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An End to Periods?

When birth control pills first hit the market in the 1960s, women generally took three weeks of active contraceptive// pills followed by one week of placebos or no pills.

“The thinking was that women would find this more acceptable, that they would feel like they were having their normal menses,” says Susan Ernst, M.D., chief of gynecology services for the University Health Service at the University of Michigan and clinical instructor in the Department of Obstetrics and Gynecology at the U-M Health System.

Now, many gynecologists believe that the week without contraception – during which a woman experiences a “withdrawal bleed” that mimics the normal menstrual cycle – isn’t necessary. And while some debate surrounds the issue, numerous women are opting to take hormonal contraceptive products continually as a way of stopping the cycle entirely or for several months at a time.

Some women use products such as Seasonale or Seasonique, birth control pills that result in four periods a year; others take birth control pills that have been around for years, but without the week of placebos or no pills. An implantable device was approved during the summer for use in the United States, and injections, patches and vaginal rings are other methods of suppressing menses.

Ernst points out that suppressing one’s menstrual cycle is not very different from taking the three-weeks-on, one-week-off cycle of birth control pills, which women have been doing for decades.

“When a woman chooses to use hormonal contraceptives, she’s giving her body estrogen and progesterone, and that suppresses her own hormonal fluctuations,” Ernst says. “So she’s already controlling her cycle by taking those hormonal contraceptives and can further control her cycle by eliminating the pill-free interval or placebo pills.”

She notes that the practice of physicians prescribing contraceptives to stop women’s menstrual cycles is not new. “Gyn
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