The Pros & Cons of Menstrual Suppression

It's estimated that the average woman will have 450 periods in her lifetime.* For the majority of women, menstrual cycles continue in the all-too-familiar 28-day pattern. But do they really have to? What if a woman could choose to have just one period a year?

In recent years there's been increased debate over suppressing monthly periods so they occur far less frequently. New oral contraceptives that deliver an extended or uninterrupted supply of hormones are being marketed as a way to fool Mother Nature and forego the flow. As a result, under the care of a physician, some women have their periods once every three or four months, or even once a year.

The strategy works this way—when a woman stops taking her hormones the body triggers the start of her period. But by maintaining the hormones continuously she in essence prevents her body from going into period mode.

Inconvenient timing isn't the only reason some women will alter their pill schedule to put off their periods for one or two months in a row. Physicians have long recommended the practice to women who experience painful, problem periods. For these women, postponing menstruation and thereby reducing migraines, severe cramps and symptoms of endometriosis is a welcome relief.

Whatever the reasons women delay their periods, whether temporarily or long-term, it's important to be aware of the consequences and the health risks of interfering with the natural, spontaneous menstrual cycle. The question remains, is it safe to fool Mother Nature? And for how long?

Some physicians consider menstrual suppression a reasonable option for healthy women, particularly those who are already comfortable with taking birth control pills. How long to delay menstruation is certainly a decision best made between healthcare providers and informed patients.

Most women recognize that taking oral contraceptives already come with side effects and risks, regardless of whether or not the meds are used to suppress menstruation. Those risks include blood clots, stroke, breast tenderness, nausea and headaches, to name a few.* For women who also smoke, the risks are even greater.*

These same health risks are also associated with taking oral contraceptives continuously and with taking the newer extended-use contraceptives, those hormones designed to suppress menstruation long-term.* But there may be other health concerns.

Which is why not all doctors support the idea of menstrual suppression. The key reason is that health implications and long-term effects of continuous or extended hormonal contraception use have not been studied. The effects on bone health, heart health, cancer risks, and fertility are all unknown. There are also additional concerns with regard to adolescent girls and young women who put off menstruation while their bodies are still maturing.

Another problem reported with some of the newer oral contraceptives designed to suppress menstruation is breakthrough bleeding. So while a woman may suppress her scheduled bleeding for up to a year, she's still subject to unscheduled, surprise spotting episodes.

Loss of bone density and an increased risk of osteoporosis is another finding associated with one particular brand of hormone injection designed to suppress menstruation. Additionally, without the predictability of a period a woman may not know she's pregnant, which opens up another can of safety concerns.

Clearly, under a physician's supervision, some women like the idea of using hormones to control their cycles and suppress their periods. The freedom to do so should always come after receiving proper counsel from a healthcare provider.

Other women are troubled by the concept of overriding the body's natural rhythm with the use of prescription hormones. Menstruation is viewed as a reassuring sign that a woman's body is functioning as it should and that the reproductive potential is still there.

Still other women object to the idea for cultural and social reasons. Menstruation is an integral part of womanhood. A pill that suppresses it essentially defines normal menstruation as a problem, potentially leading to a negative body image.

Women should always consult a physician when it comes to medical decisions like this one. What may be good for a friend, may not be good for you. Discuss your concerns and questions with your healthcare provider in order to make a comfortable and informed decision.

*Association of Reproductive Health Professionals.

*U.S. Food and Drug Administration.