Sign up for the PEP Email List

  Home   »  Get the Facts  »  Publications  »  Newsletters  »  Summer/Fall 2007 Newsletter

To Bleed or Not to Bleed

by Lisa SchulterPEP intern

Most women have absolutely nothing kind to say about their periods. It’s – insidious drum roll, please – “that time of the month” when everyone runs and hides from us, since we’re either complaining about our bloating and cramps or we just bite anyone’s head off who can’t be sympathetic. Well, who can really blame us? Not only are we physically uncomfortable, but simple activities like swimming and good ol’ sex are now at risk of being erased from our agendas for the next week. If given the opportunity, most women would gladly kick Aunt Flow out the door forever and without a kiss goodbye. And, who’d have thought this would actually be a legitimate possibility?

Many of you have heard or seen the ads for Seasonale®, the new birth control pill that lets you have only four periods a year instead of the usual 12-13. A new pill awaiting approval from the FDA, Lybrel®, has been shown to eliminate monthly periods completely. The traditional pill pack consists of 21 active pills taken everyday, and seven placebo pills that signal the week of menstruation. With Seasonale, instead of 21 active pills there are 84 plus seven placebo pills, giving the woman a period at the end of each four-month regimen. Lybrel pills are taken 365 days a year and have no placebos.

Now that we’ve roughly covered the basics of oral contraceptives, there’s an important fact most women aren’t aware of – and this is the argument behind eliminating periods. The bleeding that occurs after each cycle of active birth control pills is not a real period. It’s not caused by ovulation, when the uterus sheds its lining, but it’s actually a response to the active hormone pills – the body is withdrawing from the progesterone. This is referred to as “withdrawal bleeding.” When The Pill first came on the scene in 1960, its creators included “withdrawal bleeding” to make the whole process feel more natural and to also have a method for users to detect
pregnancy. Now, doctors and health advocates are questioning the need for this WB. “The bleeding on the birth control pill can cause the same discomfort as a regular period,” says Dr. Leslie Miller, an associate professor of obstetrics and gynecology at the University of Washington in Seattle and the creator of the website “Withdrawal bleeding is not needed, so why have it?”

Suppressing periods is not a new fad, by any means. It’s been common practice among women who are physicians with easy access to oral contraceptive pills. But since this method has not been officially approved by the FDA, it was not widely known. Women have been doing it with traditional pill packs for years – all you’d need to do is skip the week of placebos and start a new pack of active pills imme-
diately. (FYI: If you are considering this method for an impending vacation or special occasion, it’s always best to talk to your doctor first.)

Women who suffer from endometriosis are also advocates for fewer or no periods. This condition occurs when the uterine lining grows outside of the uterus, causing painful internal bleeding during every menstrual cycle. Many doctors advocate suppressing menstruation as a treatment for endometriosis.

While there is much support behind disowning Aunt Flow, there are just as many who’d rather she stay. Dr. Susan Rako is a  psychiatrist based in Boston and the author of “No More Periods?: The Risks of Menstrual Suppression and Other Cutting-Edge Issues About Hormones and Women’s Health.” She says, “Manipulating women’s reproductive hormonal chemistry for the purpose of menstrual suppression would be the largest uncontrolled experiment in the history of medical science.” Rako is concerned with the long-term health affects of this behavior, for there are no in-depth studies that can give us any ample insight. She says a normal hormonal cycle includes two weeks of significantly reduced blood pressure – this contributes to the reason women of reproductive age have fewer heart attacks and strokes.

Menstrual bleeding also rids the body of excess iron, which is another risk factor for cardiovascular disease. “Taking the birth control pill non-stop throws a monkey wrench in the workings of every organ and system in the body, not just reproduction,” Rako says. In her practice, Dr. Leslie Miller checks the iron levels of women who have been suppressing their periods for years, to make sure they do not have any problems with iron storage in the body. She recommends regular blood donation to be on the safe side, but she has not found any patient with excess iron in her system.

Each side of the argument makes some pretty valid points – both addressing risks and  benefits of menstruation and suppression. Which side makes more sense to you? Check out our Further Reading section below for more information. It’s a great conversation starter: “Hey, do you think periods will be passé?”

Notes/Further Reading

1. Ginty, Molly. “New Pills Launch Debate Over Menstruation.” Women’s E-News. 22 June 2004.
2. The Kaiser Family Foundation Weekly Women’s Health Policy Report, 29 June 2006.
3. The Kaiser Family Foundation Weekly Women’s Health Policy Report, 20 April 2007.
4. Kelley, Tina. “New Pill Fuels Debate Over Benefits of Fewer Periods.” The New York Times. 14 October 2003. .
5. Museum of Menstruation and Women’s Health.
6. No Period.

Share on Facebook


February 2010 E-Newsletter
November 2009 E-Newsletter
August 2009 E-newsletter
May 2009 E-Newsletter
February 2009 E-newsletter
December 2008 E-newsletter
October 2008 E-newsletter
April 2008 E-newsletter
June 2008 E-Newsletter
Winter 2008 Newsletter
Winter 2007 Newsletter
Summer/Fall 2007 Newsletter
Fall 2006 newsletter