Unlike Jessica, I'm not very freaked out by the idea of birth control pills that don't create a monthly period. Research is scant on the long-term health effects of using monthly birth control pills versus a trimonthly or no-period regimen, but we do know:
Early oral contraceptive developers selected a regimen of 21 days of active drug followed by 7 hormone-free days to mimic the average menstrual cycle. They believed such a regimen would be perceived as more "natural," thereby making the new product more acceptable to potential users, prescribers, and the Roman Catholic church. [...] Oral contraceptive users have limited endometrial buildup and do not require monthly shedding of the lining. Despite the appearance of being "natural," the OC withdrawal bleed is medically induced and has no proven physiologic or health benefits.
I don't see extended oral contraceptives as "treatment" for menstruation, or an implication that menstruation is a dirty thing that should be avoided. This is just another birth control option. One drawback to never getting a period is losing that monthly assurance that you're not pregnant. And many people have, rightly, pointed out the lack of long-term research on continuous use of oral contraceptives. But that should be a health risk that women can choose to take if they're informed by their doctor. For many women, like those who suffer from endometriosis, their periods are so painful that they're more than willing to take the long-term risk. We shouldn't knock "not menstruating" just because some of us aren't comfortable with that choice.
Interestingly, there's been research done on the costs of having a monthly period versus taking the Pill continuously. Maybe the cost of oral contraceptives (or tampons) has changed since then, but researchers found it was cheaper to menstruate monthly.
Entirely separate from the medical issue, Amanda points out that using the term "natural" to describe monthly menstruation is dangerous territory:
If you buy into the idea that it’s somehow better to bleed than to not, you’re buying into a mythology of the sanctity of feminine “naturalness� that exists predominantly to oppress women. [...] But what’s critical to me is that feminists get as far the fuck away as possible from being swayed by arguments about whether or not something is “natural�. If you criticize the pill or women who resent their periods because they aren’t “natural�, you’re feeding the beast that will lead to contraception bans so that women can return to our “natural� state of having one in you and one on you at all points in time.
Agreed.
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I posted this on Jessica's, but thought it appropriate here as well:
http://www.deannazandt.com/2006/05/23/missing-your-period/
It's the story of a girl who goes to her GYN and... well, I'll skip all that but there's an idea out there that all our menstruating might be causing ovarian and other cancers. Interesting. I might write an article for AlterNet about it, if I can find out more...
That cost comparison only looks at the pills and at sanitary products.
Having a monthly period vs. a quarterly period has many other costs:
1. pain meds
2. way more time spent on sanitary stuff.
3. 3x (at least) the PMS
4. 48 days in menstruation instead of just 16.
5. figuring out if the above is going to affect my schedule.
The 21+7 rythm doesn't even suit all women. There was a brief period, after my endometriosis had quietened by a non-menstruating treatment, when I tried to use the pills the normal way, and it didn't work out at all. Eventually, I realized that my own body's rythm was much stronger than the 21+7 rythm I was trying to impose by using the pills.
Eeventually, I got the bleeding to match with the pill pause by shortening the both parts of the cycle: I had to stop taking the pills when bleeding started, which was after about 18-19 days, and then have a pause that was no more than 5 days. If I tried to prolonge either part, I had bleeding every two weeks. And my pills were not among the weakest.
When I am taking the pills for endometriosis treatment, my symptoms only get worse if I try to have pauses too often. The pills help me only if I take them to stop bleeding.
Something to remember, also, is that before the advent of the pill, women spent much less time menstruating because they spent more time being pregnant. They also had shorter life spans (and, subsequently, fewer periods still). Finding out health stats on period/no period in this day and age, when women are living longer than ever before and can easily control their cycles, is going to be very difficult.
Theories abound. One states that having a monthly period isn't necessary in this day and age, when more and more women are limiting their reproduction, or are foregoing having kids all together.
Another theory is that menstruation is the female body's way to cleanse itself of toxins, particularly those deposited by semen, and is therefore important.
Nowhere does it say that menstruation is oppressive, Felix, only that the idea of having to be completely 'natural' (whatever that may be) is oppressive.
I for one would be glad to know of a safe way to avoid menstruation altogether. Emphasis on safe.
---------- Recipe via Meal-Master (tm) v8.04
Title: KEY LIME BARS
---------------------------CRUST---------------------------
1 c Butter
1/2 c Confectioners' sugar
2 c Flour
--------------------------FILLING--------------------------
4 Eggs; beaten
4 tb Flour
2 c Sugar
1 pn Salt
6 tb Key lime juice
1 ts Baking powder
Confectioners' sugar
For CRUST: Mix the ingredients and pat into a
9x12-inch pan. Bake at 350 degrees for 20 minutes.
Watch carefully! Beat together the eggs, sugar, and
lime juice. Add the flour, salt, and baking powder.
Mix and pour on top of the crust. Bake at 350 degrees
for 25 minutes. Sprinkle the top with confectioners'
sugar and cut into bars.
"And many people have, rightly, pointed out the lack of long-term research on continuous use of oral contraceptives."
I've heard it recommended that those who take their pills continuously should use a lower dose of hormones than what they used previously---preferably, the lowest dose that still functions effectively as birth control.
