Period suppression is a matter of personal choice, says Dr. Roger Pierson, director of reasearch in obstetrics and gynecology at the University of Saskatchewan. “There is no known benefit [to stopping your period], but there’s also no known health risk,” he says.
Here are some facts to help you make your decision.
There are several ways to stop your period
Though each woman’s body reacts differently, using any kind of combined hormonal contraception continuously will usually suppress menstruation, says Dr. Amanda Black, an Ottawa-based OBGYN and a member of the Society of Obstetricians and Gynecologists of Canada’s (SOGC) extended hormonal contraception guideline committee. Birth control patches, pills and vaginal rings will all stop your period if you use them every day without a break. The hormone injection Depo Provera and the hormonal IUD called Mirena may also suppress menstruation.
Seasonale is the only birth control brand specifically marketed for extended-cycle use. Approved by Health Canada in 2007, these pills are designed to give the user just four periods a year.
If you’re taking the birth control pill, you’re not having a natural period
“Some people think that it’s natural to have a period every month when they are using birth control, but it’s not a real period that you’re getting,” says Black. When you stop taking the birth control pill for seven days, you have what doctors call a hormone-withdrawal bleed—bleeding that simulates what happens at the end of a regular menstrual cycle when estrogen and progesterone levels drop.
However, when you take contraception continuously, you’re maintaining steady levels of those hormones and the withdrawal bleeding does not occur, says Black. So when you use birth control continuously, you’re suppressing withdrawal bleeding, not a natural period.
Long-cycle pills such as Seasonale contain the same hormones as 21-day combination pills
Seasonale is the brand of oral contraception that is specifically approved by Health Canada to suppress menstruation, but it’s safe to do it with any of the birth control pills that are available, says Black. “Any of the risks associated with taking combined hormonal contraception aren’t expected to be any higher if you were taking it continuously or in an extended fashion like with Seasonale.”
Seasonale contains a combination of levonorgestrel (progestin) and ethinyl estradiol (estrogen), just like many other brands of birth control such as Alesse.
The difference is that Seasonale comes in packs with 84 active pills—enough to take each day for four months, after which you take a break for “menstruation.” An advantage to taking Seasonale, says Black, is that this break preempts the breakthrough bleeding a lot of women experience after taking birth control continuously for a few months.
The concept of having a regular monthly period is relatively new
“If we go back a couple of thousand years, women were typically in some sort of a sexual relationship from the time they started having periods until they reached menopause,” says Pierson. With no contraception available, women were pregnant or lactating most of the time and Pierson estimates that they may have only menstruated about five or six time in their lives. “It was when we had efficient contraception that we got the idea that regular menstrual periods are normal. So to have someone declare that you need a regular menstrual period to be healthy, that’s just not the case,” he says.
There’s no scientific evidence that period suppression is harmful, but long-term studies haven’t been done
According to the SOGC’s guidelines on continuous and extended use of hormonal contraception, taking the pill to suppress your period for a short period of time is as safe as using it in a 21-day cycle. However, the guidelines also state that evidence on the long-term safety of using hormonal contraception continuously isn’t available.
The longest period of time that researchers have officially followed women continuously taking the birth control pill is three years, says Black. “But the first studies published on this were in 1977, so it’s something that’s been done for a long time. However, we don’t have any reason to suggest that the risks would be any higher than it would be taking the birth control pill in the regular way.”
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Web exclusive: October 2009
