December 30, 2009

No More Periods: Is This a Good Idea?

by ErinORiordan

Many of today’s newer birth control pills are specifically marketed for a new reason, other than birth control itself: menstrual suppression

Returning Mother Nature’s Gift

Birth control pills stop women and girls from having menstrual cycles. They prevent the ovaries from releasing an egg and prevent the lining of the uterus from thickening. That’s why the pill results in shorter, lighter periods.

Traditionally, a package of birth control pills contains five to seven “sugar pills” (placebos) that don’t have the hormones (almost always synthetic estrogen and progestin) in them. While she’s taking the sugar pills, the woman has bleeding from her uterus. It’s not really a period, because the pills have suppressed the cycle; it‘s referred to as “withdrawal bleeding” because the woman‘s body is in withdrawal from the synthetic hormones. But now, certain kinds of birth control pills come without any placebos. Girls and women supposedly never have any days of bleeding (other than occasional spotting) while taking them.

The trade names of birth control pills marketed as menstrual suppression options include Seasonale, Seasonique, and Lybrel (also called Anya). Seasonale and Seasonique come set up so that the woman taking them has a period once every three months, or only four times a year. With Lybrel, there are no placebos and no periods. (In reality, many of the women who take these birth control pills for menstrual suppression do experience some breakthrough bleeding, especially during their first year of taking the pill. Other women find that instead of predictable cycles, the new pills cause them to have unpredictable and irregular bleeding.)

For girls and women with certain medical conditions, such as uterine fibroids, endometriosis, or severe cramps, periods can be very painful. For them, suppressing the menstrual cycle might be a good thing. Menstrual suppression has also been used as a treatment for perimenopausal symptoms, including hot flashes and night sweats. Girls and women now also have the choice of suppressing their cycles for convenience rather than for medical reasons. Is this a good idea for women with healthy menstrual cycles, or do these women need to have a monthly period?

The Case for Red-Lighting Your Red Dot

Advocates of menstrual suppression say that if three weeks of hormone pills per month are safe, four weeks of hormone pills per month increases only slightly the risks associated with birth control pills. (All birth control pills slightly increase a woman’s risk of blood clots, stroke and heart attack, and may also increase a woman’s risk of cervical cancer.) They cite the fact that women have been taking birth control pills for more than 40 years, and the amount of estrogen and progestin in modern pills is much less than what women on the earlier pills received.

The Association of Reproductive Health Professionals also claims there are non-menstrual benefits to menstrual suppression birth control pills, including a reduction in migraines, a reduction in acne, and “an increased sense of well-being.” A survey by the ARHP suggests that most women don't have an emotional attachment to having their monthly periods. Only 8% of women in this study responded "yes" to the statement "Sometimes I enjoy having my period."

One reason women cite for wanting to suppress their periods is embarrassment. There is still a social stigma attached to menstruation that makes us uncomfortable talking about it in public. We worry about telltale odors and blood leaking onto our clothes. Though I was in an upscale home the other day where the decorations in the guest bathroom included a lovely silver bowl of tampons, this is the exception rather than the rule. For most women, periods are still our dirty little secrets.

Tampon use is also associated with a host of negative side effects. In the 1990s, some commercial brands of tampons were found to contain traces of dioxins, a chemical byproduct thought to be carcinogenic, detrimental to the immune system, and a possible cause of birth defects. Studies have also suggested a link between dioxins and higher rates of endometriosis. There is also a known risk of toxic shock syndrome associated with tampons; it killed thirty-eight women in a single year, 1980. Wouldn’t women really be healthier without having to use tampons?

Keep, Keep Bleeding, Love

Although there are many researchers who say that menstrual suppression is safe, not everyone agrees. Some say that we need periods to get rid of the excess iron that we store in our bodies. This “iron theory” states that the reason for the elevated risk of cardiovascular disease in men and postmenopausal women is that having a monthly period protects the heart. For this reason, health care providers sometimes advise women who practice menstrual suppression to donate blood to prevent excess iron from building up in their bodies.

According to Dr. Susan Rako, another unintended side effect of menstrual suppression is lowering a woman’s body’s natural level of testosterone. Though much lower than the level typically seen in men, testosterone is necessary for female bodies, too, where one of its effects is helping to regulate sex drive. Some women who take the newer birth control pills report wanting to have sex less frequently and decreased sexual pleasure.

The National Women’s Health Network has expressed concern, not so much in that menstrual suppression isn’t safe, but that the way these products are marketed by drug companies and health care providers is misleading. The NWHN cites instances in which scientists have speculated that menstrual suppression might decrease the risks of breast, endometrial and ovarian cancers without studies to provide evidence for or against these claims. There have also been several claims that because women in earlier times had fewer periods (due to shorter life spans and frequent pregnancies, among other causes), it may be “unnatural” for women to have monthly periods.

Of course, the myths about the evils of menstruation have been around for centuries. The ancient Greeks held that the touch of a woman on her period “could blast the fruits of field, sour wine, cloud mirrors, rust iron, and blunt the edges of knives.” It was said that if a menstruating woman touched a beehive, the bees would fly away and never return. In early Christianity, menstruating women were forbidden to enter a church. In the Talmud it is said that if a menstruating woman walks between two men, one of them will sicken and die.

As quaint and even humorous as some of these old myths now sound, the concern about misleading information is a legitimate one. The portrayal of a monthly period as negative is especially important when it comes to girls. Girls who haven’t yet had their first period, or who have recently started having periods, deserve to have accurate information. The attitudes they have towards their periods at this early developmental stage may affect the way they think about their periods, their bodies, and themselves for the rest of their lives.

Inside the Red Tent

Many women also feel that there is much more to the body’s natural menstrual cycle than just blood, cramps and a pissy mood. The cycle of our bodies connects us to the rhythms of nature, of the earth, and of the moon. In many ancient cultures, menstrual blood was considered sacred. Before our ancestors were able to see sperm under the microscope, they believed the blood in a woman’s womb held the magical secret to creating life. The cauldron, or womb, full of blood was an ancient symbol of the Goddess, retained to this day in the tradition that witches bear cauldrons. Old women were considered the wisest and most magical members of the community because they permanently retained their menstrual blood in their bodies. You don’t have to believe in witchcraft, though, to appreciate the positive aspects of menstruation. Some women feel energized when they bleed, and create “menstrual lodges” where they can get away from work and family while having their periods. In these lodges they may let their menstrual blood flow into the earth. They also focus on using their intuition, dreaming dreams, writing poetry, and coming up with creative new ideas.

Besides, as health care practitioner Geraldine Matus says, men’s ejaculations can be just as messy, embarrassing and inconvenient as women’s periods, yet men don’t suppress them!