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Susan Rako, a Boston psychiatrist and author of The Blessings
of the Curse: No More Periods? “Encouraging healthy young
girls and women to do away with their periods for the sake
of convenience, without educating them about the health
benefits of a normal menstrual cycle, as well as the risks of
menstrual suppression, is irresponsible and unethical.”
20th Century Roots
The notion of using oral contraception to keep menstru-
ation at bay is nothing new. The first “pill” approved by the
Food and Drug Administration (FDA) in 1957 was intended
not as a means of preventing pregnancy, but as a remedy for
severe menstrual disorders. During initial trials, women took
a pill each day, suppressed ovulation and menstruation, and reason men and postmenopausal women have more strokes
for many, their period became a thing of the past. But, under and heart attacks than naturally cycling women is because
pressure from religious groups, who thought not having they don’t bleed—and thus, store excess iron.
periods seemed unnatural, the pill’s creators added a week of Does a week of placebos give breast tissue a nec-
placebos, and the monthly, “withdrawal bleed” was born. essary break from all that estrogen? For anyone, including
“The thinking was that women would find this more celibate women who opt to medicate away menstruation and
acceptable, that they would feel like they were having their its unpleasant symptoms, do the benefits outweigh the risks?
normal period,” says Susan Ernst, a medical doctor and chief For the most part, experts agree those questions haven’t been
of gynecology services for the University Health Service at answered.
the University of Michigan. Ever since, doctors have quietly Critics also point out that cycle-stopping pills are notori-
advised women with a looming honeymoon or camping trip ous for prompting spotting between periods. Because they
to simply toss out the placebos and skip to day one in their use lower hormone dosages to make them safer for continu-
next packet. ous use, some fear they may not be as effective in preventing
In the past decade, as drug companies have scrambled pregnancy. For example, in one Wyeth-sponsored study of
to repackage and thus, renew patents on old contraception, 2,134 women, 15 women who took the pills correctly got
the once-hushed notion of ongoing menstrual suppression pregnant, anyway.
has become an industry, propelled by a marketing machine. Even the FDA has scolded advertisers of Seasonale and
That worries Christine Hitchcock, Ph.D., a researcher Yaz for overpromising freedom from menstruation-related
with the Centre for Menstrual Cycle and Ovulation problems, while underplaying the risks. In February 2009,
Research, in British Columbia: “We just don’t know what the Yaz began running a $20 million corrective ad campaign in
long-term risks are,” she says. response to FDA complaints.
On the other hand, Miller points out, periods can be
painful and inconvenient and having fewer or none can be
Evaluating the Risk
liberating. Because Western women have fewer children and
don’t nurse as long as they used to, they have nearly four
Data from the Women’s Health Initiative, a 15-year times as many periods as those in primitive, agricultural soci-
research project funded by the National Institutes of Health, eties. Ovulation and menstruation are about getting preg-
has shown repeatedly that oral contraceptive use is linked nant,” Miller concludes. “If you aren’t going to get pregnant,
to increased risk of stroke, heart attacks and blood clots in you shouldn’t have to bleed.”
women. According to the NIH, studies also have shown Medical issues aside, the idea of stopping menstruation
that women who take birth control pills are at greater risk of carries with it significant cultural implications; many see it as
breast cancer. A 2006 review in the journal Adolescent Medi- nothing short of a threat to womanhood.
cine found that use of certain forms of oral and injectible “I think, as a culture, we have come a long way in try-
contraceptives can prompt accelerated bone loss, or stunted ing to prepare young girls for menarche and tell them this
bone growth, in teen users. Although the data, overall, is is an exciting time in their lives,” observes Ingrid Johnston-
inconclusive, a few small studies over the years have even Robledo, an associate professor of psychology and women’s
suggested such pills may interfere with testosterone produc- studies at The State University of New York at Fredonia.
tion, prompting reduced libido and depression. “Now, we are sending a message that it is extremely bother-
By skipping the placebos and taking The Pill continu- some and debilitating. It’s really pathologizing a natural
ously, are women further boosting these risks? bodily function.”
Other questions loom. Does bleeding itself rid the body
of harmful elements such as precancerous cells in the uterine Lisa Marshall is a freelance writer in Estes Park, CO.
lining or excess iron? Researchers have hypothesized that the Reach her at LisaAnnMarshall.com.
May 2009 25
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