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The bleeding that the placebo week of a combined birth control pill is not actually a period. As a biomedical engineer who studies female reproductive health. So I saw this video on TikTok, the video itself and the comments, I actually realized huge misconception that placebo pills equals period week. And physiologically, that is not what's happening. So let's talk in a natural menstrual cycle, estrogen will help of your uterus. Then you will ovulate, meaning your Ovaries release an egg. After ovulation, progesterone will rise, maintain the uterine lining that was built in preparation for a possible pregnancy. However, if pregnancy doesn't happen, then your estrogen and your progesterone will fall. Hormone were maintaining the thick uterine lining, that drop triggers that thick lining and shed, and that is your period. But on a combined birth control pill, we're intentionally interrupting so the hormones in the pill suppress the signals that normally trigger ovulation. So typically, you're not ovulating, and then, B, the progestin in the pill actually helps keep the uterine lining relatively thin, thickening or buildup of the uterine lining. Going through the same hormonal cycle that normally results in a period. About those placebo pills, also known as so the placebo pills don't contain active hormones that the rest of the pack contains. So it's essentially a sugar pill. Stop taking the active hormonal pills, there's a sudden withdrawal in your body from those hormones. And that hormonal drop can cause the uterine lining to destabilize bit. Why we call bleeding withdrawal bleeding. And not a true menstrual period. It might look like a period, but biologically, it's happening for a totally different reason. And if you're bleeding isn't medically necessary, pills even exist in the first place? Well, I have for you. control pills were originally developed, the traditional regiment was designed with a hormone free interval, that would create that monthly bleeding and closely mimic a natural menstrual cycle. So having a predictable monthly bleed make this completely new form of contraception feel more familiar and socially acceptable, but that monthly withdrawal bleed was never biologically necessary. So, no, do not need to bleed every single month intentionally to clean out your uterus like comments suggest. Not have menstrual blood that's building up inside of you. If you don't take the placebo. Remember that the pill is already keeping your uterine lining relatively thin, so this is why, for many taking the combined birth control pills, the active pills can be taken continuously instead of taking the placebo pills because it avoids the scheduled hormonal withdrawal suppress the bleeding altogether. be particularly useful who have endometriosis or for people whose symptoms become worse during the hormone free interval. Now, that doesn't mean that everyone should automatically throw away their placebo pills, because birth control formulations and individual medical circumstances vary from person to person. But if you want to use your pill continuously, that you talk the pill that can actually be used in that way. The biggest takeaway is that the monthly bleeding that you experience on a combined birth control pill is not proof that your body needs to have a period. It is withdrawal created by the hormone free interval, and that interval is largely a feature of how historically designed and not something biologically requires while on the pill.