Combined hormonal contraceptives have been increasingly marketed and prescribed in extended regimens to manage menstrual-cycle-related complaints and accommodate patients’ preferences. Extended regimens provide less frequent menstruation and may confer better ovarian follicular suppression and, thus, more effective pregnancy prevention. Most healthcare providers prescribe extended regimens and believe that menstrual suppression is safe; many women, when given the choice, would prefer to menstruate less frequently. However, most women will experience breakthrough bleeding, which may limit patient acceptance of an extended regimen. Recent studies have addressed strategies for minimizing unscheduled bleeding, but further research is needed to identify how best to tailor regimens to the medical needs and preferences of individual women.