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Most Women Prefer Having Fewer Periods
New Birth Control Pills May Limit Periods to Every 6-12 Weeks
By Jeanie Davis
WebMD Medical News
June 21, 2002 -- Given a choice, most women would opt to never have another period -- ever again. Now, there's a study showing that by simply taking a few more birth control pills every month, women can indeed enjoy better quality of life sans the period.
The standard birth control regimen is 21/7 -- 21 days of hormone pills, then a hormone-free interval that triggers a week of menstruation. Many women have headaches, cramps, or mood swings during that time of the month -- what doctors call "hormone withdrawal symptoms."
Smaller studies have shown that if women have no periods -- or shorter periods -- it means goodbye to misery.
This is the first large study to review women's satisfaction with an "extended-pill regimen" to create these extended menstrual cycles. Essentially, it means that on day 21 of her pill pack, a woman continues taking hormone pills -- not placebos.
In this study, the 292 women could choose whether to have a period every six, nine, or 12 weeks -- or just when their body naturally developed breakthrough bleeding.
The majority of the women -- 91% -- preferred having a period every three months or never, writes study author Patricia J. Sulak, MD, professor of obstetrics/gynecology at Texas A&M University System Health Science Center College of Medicine in Temple.
Her report appears in this month's American Journal of Obstetrics and Gynecology.
Of that group, 94% reported that their quality of life was greatly improved. There were no unintended pregnancies during the five-year study period, Sulak reports.
The small percentage that chose to stick with the standard regimen cited several reasons:
they preferred having a monthly period,
they didn't have symptoms severe enough to warrant changing
they had fears or concerns about taking hormone pills longer than the usual 21 days.
But is there a downside to taking birth control pills for a long time? "There is no completely safe medicine," says David Grimes, MD, clinical professor of gynecology at the University of North Carolina Hospital System in Chapel Hill.
"Every medicine has a downside," he tells WebMD. "Getting estrogen by itself can be damaging, but in birth control pills we use today, estrogen is counterbalanced by progestin -- or they contain progestin alone. The predominant effect is progestin, which calms the uterus, quiets the endometrium." Also, today's pills contain much lower doses of estrogen than earlier versions, he says.
However, Sulak's findings ring true, says Freedolph Anderson, MD, director of clinical research at The Jones Institute of Reproductive Medicine at Eastern Virginia Medical School in Norfolk.
"Frankly, I can't imagine why [women would] even want one every three months," he tells WebMD.
Decades ago, oral contraceptive pills were developed to give women the reassurance of monthly bleeding -- even though cycles of bleeding are unnecessary, says Anderson.
"If a woman doesn't want to have a baby, there's absolutely no medical reason why she needs to have a period," he explains. If she does not bleed, there are no negative effects on her body or her hormone levels.
The reassurance of a monthly period is certainly legitimate, says Anderson. "If you look at the wide population of women, most would prefer not to have menses regularly as long as it's safe."
But most women don't need bleeding to indicate whether they're pregnant, he tells WebMD. "I really believe most women know if they're pregnant. They feel different immediately, and they can get a pregnancy test at the drugstore that's just as accurate as the ones we use in research."
The body's ability to adapt to hormone changes is obvious, especially when a woman stops taking the birth control pills, he says. "Very quickly -- within days -- her ovaries are working hard again to put out an egg. That's why women get pregnant while they're taking the pill. All it takes is one, two, or three days of missing a pill, and bingo, she's pregnant."
Pregnancy can also occur when a woman's metabolism is causing drugs to be absorbed by the body too rapidly to make them effective.
His studies of shortening the pill-free interval to three days "have gone beautifully," says Anderson.
Earlier this year, Anderson presented results of a study of Seasonale, a birth control product that produces a period seasonally -- every three months. Women taking 84 days of active pills, then seven days of placebos, had nearly 100% effective contraception when compared with women taking standard regimens. Seasonale is not yet approved by the FDA, but approval is expected some time next year.
