When I first asked female friends and family members about it, they were unanimous -- menstrual suppression is unnatural, they said. However, they all liked the idea of ditching cramps, bloating, irritability and the other not-so-nice symptoms associated with a monthly period. But is menstrual suppression detrimental to a woman's health or is it a safe solution to controlling what comes naturally?
How does menstruation suppression work?
Many women, using either 21- or 28-day oral contraceptive packets, already subject their bodies to the hormonal effects of menstrual suppression. The pill typically consists of synthetic hormones estrogen (which suppresses ovulation) and progestin (which thickens cervical mucus and changes uterine lining, reducing the changes of fertilization and implantation.) There's also an oral contraceptive that contains only progestin.
The vaginal bleeding that occurs for most women in the last week of taking the birth control pill happens as a result of estrogen and progestin withdrawal. The last week's worth of pills in a cycle have no active ingredients and this allows the uterine lining to break down. This is known as "withdrawal bleeding" and not "menstruation" because the pill shuts down the normal menstrual cycle by suppressing ovulation.
Contraception options
But there are currently two ways to extend the time between periods: The first is the well-known method of using a 21- or 28-day pill packet and altering your use of them. Rather than taking a final week's worth of the inactive pills, women take active pills consecutively, allowing them to "customize" their cycles according to their lifestyles (so they can go period-free on a honeymoon, on vacations, etc).
Another method of keeping menstruation at bay, not yet available in Canada, commits a woman to 12 consecutive weeks without a period using a pill cycle that reduces a woman's period from once a month to four times a year. The appropriately named Seasonale contains the same combination of low-dose estrogen and progestin contained in many oral contraceptives but it contains three months worth of active pills instead of the typical three weeks.
Expert opinions
Although some women perceive prolonged menstrual suppression as unhealthy, according to gynecologist Nancy Durand of the Sunnybrook & Women's College Health Sciences Centre, it can be a welcome solution for painful periods. "Some people feel so horrible on their natural cycle, but being on the pill may make patients feel more stable." Those who benefit most include women who suffer from endometriosis and other severe symptoms associated with menstruation.
But are medications like Seasonale safe? According to Durand, women who have a history of blood clots, high blood pressure and/or smoking should remain cautious. "Obviously, anybody who shouldn't be on the pill shouldn't be on this [Seasonale]." Durand also cautions that some women may experience "breakthrough bleeding" meaning they may experience some bleeding between periods.
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