A period happens when our body sheds the lining that was prepared to accept a pregnancy, when pregnancy does not occur. After we ovulate (release an egg) the uterine lining grows ready to accept an embryo, and if no pregnancy occurs then the lining sheds and the cycle repeats again. When we are on birth control pills we do not release eggs, so this process is halted.
On birth control pills we don’t really have a true period, but we do bleed during intervals when we stop taking the active pills (most pills have a 4-7 day pill free interval at the end of the pack allowing our hormone levels to drop and the lining will shed). Sometimes the lining gets so thin on pills that there is no lining there to shed and no bleeding occurs during the pill free interval. This is perfectly healthy. When the pills are stopped for a few weeks, the lining will come back as we start to release eggs again.
Some pills are packaged with no pill-free interval, so we don’t have a period at all. That is fine as well, since over time the lining gets very thin and there is simply nothing there. In comparison, if we are not on the pill, not having a period means there is something wrong with our hormones that is preventing ovulation. But when we are on the pill, not having a cycle is great. Similarly after endometrial ablation we may not have periods at all, since the lining is destroyed permanently and hopefully will never grow back even though our hormones are still normal.
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