Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Using the Pill to Have Fewer Periods | | | QUESTION | | | Dear Dr. Greenfield,
My friends were saying that women are supposed to only get their periods nine times a year, not every month. And, that it's better not to get your period at all. They said some women on the pill just keep taking them without ever stopping between packages--so that they don't get any period at all. I've always heard that NOT getting your period is a bad sign.
Should I believe my friends or are they just spreading rumors?— Confused in Menlo Park, CA | | | ANSWER |
March 22, 2002 | | | Dear Confused,
This is a great question and one that I have been asked a lot lately in my practice.
First some background. Traditionally, birth control pills were packaged to mimic the normal 28-day cycle, with three weeks of real pills, and one week of empty pills that allow menstruation. This makes some women feel like everything is working right and gives confirmation each month that they aren't pregnant. But there isn't any medical reason that pills have to be taken this way. Many women would prefer to have fewer periods, as long as it is safe. There is a pill that I have heard will be coming out soon called Seasonal, packaged to allow a period four times a year (once each season, hence the name). Since this pill isn't available yet, some doctors are prescribing women to take active pills for more weeks in a row, before allowing menstruation. This is safe, although a little more expensive, since a pack only lasts three weeks. Also some women get breakthrough bleeding when they take active pills for more than three weeks at a time, and erratic bleeding often isn't viewed as preferable to predictable periods.
Why is it okay to make yourself miss periods on the Pill, but a bad sign when it happens on its own? If you aren't on birth control pills, missing periods is a sign of a hormonal imbalance. Most women who skip periods aren't ovulating regularly--they have the hormone estrogen without the balancing effects of the hormone progesterone. This situation is called unopposed estrogen. In this case, the uterine lining is building up and not shedding, which can lead to hemorrhage and later in life can even cause cancer of the uterus. Other women who don't get regular periods have low levels of estrogen and progesterone, putting them at risk for osteoporosis. When someone on the Pill doesn't get her period, we know what hormones are in her body, and we know that she has both estrogen and progesterone. Women who have both of these hormones do not build up their uterine lining, and aren't at increased risk for hemorrhage or cancer, and women on the Pill are at decreased risk for osteoporosis.
So the bottom line is that taking pills with less frequent breaks (and therefore less frequent periods) may be the wave of the future--as long as you are comfortable with not having periods to show you that you aren't pregnant and are lucky enough not to get a lot of breakthrough bleeding as a side effect. Any woman planning on taking pills in an alternative way should discuss it with her physician to be sure that it is appropriate for her particular situation. I hope that this answers your questions. Good luck!— by Marjorie Greenfield, M.D. |
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