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The No-Period Pills

The newest birth control pills suppress women's menstrual cycles. But is this wise?
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WebMD Feature

Let's face it, many women dread getting their monthly period. So take a minute to imagine this: What if you could take a birth control pill that reduced your periods from 13 to 4 each year? What if you could schedule life's big events - vacation, a wedding, family gatherings - around your "spring" period, or your "summer" period, or your "fall" period?

Pharmaceutical companies and many doctors are betting that women will jump at the chance. The first of these so-called continuous birth control pills, Seasonale from Barr Laboratories, will hit the market this fall. Others will likely soon follow. Surveys have shown that many women are enthusiastic about the idea of having fewer periods. Already, researchers at a number of institutions are now studying a pill that would involve menstruating only once a year. But a few gynecologists worry these pills may boost a woman's lifetime hormone exposure, with unforeseen health consequences.

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The truth is, some women have been using birth control pills to suppress their periods for decades. All you have to do is buy three extra packets pills a year, and substitute your extra active pills for the placebos each month. But many women don't know about this option. It's certainly not advertised. And insurers usually won't pay for the extra pills. As a result, continuous birth control pills could create huge new demand.

Is It Safe?

Is it safe to turn off your cycle for so long? Many doctors say yes. In fact, oral contraceptives were originally designed as a continuous-hormone model, but the "placebo week" was inserted for "purely cultural reasons," says Carolyn Westhoff, MD, professor of obstetrics and gynecology at Columbia University. "It was thought that women would find it reassuring to get a period every month. The week off was inserted not for biological reasons, but just to make women and doctors more comfortable." In fact, she says, the overall hormonal dosage found in the new Seasonale pill is lower than that in the most popular oral contraceptive on the market today, Ortho Tri-Cyclen.

Mitchell Creinin, MD, is a researcher studying the one-year pill, and he agrees. "The idea that a woman 'needs' to have a period is folklore. The blood doesn't build up inside, and it has nothing to do with cleaning out your system or proving that you're normal," says Creinin, director of family planning in the obstetrics and gynecology department of the University of Pittsburgh's Magee-Women's Hospital. "There's no biological plausibility that a one-week break confers any protection against anything. At the turn of the century, the average number of menses per year was one or two, because women were breastfeeding or pregnant more often."

So far, these researchers say, the most common drawback to continuous birth control is that some women have unpredictable spates of breakthrough bleeding. "Women will have individual responses to this regimen," says Westhoff. "Some women will respond very well, won't have any breakthrough bleeding at all. Others will have more spotting, and some of those women will probably want to go back to the original method and know when they're going to bleed. That's why we want to have a lot of options available. No birth control method is going to be ideal for everybody."

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