It's OK to skip your period while on the pill

May 17, 2018 by Mia Schaumberg, The Conversation
Women commonly suppress their period around special events and holidays. Credit: Haley Phelps

The pill is the most common form of contraception in Australia, with up to 60% of young women choosing this option to prevent pregnancy.

Women on the are able to manipulate or suppress their to have fewer "periods," or to avoid bleeding at important or inconvenient times. But it's best to consult your GP to work out a plan that suits you and be on the lookout for any side effects.

How does the pill work?

The combined (known as "the pill") provides a daily dose of synthetic ovarian hormones oestradiol and progestogen, which suppress the natural production of ovarian hormones (oestrogen and progesterone) to prevent ovulation.

The idea of an oral contraceptive using ovarian hormones was first proposed in the 1950s by American researcher Dr. Gregory Pincus. His idea was to mimic the natural cycle, with 21 days of hormone, followed by seven days of no to allow for a "withdrawal bleed."

While the withdrawal bleed may seem like a period, it has little physiological relation to menstruation and may be lighter, shorter and less painful.

Nonetheless, early research described the 21/7 regimen as a "morally permissible variant of the rhythm method," hopefully leading to acceptance by women, their doctors, and the Catholic Church.

How did menstrual suppression come about?

In 1977, the first study was published on an extended oral contraceptive regimen of 84/7 (84 days of active pills and seven days of no hormones). This showed reducing the frequency of menstruation to every three months was safe.

Since then, researchers have studied the various ways the pill can be used to suppress menstruation.

Most studies show the practice is well-accepted by patients. An 84-day cycle is usually recommended, allowing four withdrawal bleeds per year. This schedule minimises the risk of endometrial hyperplasia, an abnormal thickening of the lining of the uterus, which is also a risk factor for endometrial cancers.

While the most common way to manipulate the menstrual cycle is through extending the days of oral contraceptive use, there are several other long-acting reversible hormone contraceptive methods that can be used to suppression menstruation for months or years. These include Implanon (a hormonal implant in the arm), Mirena (a device that sits in the uterus), or Depo-provera (an injection).

The sugar pills don’t have any active ingredients. Credit: Thought Catalog

How common is menstrual suppression?

In my recent survey of young Australian women, 74% reported manipulating their menstrual cycle at least once in the previous year. Almost one-third of respondents had manipulated their cycle two to three times. But less than 1% had used the pill to stop menstruation altogether.

The most commonly cited reason was to be able to suppress a period around special events or holidays, with 75% of the women rating this as important or very important.

Suppressing menstruation can be more practical than just ensuring you don't have your period for a wedding or important exam. In a survey of deployed US female aviation personnel, 60% chose to suppress to ensure they could meet the demands of their job.

More than 50% of competitive athletes use the pill to ensure they don't have their period on competition day.

What about women who suffer severe or painful menstrual symptoms, like heavy bleeding or endometriosis?

Menstrual manipulation or suppression can also help women with endometriosis, heavy bleeding or painful periods to minimise menstrual symptoms. Currently, about 30% of women take four or more sick days per year due to premenstrual symptoms alone. Those who suffer severe symptoms may be absent from work or school for one day every month. This is a large potential economic burden.

Menstrual manipulation is a strategy to reduce absenteeism from work and school and may be of benefit at both an individual and societal level.

This all sounds so good – so what are the risks?

Some arguments suggest that by skipping the "sugar pills," are effectively increasing the overall exposure to synthetic hormones by up to 25%. This may lead to a greater risk of depression, blood clots, or oestrogenic cancers.

Unfortunately, there is no research yet to support or refute these claims.

However there is evidence that menstrual manipulation can lead to greater incidence of "spot" or "breakthrough" bleeding. Women can also find it more difficult to tell if they become pregnant.

While there is no evidence to suggest menstrual manipulation or suppression is harmful, it's a good idea to discuss it with your GP or gynaecologist, who can assess your individual circumstances and potential risk factors.

Under medical guidance, you can decide on a system to suppress your periods, and have a plan to contact your doctor if you experience any side effects such as abdominal pain, chest pain, bleeding, vision changes or severe leg pain.

Explore further: Women's wellness: Birth control pill benefits, risks and choices

Related Stories

Women's wellness: Birth control pill benefits, risks and choices

April 23, 2018
The birth control pill is surrounded by misinformation. Get the facts on common concerns and questions about taking the pill. If you take the birth control pill (oral contraceptive), you're probably happy with its convenience ...

Women need to know about the link between the pill and depression

May 15, 2018
The introduction of the contraceptive pill in the 1960s was a major milestone for female empowerment. It allowed women to separate sex from procreation, and to increase their participation in work outside the home.

The pill lowers ovarian cancer risk, even for smokers

January 18, 2018
(HealthDay)—It's known that use of the birth control pill is tied to lower odds for ovarian cancer, but new research shows the benefit extends to smokers or women who are obese.

Study raises doubts about safety of some forms of birth control pills

June 28, 2017
New research on how birth control pills affect the level of hormones in women's blood serum has found much higher levels of hormones in women who take birth control pills compared to women who don't.

Continuous oral contraceptive pills offer women earlier pain relief

August 15, 2012
(Medical Xpress) -- Taking oral contraceptives continuously, rather than as traditionally prescribed for each cycle, provides earlier relief for moderate to severe menstrual cramps -- dysmenorrhea -- according to researchers ...

Insight into heavy periods could pave the way towards new treatment

January 24, 2018
Scientists from the MRC Centre for Reproductive Health at the University of Edinburgh have uncovered a cause of heavy menstrual bleeding – a finding that offers hope for a new treatment for women living with the condition.

Recommended for you

Insufficient sleep, even without extended wakefulness, leads to performance impairments

May 21, 2018
Millions of individuals obtain insufficient sleep on a daily basis, which can lead to impaired performance and other adverse physiological outcomes. To what extent these impairments are caused by the short sleep duration ...

New study shows higher formaldehyde risk in e-cigarettes than previously thought

May 21, 2018
Portland State University researchers who published an article three years ago in the New England Journal of Medicine about the presence of previously undiscovered forms of formaldehyde in e-cigarette vapor revisited their ...

Sleep better, parent better: Study shows link between maternal sleep and permissive parenting

May 21, 2018
Research has shown that consistently not getting enough sleep, or getting poor quality sleep, can put you at risk for a number of health conditions. But how does sleep, or the lack of it, affect how you parent?

Avoiding the car for travel could significantly lower risk of illness and death

May 21, 2018
People who are more active when commuting to work by walking or cycling could be cutting their relative risk of developing ischaemic heart disease or stroke by 11% and their relative risk of dying from these diseases by 30%, ...

Mediterranean diet may blunt air pollution's ill health effects

May 21, 2018
Eating a Mediterranean diet may protect people from some of the harm of long-term exposure to air pollution, and reduce their risk of dying from heart attacks, stroke and other causes of death, according to new research presented ...

Autism is not linked to eating fish in pregnacy

May 21, 2018
A major study examining the fish-eating habits of pregnant women has found that they are not linked to autism or autistic traits in their children.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.