No More Periods
Eliminating periods with continuous birth control may sound like a woman’s dream, but is it safe?
So far, there's not enough data to declare menstrual suppression safe, the group says. It calls for greater research into the health effects of menstrual suppression, including effects on bone health, risks for blood clots and strokes, and effects on fertility, among other issues.
Prior worries, too, that continuous oral contraceptive use could increase risk of breast cancer. "My impression as somebody who cares about normal physiology is that the breasts need a break from hormones each month. That's why during menstrual flow, estrogen and progesterone levels are low." With continuous hormones, "the breasts never get a break.
"I think that there are acceptable side effects of hormonal contraception," she says. For example, a woman may be willing to accept increased risk of blood clots as a trade-off for preventing pregnancy. "But if you're going to use this not as a contraceptive, but as a lifestyle thing -- as something just because 'I want to get rid of my period' -- then you have to look at the risks in a totally different light."
How to Talk With Your Doctor
Opting out of periods is so new that doctors have no consensus on how many years a woman should go through normal menstruation before she tries menstrual suppression. Nor are there any age guidelines.
But here are some pointers to help women and their doctors to decide:
Effectiveness. Menstrual suppression isn't a sure bet, Miller says. "It doesn't always work. Irregular bleeding is very common, especially in the first three to six months, and that's a hard thing to go through. A lot of women don't get those four perfect periods."
By six months, 70% of women on extended birth control will have no more bleeding, she says. By one year, the figure rises to 90%. Still, researchers are trying to figure out how to reduce irregular bleeding. Women who don't want to deal with surprise bleeding may want to avoid the new drugs, Miller says.
Age. Which groups should avoid extended or continuous birth control? What about adolescents? "That's a hard thing," Miller says. While no age guidelines exist, Miller says that women aged 18-22 might be the youngest age group that she would recommend for prescriptions.