If that is done, I really don't see much difference in taking less hormones continuously, or more hormones intermittantly---they should more or less even out (since you're taking them more often, you need less per dose). Dosed correctly, it should be the difference between taking two Advil every four hours, and one every two hours.
By the way, regarding the lack of long-term studies, we're forgetting that the "normal" way to take hormonal birth control, with its breaks, was decided arbitrarily by the makers of the pill, also for "convenience" (free pregnancy test each month), and is not really any paragon of "naturality," either. We may be flying a bit blind here, but nowhere near as blind as the first women who used hormonal contraceptives were.
When there's such a limited endometrial buildup, there's nothing natural about a triggered withdrawel bleed that there isn't about a lack thereof.
I think the choice about having your period should be the users. I would keep mine because I'd know I'm not pregnant. Also for women with chronic vaginitis and related problems getting your period helps flush out any residual bad bacteria and allows good bacteria to stay. It can return your vag back to a ballenced state if you are on the verge of getting a yeast infection.
So for some women its just the general flushing with blood that is itself beneficial
I agree that the choice is ours. But I do not agree with the merits of blleding as cleanser. In my case, I have less vaginal infections when I have no bleeding, and I have regular infections when I do bleed. I feel that whatever comes out of my womb is the culprit for my infections. But I have endometriosis, so my experience cannot be applied to all.
It can return your vag back to a ballenced state if you are on the verge of getting a yeast infection.
Actually, it's the pH change from the blood that can precipitate a yeast infection--blood is alkaline, and the first few molecules of blood can create an alkaline environment in the vagina that's beneficial to yeast.
The only reason we have period breaks in our pill at the moment is because Doctors thought women would freak out at the prospect of not having a period. Personally i could do without it.
I've been very confused by reading all the discussion about not having one's period. The reason for my confusion is that PCOS (poly cyctic ovarian syndrom) is a condition where women do NOT have their periods regularly unless they use perscription drugs. It has been my understanding that the reason this is a problem for women, aside from the fact that it makes getting pregnant almost impossible without specialist assistance, is that it increases the chance of uterine cancer because the endometrial lining is not being sloughed off.
Hi, there:
I'm 43, so hardly a "young" feminist, but this is an issue I've been dealing with lately.
I've always had extremely heavy and painful periods, leaving me unable to function for 2 out of the 5 days I bleed in my cycle (which averages 26 days, but can range from 21-31).
So, not being able to predict when I would have these heavy/painful periods makes planning travel and social events very difficult.
Also, at my last physical, I was found to be anaemic, with almost totally depleted iron stores.
I hadn't used oral contraceptives in over 15 years. I stopped taking them when I was 27, after I discovering that I had cervical dysplasia (for which I reluctantly underwent cryosurgery). Avoiding the hormones and using condoms instead seemed a prudent precaution to me at the time.
I don't intend to have children, and my husband and I have been using condoms for birth control over the past 15 years.
I recently heard about the practice of total menstrual suppression using oral contraceptives on a continuous rather than cyclic schedule. I looked into what little research is available, and came to the conclusion that the risks of stroke and various cancers are probably not any greater that using OCs on the normal schedule.
While I was unwilling to use OCs with their slight associated risks simply for birth control (when it's so easily achieved with a condom), I AM willing to take these slight risks to achieve the complete elimination of my debilitating periods.
Having made this decision, I asked my doctor's advice on the issue. She was unwilling to prescribe OCs for use on an indefinite continuous basis, saying that, theoretically, there might be an increased risk of developing endometrial cancer, since abnormal cells would get a chance of developing and growing instead of being sloughed off at regular intervals. She said that she felt a minimum of 4 bleeds per year were necessary to avoid this potential risk.
She prescribed Alesse, which I can use on my own schedule, provided I have 4 withdrawal bleeds spaced fairly regularly through the year at my own discretion.
Personally, I don't find the "theoretical" increased risk of endometrial cancer very convincing or worrying. There's no clinical research to back it up (or disprove it either, though).
I'd prefer to take the pills continuously with no withdrawal bleeds, but I can't do this without my doctor's consent as she controls the frequency with which my prescription can be renewed. Thus, she would be aware if I do not undergo the withdrawal bleeds she recommends, as I would require the prescription to be renewed too soon.
I understand and respect my doctor's caution. She is on the faculty of a large teaching hospital specializing in women's health, and has done extensive research on reproductive cancers.
However, I'm frustrated that, as a mature woman of 43, with a master's degree in the area of women's health, this decision is not actually "mine" to make.
Even more disconcerting, when I filled my doctor's prescription for "6 month's" worth of Alesse, the pharmacist doled out only 3 packs, saying that was all my husband's insurance plan would cover at one time. I'm definitely not happy to know that both the pharmacist and the insurance company are also monitoring the frequency with which I take this medication.
Currently, Wyeth is seeking approval in North America for a continuous OC pill called Lybrel. I will follow the approval process, and will again approach my doctor on the subject when this method has been tested and approved (hopefully soon).
Lybrel has been developed by Wyeth, the same company that makes Alesse. The hormone combination is the same in the two pills, except that Lybrel contains 10% less levonorgestrel.
Interested to hear other women's experiences with practicing menstrual suppression using conventional OC pills, and their doctor's attitudes towards the practice.
Cheers, Hester