“The talk,” as I received it, included some variation on the phrase, “Women menstruate and it’s a pain, but you’d better learn to live with it.” Not knowing there were other options, I accepted monthly periods as just another inescapable, incontrovertible part of being a woman. Not the most exciting or fun part, but an important reminder of what it is our bodies are meant to do.
Having menstruated for almost two thirds of my life now, it’s become just another part of the routine. Once a month, I just write myself another note to buy tampons and I get on with life. There are definitely times when it becomes a bother, so I, along with many other women on the Pill, forego the inactive pills in the pack so I can purposely skip my periods to accommodate vacations and important events. According to the Association of Reproductive Health Professionals, 71 percent of women would rather not have a monthly period. Maybe we don’t want periods every month, but do we need them?
The invention of the birth control pill has had more impact on women’s lives than almost any invention of the past hundred years. The Pill prevents pregnancy by fooling the body into thinking it’s already pregnant, so it doesn’t ovulate. It has allowed women to control their reproductive lives and enter the workforce in record numbers. Besides pregnancy prevention, the health benefits of the Pill are also numerous: it reduces cramps and PMS, inhibits acne, protects against ectopic pregnancy, and lessens the likelihood of ovarian cysts, ovarian cancer, and endometrial cancer. It also offers shorter, lighter periods.
Menstrual periods are shorter and lighter on the Pill because they’re not real periods. Real menstrual cycles are dictated by the rise and fall of hormones, but many modern pills are comprised of only a single hormone level. Without ovulation and the real interaction of hormones, what women experience as a “period” is really just withdrawal bleeding from the Pill’s one-week absence of hormones.
The co-inventor of the Pill, John Rock, was an observant Catholic and when developing the formulation, he realized that the Pill could control the length of the menstrual cycle. Rock decided that by adding a week where women experienced a “period,” he could mimic regular menstruation and make the pill seem more natural. The “period” experienced on the Pill was originally nothing more than a marketing gimmick.
Since the withdrawal bleeding isn’t medically necessary when you’re on the Pill, pharmaceutical companies have begun to offer women period control as a lifestyle choice. “Too busy for a period? Don’t have one!” they say. “Who says you have to have a monthly period on the Pill?” ask the ads for Lybrel, approved by the FDA in 2007. It went one step further than the four-periods-per year pills by stopping the menstrual cycle altogether. Women who take pills like Lybrel and Seasonale experience the same risks and benefits as women who take a regular pill, but with the added bonus of fewer or no monthly periods. When Seasonale hit the market in 2004, women who wanted fewer periods greeted it with enthusiasm, but when Lybrel arrived, many skeptics were unsure. Wanting fewer periods is understandable, but is it natural not to have periods at all?
Too Many Menses
Many doctors claim that since there’s pseudo-periods aren’t real, there’s no harm in eliminating them. Women often skip the inactive pills in their packs anyways, when they want to avoid having their period while on vacation or over a holiday, and gynecologists have endorsed that practice for years. Rather than being harmful, there’s actually a case to be made that suppressing menstruation is good for women’s bodies. For most of human history, women had far fewer menstrual periods than women do today. During hunter-gatherer days, women started menstruating later, spent more time pregnant or breastfeeding, and their life expectancy was shorter. Overall, experts estimate that those women experienced only about 160 periods in their lifetime, compared with the 450–500 periods that modern women have.
Numerous studies link the number of menstrual cycles a woman has with her risk of ovarian, breast, and endometrial cancer. Women who have more periods have a greater risk of developing these cancers. It’s widely known that having children and breastfeeding have a powerful impact on cancer risk, because they give a woman’s body a break from menstruation. Fewer periods also helps prevent anemia and mitigates the symptoms of PMS.
A Necessary Evil?
Some doctors feel that the long-term effects of pausing menstruation are unknown and we can’t yet know whether drugs like Lybrel or Seasonale are safe. Experts who are against menstrual suppression argue that a woman’s period is important because it flushes away harmful bacteria and dead cells, which could cause diseases of the reproductive tract. Anti-suppression doctors also theorize that menstruation allows women to rid the body of excess iron, which may be a risk factor for heart attacks and strokes. Also, the hormones used in the Pill can diminish a woman’s sex drive over time, especially if taken regularly without a break. On the philosophical side of the argument, feminists and physicians alike argue against turning the normal, healthy process of menstruation into just another messy, inconvenient affliction that should be managed with medication.
Since Seasonale, Lybrel, and the regular pill all work the same way, with the same risks and benefits, it’s left up to the woman to choose which pill fits into her lifestyle. Some women prefer traditional pills, since getting a monthly period reassures them that they’re not pregnant. Other women have embraced the new period-suppressing forms of contraception, rejoicing in the freedom they provide. Talking to a doctor is the best way to decide what’s right for you but medical evidence suggests that the new forms of birth control are perfectly safe. Only one thing is for sure—they will save you money on tampons.