Menstrual periods may soon be passé, according to several leading women’s health experts. Sound too good to be true? It’s not, says Carolyn Westhoff, M.D., professor of obstetrics and gynecology and public health at Columbia University, who recently spoke at a press briefing in New York City, sponsored by the Coalition for Cycle Freedom of Barr Laboratories, Inc. With traditional oral contraceptive regimens, hormones are taken on days one through 21; on days 22 through 28, a woman takes placebo pills. During this time, withdrawal bleeding occurs. The use of hormones back-to-back with no placebo, however, eliminates monthly bleeding, Dr. Westhoff explained. “The continuous method provides excellent contraceptive protection — maybe better than traditional,” she said. What’s more, she added, the continuous method has been shown to lower risk of breast and gynecological cancers.
For many women, monthly periods are heralded by mood swings, bloating, migraine headache and other physical symptoms that make menstruation unbearable. For years, some doctors have been prescribing "continuous" oral contraceptives to treat such conditions as endometriosis, migraine and iron-deficiency anemia. But once there is an FDA-approved long-interval pill regimen, more women will have the option to control their cycles, experts say. One such pill, Seasonale, is being studied by Barr Laboratories in Pomona, N.Y. With Seasonale, women take the product for up to 84 consecutive days, followed by seven days of placebo. The regimen is designed to reduce the number of withdrawal bleeds from 13 to four per year. It’s what women want, Dr. Westhoff says. “ Across all age groups in three surveys, women said they would like shorter, lighter and less painful periods.” In one survey, 75 percent of the women said they would want their periods less frequently — or never at all,” Dr. Westhoff reports. “If it could be done safely, women said that they would be interested in fewer periods.” In fact, more than 90 percent of the women in the studies already taking oral contraceptives say that they chose to take them longer then the traditional 21 days to limit the number of times they experienced withdrawal bleeding, and 94 percent said that their quality of their life improved by doing this. Estrogen and progestin are the main hormones included in birth control pills. Estrogen causes the uterine lining to grow and thicken; progestin inhibits ovulation. When women stop taking active pills, the uterine lining begins to shed, resulting in bleeding. Oral contraceptives were originally developed to include a monthly menstrual period so that they would seem more "natural”, but there is no real reason for it, Dr. Westhoff explains. While not getting a monthly period may seem unnatural, experts say that throughout the centuries, most women did not menstruate as regularly as we do today. In the past, women had an average of six pregnancies and breastfed for one to two years after each pregnancy. Today women average two or three pregnancies and breastfeed for a few months, if at all. In addition, puberty began at age 16 in the past; now the average age is just over 12. Many women in the past had their first birth at 19.5, but today it is closer to 25. Menopause, too, occurs later. While some women may have concerns that this method may limit their chances of conception when they are ready to start or continue their family, that’s not the case, the panel experts said. “No matter how long a woman takes oral contraceptives, she will be just as fertile or infertile as she would have been before,” said Hester M. Sonder. M.D., clinical instructor at the Temple University School of Medicine in Philadelphia. As always, women should talk to their care provider about such options.