No more periods?

[Hayley]

Last year, the FDA approved Lybrel, a continuous-use birth control pill. Unlike all other birth control pills on the market, this pill does not have a placebo or "off" period that would allow for menstruation. It is apparently intended, or at least safe for, long-term use and would eradicate the presence of menstruation entirely.

A number of contraceptives advertising four periods per month have come onto the market in the past couple of years, but this is the first to stop the period completely. According to much of the Lybrel's clinical research, this pill can cause irregular bleeding or spotting that will apparently decrease over time. Once off Lybrel, menstruation should supposedly reoccur within three months.

Despite touting itself as a "liberation movement," Lybrel has met quite a bit of controversy. Salon published an article on the outdated nature of Lybrel's sales pitch. Is menstruation really that big an issue that most women would find it necessary to stop their periods entirely? Is it safe? Wyeth, the pharmaceutical company that manufactures Lybrel, published the results of a study that claims that stopping periods entirely would pose no threat to a woman's health:

"In the survey, approximately 97 percent of OB-GYNs thought it is safe to use oral contraceptives continuously, without a placebo phase, in the appropriate patient population. The survey polled 205 OB-GYNs and 200 nurse practitioners."

But is it really necessary? Would you take something that would stop your period entirely? Do you think it's safe?

[Hayley]

Thanks for replying, Paula! I do have to agree with you. They claim that it's safe for long-term use, but how do they know anything about long-term use if the drug has only been on the market for a year?

I also wonder if there would be increased issues with too much iron. It's not a common problem in women—far more common in men—but I know that anemia can be a problem in women because of their periods. I wonder if too much iron in the blood would become a problem if women stopped having their periods?

[Janeen]

This makes me nervous. The period is a normal function of a womans body and although I don't have a problem with pills that make it less painful or lessen the length of the cycle, getting rid of it altogether just seems wrong to me. How is a woman ever supposed to get to know her body of she doesn't experience what it does? If you don't know what normal is, how will you know when something isn't normal? Now having said that, I'm not for taking the drug off the market, I just feel maybe we should study this one a bit more.

[Stephanie]

I agree with all of you. While it would be great to not have to deal with getting your period once a month. I think it would make me nervous. It is part of the process of being a woman. And this study doesn't seem like it has looked far enough into the future to see what kind of long term effects this drug might have. I think some more research needs to be conducted.

[Marie]

Thanks for posting this, Hayley!

Obviously, this is a very hot topic in the women's health community right now, and something I've heard a lot of people talking about. There is a lot of buzz about Lybrel, as well as other pills (like Seasonal/Seasonique) that move away from the 21/7 cycle.

I wanted to point out something that DinDin brought up in her recent Spotlight Interview:

"The standard 21 /7 cycle is completely arbitrary and medically unnecessary. It was created in 1954 to allow for a menstrual period – the thinking was that a birth control pill would only be accepted if it didn’t seem to interfere with a “normal” menstrual cycle."

The period women receive when they're on the pill isn't a "real" period, there's no ovulation, so there's no build up of the uterine lining, and therefore, no need to shed it.

Because of this, I'm not sure what difference it makes whether a woman takes a pill that has a 21/7 cycle, or something like Lybrel, which has been approved for continuous use for 5 years. If someone is on the 21/7 pill for 5 years, they still haven't had a "real" period for 5 years.

So, while it might seem a little odd not to have a monthly cycle, if the "traditional" pills are safe, I'm not sure why these newer pills would be unsafe just because they stop the artificial period.

Of course, I know that there have been some issues with "new" forms of hormonal birth control in recent years, so I wonder if maybe we are just more nervous and suspicious because these drugs are new and haven't been "proven" and tested by generations of women?

On the whole, I think it's a nice option that probably appeals to a lot of women, but certainly not everyone!

[Janeen]

Marie,
Your point is well made. And until I started working with the birth control board, I HAD NO IDEA that women had a false period on the pill. But once I read that, it makes a lot more sense. I think women really don't have a full view of what they are taking when they take the pill. They don't exactly know what it is doing to their bodies (not that I think it's bad). And I'm sad for that. I'm in included in that group of women. Doctors need to a better job of educating their patients and patients need to a better job of researching what they are taking. I'm still a little concerned about long term effects, but less so now that I've done research.

[Marie]

Janeen,

I know, this was something I learned after I started working with WEGO Health as well!
There are so many questions out there about hormonal birth control methods, like the pill, and it's very surprising to me, because the information isn't that hard to find, but we have to look for it, right?

I think it would be great if doctors were able to educate their patients more about how the pill works and what the risks/rewards are, but I think more often than not, it's a simple "transaction". That makes me nervous! Especially when I think of the number of my friends, in college, who didn't know that certain antibiotics could decrease the effectiveness of the pill!

Not everyone reads the pill pamphlets I guess..

[dindin]

Hayley - Lybrel is a new concept in marketing, not a new concept in birth control. Progestin-only products such as Depo Provera, mini-pills, and the Mirena IUD have effectively been nearly eliminating or eliminating women's periods for years. Also women have been using birth control pills to skip or eliminate their periods as an"off-label" use for years before the approval of Seasonale and Lybrel. It's been done safely for quite some time already, it's just now with the official marketing of it as a "product" that it's in the news. Women don't have their periods during pregnancy, breastfeeding and menopause. There's nothing different about this. Yes, I have a Mirena IUD, I do still get a "period", though there's not much of it. I haven't used anything heavier than a pantiliner in nearly 2 years and I'm thrilled.

[mothershaffer]

I have to say that I have no medical basis for this, but I have a suspicion that "the pill" (including all ingested or injected female contraceptives) have an adverse impact on a woman's overall health. I took the pill for years and Depo Provera for a short time (also eliminates your period) and I'm convinced that my auto-immune issues that surfaced years later are somehow linked. Why, you may ask?

Well, auto-immune diseases effect 90% women and researchers cannot determine exactly why that is. My guess (again, based on intuition) is a large number of women ingest birth control pills during their reproductive years (exactly when auto-immune problems pop up) without a second thought of how they are altering their normal cycle and hormone balance. Seems like a no-brainer that if you mess with your hormones, you are going to pay a price.

Just my own thoughts. Would love for some doctor to prove me wrong, but I don't think anyone can.

[Kelly D]

At one point I tried depo provera and it has similar effects, I didn't get my period. However, I lost my sex drive too (a side effect of Depo). After only 3 shots I decided I didn't like the idea of not getting my period and didn't like the mood swings from Depo. It took my body almost 12 months (each shot is only supposed to last 3 months) to get my periods back. I would be concerned something similar might occur with this new product. And if someone stops using this pill because they want to start a family, how long will it take their body to get back on track? Could be terrible if a woman is a little older as fertility decreases with age!

[dindin]

Depo Provera has a particular side effect profile that's specific to that product, which frequently includes weight gain, mood swings and loss of sex drive.

Lybrel is just a birth control pill taken continuously. It has the same potential for side effects or not as any other birth control pill, plus an added potential for irregular bleeding the first year. Birth control pills don't have any effect on fertility once you stop taking them.

[Sangeeta Garg]

I don't think so.Don't you think the problems associated with Menopause proves that no mensuration is not a good thing as far as our health is concerned.No mensuration for me means that it is playing with the hormonal balance of our body and I don't think its a good thing.

[Luna]

I agree with the first few ladies. I actually tried Depo Provera a few years ago. It cause significant weight gain, headaches, and other side effects. My body actually changed from not having periods, so now I am skeptical about any birth control products that claim to "Stop your periods." I think that this is fairly dangerous to your body.