No Period? No Problem!


The first birth control pill that is designed to stop menstrual cycles indefinitely was approved by the FDA (Federal Drug Administration) last month. Expected to be in stores this July, Lybrel is marketed as the "no period pill."

But this isn't exactly new information or technology. Despite the fact that this new product is the first FDA approved birth control pill for this purpose, health care providers have long known that other types of birth control can be used to skip periods. They have advised patients to just skip the placebo/spacer pills in certain types of birth control pills and start a new pack if they want to skip their period (similar to the pill, the birth control ring and the patch can also be used to skip periods).

Medically, there is no reason to have a monthly period when taking hormonal contraception—which prevents ovulation and build up of the uterine lining. The placebo/spacer week in pill packs were developed because pharmaceutical companies thought women would feel unsettled or unnatural not having their period. Women taking hormonal contraception experience withdrawal bleeding during the week of placebo pills because of the gap in hormones; taking the pills continuously eliminates the withdrawal bleeding.

Reaction has been mixed. Most women's health advocates see this as a minor step in expanding birth control options and a way to help women who experience difficult periods. The Reproductive Health Technologies Project (RHTP) didn't even release a statement because Lybrel's approval wasn't big news. But RHTP's president, Kirsten Moore, said, "Any method that's been shown to be safe and effective and that can provide a woman with the option to prevent unintended pregnancy is good."

Many conservative groups had knee-jerk reactions about the "unnaturalness" of skipping periods and lamenting the affront to fertility. (Watch the video of Leslie Unruh, President of the Abstinence Clearinghouse, debating Lybrel on Fox News—she calls birth control "pesticides" and accuses Big Pharma of "playing God.") These statements highlight the fact that these groups are opposed to contraception in the first place, regardless of whether it's designed to reduce or eliminate menses. (Along the same lines, some feminists have complained that Lybrel sends a negative message about menstruation.)

Following suit, the mainstream media has had a field day with Lybrel's approval, discussing the potential implications of women eliminating their menstrual cycle on society and family life, and how having a period affects their very identity as women. ABC News ran an article called "Gender Bender: Redefining the Curse of Menstruation. Women Reexamine Their Identities As They Embrace the New Pill." The New York Times wasn't as inflammatory, but still didn't get it right. William Saletan at Slate.com considered the possibility that some women would skip their periods "to satisfy other" like their boyfriends or coworkers. Reporters either didn't know or didn't care that they were buying into Lybrel's marketing hype and contributing to gender stereotypes.

Plan B experienced even greater negative reactions when it was approved by the FDA. Yet this also is not an altogether new technology—health care providers had previously been prescribing regular birth control pills as emergency contraception. If Plan B works like regular birth control, why all the fuss? Kirsten Moore explains:

I think it's a basic underlying understanding of anatomy; it was really hard for the public to understand that pregnancy doesn't happen in one moment—it's a process. In the cultural mindset, sex and pregnancy are one and the same, but biologically they're not. Also, a good chunk of the opposition to Plan B came from people who object to contraception. It took heavy education and basic information efforts, but once people understood that it worked like birth control, that opened doors.

As contraceptive technology advances, we will continue to see opposition to new methods. But at the heart of the matter is the fact that opponents don't want women to be able to use contraception at all.

Marcy Bloom, former executive director of Aradia Women's Health Center, adds:

As long as these "new" technologies truly support women's choices, health, and freedom, they need to be viewed as simply the innovative use of science to advance women's lives … and that is what we all want. Inserting right-wing anti-women's sexuality messages into the discussion demonstrates, yet again, the conservative agenda that points to their anti-contraception position and to the ultimate control of women. 

We must continue to educate and work towards the right for everyone to decide for themselves whether and when to start a family. Plan B and Lybrel are simply two additional safe and effective methods for doing so.

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  • invalid-0

    You don’t produce eggs, you don’t have to bleed.
    Some people are stupid. Keep bleeding unnaturally if it makes you feel safe, I’ll be enjoying my no period life.

  • invalid-0

    Dear Tyler:

    I’ve just started reading your blog and I respect your work as a sexual health advocate. It’s great to get a young woman’s point of view on these issues. I would like to offer you another perspective on those who urge caution in the menstrual suppression debate. I am one of them.

    There is much valid concern over the move towards cycle-stopping contraceptives as a life-style choice by many who study and research menstruation and menstrual cycle functioning or work with women in clinical and educational settings. We are by no means all right-wing, anti-contraception fanatics. Quite the contrary.

