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No More Periods

Eliminating periods with continuous birth control may sound like a woman’s dream, but is it safe?

How to Talk With Your Doctor continued...

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.

There's not much research about effects on adolescent girls, but Miller expresses concerns that the drugs could affect bone density. "That's an important consideration in girls still growing," Miller says.

Pregnancy. If menstrual-suppressing pills are used according to instructions, they seem to work as well as standard birth control pills to prevent pregnancy, Miller says.

Without periodic bleeding, how can a woman tell if she's pregnant? That's a real drawback, Mass says. Miller suggests that women can do frequent urine pregnancy tests at home. "Urine pregnancy tests are very sensitive and good, so first of all, you could use a lot of that. However, the longer that women do the everyday [contraception], the more they trust it. You are very unlikely to ovulate."

On the flip side, some women worry that they won't be able to get pregnant if they've been on continuous birth control. But recent research presented in May 2006 at an American College of Obstetricians and Gynecologists' meeting should offer some reassurance. It found that among 187 women taking the experimental Lybrel, 99% either returned to menstruating or became pregnant within 90 days of stopping the drug.

Sexually Transmitted Diseases. No birth control pills will protect against STDs or HIV infection, so women who try period-suppressing oral contraceptives may still need other forms of protection, such as having their partners use condoms.

Other Conditions. Women with certain conditions shouldn't use oral contraceptives of any kind, for example, those with a history of blood clots, stroke, heart attack, or smokers, especially those over age 35.

Mass recommends that all women on birth control pills see their doctors for a yearly exam that includes a blood pressure check, Pap smear, and breast and pelvic exam.

Reviewed on February 18, 2008

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