voluntarily cause a pseudo-menstrual flow. After the break, you can start taking the pill with the same regimen (even if the flow is not completely finished). Spotting does not in any way suggest a reduced effectiveness of the pill, unless the woman has forgotten to take one or more doses, and is not a contraindication to following the extended regimen. In any case, in regards to all these aspects, it is best to discuss things verbally with your gynecologist to assess risks and benefits together, taking into account sensitivity, lifestyle, culture, religion and any factors that can affect the choice of one method compared to another.
