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

Receiving genetic information can change risk

December 11, 2018
Millions of people in the United States alone have submitted their DNA for analysis and received information that not only predicts their risk for disease but, it turns out, in some cases might also have influenced that risk, ...

Effect of oral alfacalcidol on clinical outcomes in patients without secondary hyperparathyroidism

December 11, 2018
Treatment with active vitamin D did not decrease cardiovascular events in kidney patients undergoing hemodialysis, according to a research group in Japan. They have reported their research results in the December 11 issue ...

Yes please to yoghurt and cheese: The new improved Mediterranean diet

December 11, 2018
Thousands of Australians can take heart as new research from the University of South Australia shows a dairy-enhanced Mediterranean diet will significantly increase health outcomes for those at risk of cardiovascular disease ...

Licence to Swill: James Bond's drinking over six decades

December 10, 2018
He may be licensed to kill but fictional British secret service agent James Bond has a severe alcohol use disorder, according to an analysis of his drinking behaviour published in the Medical Journal of Australia's Christmas ...

Obesity, risk of cognitive dysfunction? Consider high-intensity interval exercise

December 10, 2018
It's fast-paced, takes less time to do, and burns a lot of calories. High-intensity interval exercise is widely recognized as the most time-efficient and effective way to exercise. In a first-of-its-kind study, researchers ...

How to survive on 'Game of Thrones': Switch allegiances

December 9, 2018
Characters in the Game of Thrones TV series are more likely to die if they do not switch allegiance, and are male, according to an article published in the open access journal Injury Epidemiology.

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.