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    FDA OKs 'No-Period' Birth Control Pill

    Lybrel Is 1st Oral Contraceptive Designed to Stop Menstruation

    Breakthrough Bleeding continued...

    The other women experienced sporadic bleeding or spotting that diminished with time, Shames notes.

    "Women are going to have to decide whether they want to begin this experience, and understand that it's going to take them a while before they perhaps get to where they want to be, which is having no bleeding or spotting," Shames says.

    As with other low-dose contraceptives, "you need to be sure to use some other form of contraceptive if you find you've missed a pill or forgotten a pill," says Shames.

    Because Lybrel eliminates periods, women who suspect they may be pregnant should take a pregnancy test, Shames notes.

    Eliminating Menstrual Cycles

    While Lybrel is the first oral contraceptive designed to completely stop menstruation, Steve Goldstein, MD, says that's not as dramatic as it sounds. Understanding how the menstrual cycle works helps to understand why.

    Normally, says Goldstein, a rise in hormones linked to ovulation causes the lining of the uterus to thicken in anticipation of a fertilized egg. If fertilization does not occur, hormone levels drop and the lining is shed in the form of menstrual blood. Oral contraceptives, however, change that activity.

    "The pill shuts down your normal hormone production and replaces it with a very tiny amount, so there is no buildup of the uterine lining," says Goldstein, a professor at NYU Medical Center in New York City. Without a lining, there is no shedding, so the bleeding that occurs when you stop the pill is a "withdrawal bleed caused by a drop in hormones," explains Goldstein.

    Goldstein tells WebMD that the monthly bleeding that occurs during pill use is unnecessary, so avoiding it -- the way you can with Lybrel -- should have no impact on health. Moreover, Goldstein says the menstrual cycle and fertility should return soon after stopping this pill, much the way it does with other oral contraceptives.

    In at least one study conducted by Wyeth and presented at the 2006 annual meeting of the American College of Obstetricians and Gynecologists, 99% of 187 women taking Lybrel for one year either returned to menstruating or got pregnant within 90 days after stopping the drug.

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