    First let me state I am a Canadian with over 20 years experience as a pro-choice sexual and reproductive health and rights advocate/activist. I served 10 years on the board of directors of Planned Parenthood Federation of Canada (now Canadian Federation for Sexual Health). I currently am Executive Director of Sexual Health Access Alberta (formerly PP Alberta), a small non-profit org that does sexual health public education and advocacy. (Many Canadian PP affiliates have been making the transition to new org names that include the broader based phrase: Sexual Health, though some remain Planned Parenthoods. All are pro-choice.)

    I also am a member of the Society for Menstrual Cycle Research (www.menstruationresearch.org) a multi-disciplinary organization that will be posting our updated statement on menstrual suppression within a few days. We just held our 17th biennial conference in Vancouver, BC last week. Contrary to your representation of menstrual suppression detractors as conservative, anti-choice sterotypes, the SMCR is anything but. The society is a group of medical professionals, scientists, academics, clincians and women’s health advocates who deem the menstrual cycle worthy of study. You can link to the work of many members from the above noted site.

    So let’s talk about “choice”. What most young women are not aware of are the many health benefits associated with ovulatory menstruation. Your statement that “medically, there is no reason to have a monthly period when taking hormonal contraception—which prevents ovulation and build up of the uterine lining.” though accurate to some degree, is too often construed to mean there is no reason to ovulate or menstruate, period. I have heard this statement mentioned in many news reports on Lybrel’s FDA approval.

    But is it really true? Scientific research indicates that normal ovulatory menstruation is associated with bone, breast and cardiovascular health, sexual desire and sexual response, thyroid function and immune function. There are many benefits to good health that accrue to women who ovulate and menstruate. In other words ovulation and menstruation are not just about reproduction. But as long as women believe that stopping menstruation matters not to anything but their ability to become pregnant, drugs that induce menstrual suppression will be an easy sell. And remember, these drugs cannot ensure no bleeding at all. Many women discontinue them because of irregular, breakthrough bleeding that is not predictable.

    One of the main reasons, I believe, that reproductive health organizations and specialists, including most of my colleagues, are sounding not even a note of caution about cycle-stopping contraceptives is that to do so would force us to reassess what has become an overwhelming reliance on hormonal methods of birth control and menstrual cycle management. Yet the day approaches when we may be forced to do so.

    I agree with all who say that “choice” is everything. But informed choice is not possible without full disclosure of the health benefits and risks of both ovulating and menstruating and NOT ovulating or menstruating. I recommend that young women educate themselves more thouroughly about the menstrual cycle before buying into the idea of “no period, no problem”.

    With that said, I’d like to ask two questions of the young women out there who may be reading this.

    1. Do you believe that you have accurate, comprehensive information about normal menstrual cycle functioning and its relation to your reproductive and general health?

    2. Are any of you finding it difficult to make the choice NOT to use hormonal birth control? Are you finding support for this chocie and good information about the full range of non-hormonal alternatives?

    I’m interested in hearing your opinions and experiences.

    Thank you for the chance to continue this discussion about a complex and compelling issue in women’s health.

  • tyler-lepard

    Dear Laura,

     

    Thank you very much for contributing to this dialogue. I will definitely take a look at the Society for Menstrual Cycle Research. And please accept my apology — I did not mean to imply that everyone who is opposed to suppressing menstruation or withdrawal bleeding is a right-wing nutjob. I appreciate the diversity of perspectives on this issue and was really trying to highlight the fact that Lybrel is more about new marketing and media hype, than an actual new technology (since people have been using previous forms of hormonal contraception for the purpose of skipping periods). I agree that more research on this subject would be helpful.

     

    Though there may be benefits to regular ovulatory menstruation, I do think that hormonal contraception continues to be an important option for family planning and other health purposes. However, I find the SILCS diaphragm an intriguing non-hormonal method — check out Maggie Kilbourne-Brook's article for more info.

     

    If you would like to contribute an article to RH Reality Check, please contact me.

    Regards,

    Tyler

    tyler(AT)rhrealitycheck(DOT)org

  • invalid-0

    Working at a Planned Parenthood (PP) in a fairly progresive state, we haven’t heard as much local uproar about this.

    But I wonder, What would my Great x 5 grandmother would think about all of the periods that we have today. Our Medical Director explained it to us this way:

    Generations ago, women were having their periods later (this is a whole nother can of worms to open) and within a short period of time of starting menses they began having children. Well as they had these children, they were obviously not having periods during the 9 months, or during the (up to 3 years) while they breast fed their children. Then they would be pregnant again within, again, a short period of time… and the cycle (pardon the pun) would continue.

    It’s true my great x 5 grandmother had a ton less periods than I did… it’s not necessary to have a period every month, I love it when I skip my period… and when I’m ready to have kids, my skipping periods will not prevent me from having healthy happy children…

    I just wonder what 4 or 5 generations before us would think about this.

    Period Free,
    ~Felis-Catus