Seasonale is an extended cycle OCP. It is a combined estrogen/progesterone pill that gives women only four periods a year. Each package contains a three month supply with 84 active pills and 7 placebo pills, during which menses occur, for a total 91 day cycle. Instead of getting 13 periods a year as with traditional pills, seasonale decreases this number to four periods a year.
Concern has been voiced that we are increasing the total exposure of estrogen and progesterone on a yearly basis, and what this will do to cancer risk in the long run. This is a valid concern, but it has been a common practice over many years before Seasonale existed to omit the pill free week in traditional OCPs in endometriosis and menstrual migrane sufferers, and to date no untoward effects have transpired.
There is much more break through and irregular bleeding with Seasonale over traditional regimens, especially in the first year of use, and then it gets better in most patients. Efficacy, risks, side effects and contraindications are the same as for traditional OCPs.