Is It OK to Skip Your Period with Hormones?
Is skipping your period bad for you? Or is it OK?
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Is It OK to Skip Your Period with Hormones?
With the advent of extended cycle contraception (continuous birth control pills such as Seasonale), lots of women are talking about whether or not to have periods. It’s such a juicy topic, I wanted to share with you some thoughts, in case you’re one of those women trying to figure out whether to bleed or not to bleed.
Are Periods Good or Bad?
The only reason you get a period when you’re on the Pill is because those who developed it back in the 1960’s assumed women would prefer to have periods so they would know they weren’t pregnant.
So what’s the deal? Is it good or bad to get periods? Should we have more? Less? Well, it depends. If you’re not on any type of hormonal birth control and you’re not pregnant, nursing or menopausal, it’s not good to skip periods. But if you’re skipping periods because you’re taking hormones, that can be good or bad, depending on how you look at it.
Here are a few of the common questions women ask me regarding using birth control to skip periods.
Is it Natural To Skip Periods With Hormones?
Well, no. There’s nothing natural about the birth control pill, the Depo-Provera shot, or the Mirena IUD. Menstrual cycles while on birth control are not the same as non-hormonal cycles the body has naturally. If you’re not taking birth control, skipping periods can cause overgrowth of the lining of the uterus and lead to problems. But while taking continuous hormones such as Seasonale, skipping periods results from shrinkage of the uterine lining, rather than unshed overgrowth, so there is no need for a monthly period.
Why Do You Have Periods When You’re on The Pill?
The only reason you get a period when you’re on the Pill is because those who developed it back in the 1960’s assumed women would prefer to have periods. Why? So they would know they weren’t pregnant. So they would feel “natural.” Now, pharmaceutical companies are rethinking things, since many women surveyed say they would love to skip periods.
How Does the Pill Work?
When you’re taking the Pill, the period that comes during the placebo week of birth control is the body’s natural withdrawal from taking the hormones. By continuing to take the hormones instead of the placebo, the body does not withdraw from the hormones and no period occurs. This is different than missing menses when not taking birth control. While taking continuous birth control, the lining of the uterus gets thin and periods, when they do occur, are often very light.
Why Would I Choose to Suppress My Menses?
Most patients choose this regimen purely for convenience, to avoid the nuisance of menses and to fit with their lifestyles. However, OB/GYNs have been recommending this regimen for many years for the treatment of endometriosis, PMS, menstrual migraines, anemia, painful periods, mittelschmerz (painful ovulation), ovarian cysts, and heavy periods.
Is Extended Cycle Birth Control As Effective as Regular Birth Control Pills?
Yes. Like traditional birth control, extended cycle birth control is >99% effective if taken correctly and may even be more effective.
What’s the Down Side to Skipping Periods With Extended Cycle Contraception?
Well, it depends how you do it. Birth control pills, the Patch, and the Ring all contain synthetic hormones that may increase the risk of estrogen sensitive problems, such as blood clots and, potentially, breast cancer. Some women are also very sensitive to synthetic hormones and have mood issues, irritability, or exacerbation of other health conditions. Using bio-identical hormones instead may help, but they have not been tested for use as birth control, so there is no bio-identical birth control pill.
Also, because you are skipping the placebo week, you’re getting 25% more hormones in your body, which may pose some risk. Although studies to date have demonstrated safety in using extended cycle regimens, we don’t have long term data yet.
In addition, menstrual cycles give a lot of information about the health of the body, and skipping them may rob you of this useful barometer of health. For example, an anorexic or competitive athlete will often skip periods, a signal that the body is unfit for pregnancy. If you’re taking extended cycle contraception, you’re masking this signal. You may also blunt the natural ebb and flow of emotions and intuition that comes with a natural cycle, but this is the case for anyone on hormonal birth control.
What about the Mirena IUD or Depo-Provera?
Is it okay that I don’t get my period with these methods? Yes. Like other hormonal birth controls, it’s important to understand that these hormones are synthetic. However, because these contraceptives don’t contain estrogen, they are much safer and do not contain many of the risk of the Pill, the Patch, and the Ring.
What if I Don’t Get My Period When I’m Supposed to?
The uterine linings of some women using extended cycle contraception become so thin that they don’t bleed at all. If you don’t get a period, check a pregnancy test and if it’s negative, don’t be concerned. Just keep taking your birth control.
What Do I Think?
Well, I have mixed feelings. I always hated having periods. I was a ballerina, and then, in my medical training, I had to scrub into 8 hour surgeries with no breaks for tampon changes. So I was never particularly moon goddessy about my menstrual cycle.
Personally, I went 9 years using an extended cycle contraception regimen during my medical training and didn’t have a single period until I decided to get pregnant, which happened very quickly once I quit. I never had any side effects and felt perfectly happy not to deal with it. Then I was pregnant. And after that, I was nursing, when I had a Mirena IUD inserted, which also suppressed menstruation.
So now I’ve had my IUD in for 4 years, and I’ve never once had a period. Which works for me. But it doesn’t work for many of my patients. I’m a big believer in listening to your body, tuning into your intuition, listening to your yoni, and going with your gut. My job as a doctor is to educate you about your options, but ultimately, the choice must be yours.
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Thanks for listening to The Girlfriend MD’s Quick and Dirty Tips to understand your body.
Birth Control image courtesy of Shutterstock