Most Women Prefer Having Fewer Periods
New Birth Control Pills May Limit Periods to Every 6-12 Weeks
By Jeanie Davis
WebMD Medical News
June 21, 2002 -- Given a choice, most women would opt to never have another period -- ever again. Now, there's a study showing that by simply taking a few more birth control pills every month, women can indeed enjoy better quality of life sans the period.
The standard birth control regimen is 21/7 -- 21 days of hormone pills, then a hormone-free interval that triggers a week of menstruation. Many women have headaches, cramps, or mood swings during that time of the month -- what doctors call "hormone withdrawal symptoms."
Smaller studies have shown that if women have no periods -- or shorter periods -- it means goodbye to misery.
This is the first large study to review women's satisfaction with an "extended-pill regimen" to create these extended menstrual cycles. Essentially, it means that on day 21 of her pill pack, a woman continues taking hormone pills -- not placebos.
In this study, the 292 women could choose whether to have a period every six, nine, or 12 weeks -- or just when their body naturally developed breakthrough bleeding.
The majority of the women -- 91% -- preferred having a period every three months or never, writes study author Patricia J. Sulak, MD, professor of obstetrics/gynecology at Texas A&M University System Health Science Center College of Medicine in Temple.
Her report appears in this month's American Journal of Obstetrics and Gynecology.
Of that group, 94% reported that their quality of life was greatly improved. There were no unintended pregnancies during the five-year study period, Sulak reports.
The small percentage that chose to stick with the standard regimen cited several reasons:
they preferred having a monthly period,
they didn't have symptoms severe enough to warrant changing
they had fears or concerns about taking hormone pills longer than the usual 21 days.
But is there a downside to taking birth control pills for a long time? "There is no completely safe medicine," says David Grimes, MD, clinical professor of gynecology at the University of North Carolina Hospital System in Chapel Hill.
"Every medicine has a downside," he tells WebMD. "Getting estrogen by itself can be damaging, but in birth control pills we use today, estrogen is counterbalanced by progestin -- or they contain progestin alone. The predominant effect is progestin, which calms the uterus, quiets the endometrium." Also, today's pills contain much lower doses of estrogen than earlier versions, he says.
However, Sulak's findings ring true, says Freedolph Anderson, MD, director of clinical research at The Jones Institute of Reproductive Medicine at Eastern Virginia Medical School in Norfolk.
"Frankly, I can't imagine why [women would] even want one every three months," he tells WebMD.
Decades ago, oral contraceptive pills were developed to give women the reassurance of monthly bleeding -- even though cycles of bleeding are unnecessary, says Anderson.
"If a woman doesn't want to have a baby, there's absolutely no medical reason why she needs to have a period," he explains. If she does not bleed, there are no negative effects on her body or her hormone levels.
The reassurance of a monthly period is certainly legitimate, says Anderson. "If you look at the wide population of women, most would prefer not to have menses regularly as long as it's safe."
But most women don't need bleeding to indicate whether they're pregnant, he tells WebMD. "I really believe most women know if they're pregnant. They feel different immediately, and they can get a pregnancy test at the drugstore that's just as accurate as the ones we use in research."
The body's ability to adapt to hormone changes is obvious, especially when a woman stops taking the birth control pills, he says. "Very quickly -- within days -- her ovaries are working hard again to put out an egg. That's why women get pregnant while they're taking the pill. All it takes is one, two, or three days of missing a pill, and bingo, she's pregnant."
Pregnancy can also occur when a woman's metabolism is causing drugs to be absorbed by the body too rapidly to make them effective.
His studies of shortening the pill-free interval to three days "have gone beautifully," says Anderson.
Earlier this year, Anderson presented results of a study of Seasonale, a birth control product that produces a period seasonally -- every three months. Women taking 84 days of active pills, then seven days of placebos, had nearly 100% effective contraception when compared with women taking standard regimens. Seasonale is not yet approved by the FDA, but approval is expected some time next year.