Speaking as a family physician who sees lots of women for gynecologic problems, skipping the placebo week might work for you. I have had lots of problems with patients with the Seasonale pills that have had difficulty with spotting the first three months or so. (This is equivalent to taking three months of low dose pills in a row, theoretically only have four periods in a year). I usually advise patients that it isn't for certain that they can keep from having their period by doing what you propose. It usually takes a few months for your body to adjust. Some people do just fine, and that is great. If a person were getting married, and wanted to keep from bleeding on their honeymoon, for example, I would suggest trying to skip the placebo week several months before the wedding, so that they could see how their body reacts to that change. Depo provera, also, may result in spotting during the entire three month time the shot is active, rather than the amenorrhea that is more common with that. We can't predict how any particular patient will react to a specific birth control pill or shot.