Fewer Periods? Sign Me Up!

  • By:  Emily Nobles, WHNP

For most women, reducing the number of periods you have is as easy as taking a pill.

The combination birth control pill continues to be one of the most common and well-known forms of contraception. It is called the combination pill because it uses a combination of estrogen and a progestin (a man-made form of the body’s hormone progesterone) to prevent ovulation. While it is a familiar and effective form of birth control, it is also used in the treatment of a variety of medical conditions. What many women do not know is that it can also be utilized to reduce the number of periods a woman has in a year.

There are a number of reasons for women to skip their monthly bleeding. Some women with medical conditions, such as endometriosis, benefit from not having a monthly cycle. Another reason a woman might benefit from skipping a period is if she experiences uncomfortable symptoms such as painful menstrual cramps or heavy bleeding with her cycle. Even the simple inconvenience of being on your period during travel, or when on deployment, or during a special event might cause some women to wish they could go without monthly bleeding.

Many patients ask whether it is safe to go an extended time without having a menstrual period. If a reproductive-age woman is not having a menstrual period regularly and she is not on a birth control or another medication to regulate her periods, then she should be evaluated by her doctor to determine why she is not having a menstrual cycle and to make sure the lining of the uterus (or endometrium) is not becoming too thick.

However, if a woman is on a hormonal medication designed to stop her monthly periods, then it is safe for her to not have a monthly period because her uterus lining is being protected with a progestin. It is not medically necessary for a woman to have a period once a month or in any regular interval if she is using a medication or hormonal birth control device.

One way to reduce or eliminate monthly menstrual bleeding is to use the birth control pill continuously. The combination birth control pill uses both estrogen and a progestin to prevent ovulation. Birth control pills most commonly come in packages with 21 active, hormonal pills and 7 inactive, or placebo, pills. When a woman takes the placebo pills, the levels of hormone drop and trigger her to have a “withdrawal” bleed.

Women on the combination pill do not have a true menstrual cycle every month because they are not ovulating. The bleeding they are having is designed to happen once a month to mimic a natural cycle. The birth control pill has been shown to be effective in reducing the amount of bleeding a woman has each month, and many women report that they have less menstrual cramping when on the birth control pill.

To use the combination birth control pill to reduce or eliminate periods, a woman takes an active pill every day and skips the placebo pills. There are brands of birth control pills that are pre-packaged to allow a woman to take birth control pills continuously and to have a period only four times per year.

A woman may also work with her healthcare provider to be prescribed more packages of birth control at a time and skip taking the placebo pills. Additionally, the contraceptive vaginal ring can be used in a continuous manner, and women on this birth control method can talk to their provider about how the ring can be used to skip periods.

There are several benefits of taking birth control continuously. Women on continuous birth control experience reduction in monthly menstrual symptoms, such as cramps, headaches, and bloating. Continuous birth control is also a good treatment option for women with heavy or prolonged bleeding. Continuous birth control may also be a treatment option for women with medical conditions, such as endometriosis, menstrual-associated migraines, fibroids, and anemia.

Women may also save money by taking the pill continuously because of reduced costs associated with monthly menstrual products, such as pads and tampons. For many women, the convenience of not having a menstrual cycle is another added benefit. In addition to the benefits of continuous use of oral contraceptives, studies have shown that continuous use of the birth control pill is just as safe as cyclic (or typical) use of the medication.

Despite benefits of continuous use of birth control, there are some drawbacks to this method as well. The most common side effect of using the birth control pill continuously is “breakthrough,” or unscheduled, bleeding. Unscheduled bleeding is most likely to occur in the first few months of being on a continuous birth control regimen, and for many women it will go away after continued use. The amount of unscheduled bleeding will also depend on the specific dosage of estrogen and progestin component or use of a pill versus the contraceptive vaginal ring.

While skipping menstrual cycles by using a hormonal method may sound like a great option, not all women are candidates to be on hormonal therapy. It is up to your healthcare provider to determine if the combination pill or ring, whether used cyclically or continuously, is a good option for you.

But if you are a candidate for taking the combination birth control pill, be sure to talk with your healthcare provider if you are interested in using this method to reduce the number of periods you have in a year. It is a safe and effective option for many women who do not wish to have a period every month.

Emily Nobles, WHNP, is a nurse practitioner at Atlantic Ob/Gyn located in Va. Beach and Chesapeake. Please visit www.atlanticobgyn.com.

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