Gynecologic Health

Should Women Put an End to Periods?

Lybrel, if approved, would take this idea of skipping the inactive week a step further, giving women only active pills to take. In several studies completed by the drug’s manufacturer, Wyeth Pharmaceuticals, Lybrel seems to be just as safe as the standard birth control pill. The most common side effect of this drug seems to be breakthrough bleeding, a side effect also experienced by women who skip placebo pills with normal hormonal birth control.

The Period Problem
When offered the option of delaying their period, some women are understandably worried that it will somehow harm their reproductive cycle and even prevent them from getting pregnant when they want to.

“When considering a non-cyclic oral contraceptive option, women want to know, once they stop use, when they will begin to menstruate again,” says Dr. Ginger Constantive, vice president from Wyeth Pharmaceuticals.

In one study of Lybrel, 99 percent of the 187 participants who took the pill for a year either became pregnant or starting having their period again within 90 days of stopping the drug.

However, approximately 60 percent of women say they rely on their period to let them know that they are pregnant, whether they take birth control or not. So, reluctance to suppress the menstrual cycle for months or years at a time may stem from the tangible reminder that a period brings.

However, Dr. Peggy Stubbs from the Society for Menstrual Cycle Research believes that too many young women without a real need for it are too quick to begin menstrual suppression and are using it for the wrong reasons.

“I think young people are confused,” she says, pointing out advertisements for Seasonale which “feature women dancing in pristine white dresses playing to [women’s] insecurities about their bodily functions.”

Stubbs agrees that menstrual suppression is important for women with overly painful or heavy periods, but too many take it just because they view their periods as a nuisance. “Taking a pill is a very easy way to deal with it,” she says, but then calls up reminders of other hormonal therapies, such as hormonal replacement therapy (HRT) to treat menopause symptoms; it was used for years until it was found to significantly increase the risk of breast cancer.

“[Older women] seem to be more likely to view menstrual suppression as a new and problematic technology,” she says.

The Masses Speak
Menstrual suppression is nothing new and it’s not something doctors shy away from either. For years, hormonal birth control has been prescribed to help women with painful, heavy or irregular periods, says Ernst. It is also used to treat women with endometriosis, a condition in which the tissue that is normally found on the inside of the uterus extends to the outside, making periods especially heavy and painful.

But do experts agree that even healthy women can go without their period?

In the survey, over 70 percent of health care providers have prescribed hormonal birth control to delay or stop a patient’s period for a given amount of time and 76 percent strongly disagree with the belief that it is physically necessary to have a period every month. In contrast, 50 percent of women think a period is necessary every month.

“There appears to be a disconnect between what health care provides know and do about menstrual suppression, and the general public,” says Dr. Linda Andrist, lead study author from the Association of Reproductive Health.

A 2003 Gallup survey, conducted for The American College of Obstetricians and Gynecologists found that 69 percent of female Ob/Gyns believe that long-term suppression of a woman’s period is safe, with an additional 30 percent believing it is safe if suppressed occasionally.

More research will have to be done before a conclusive answer can be given about the safety of menstrual suppression. Until then, if you are considering delaying or stopping your monthly period, experts warn that there are always risks related to taking hormonal contraception, even as prescribed. These risks include blood clots, hypertension, stoke and heart attack and are greater for smokers. Long-term use of certain forms of hormonal birth control, such are progesterone injections, have been shown to cause a decrease in bone density, increasing a woman’s risk for osteoporosis.

“A woman has to take these risks into account when thinking about using hormonal contraception for menstrual suppression,” says Ernst.

As always, speak with your doctor and fully consider all risks before deciding to begin any form of hormonal birth control, especially if you are considering skipping your monthly cycle.

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