Which of the following statements about extended-cycle COC bleeding patterns is true?

• A. Bleeding occurs every 3 months
• B. Bleeding occurs monthly
• C. Bleeding occurs weekly
• D. Bleeding occurs daily

Answer: (A)

Extended-cycle combined oral contraceptives are designed to minimize withdrawal bleeding by extending the time on active hormones. In these regimens, you take active pills for a long stretch (often about 84 days or more) before a short hormone-free interval, which triggers a withdrawal bleed only about every three months. That quarterly pattern is the hallmark of extended-cycle use and contrasts with the monthly bleed seen with traditional 28-day COC packs. Bleeding weekly or daily would not align with the intended extended-cycle schedule, which aims for infrequent menses rather than frequent or continuous bleeding.