By KATIE ROGERS
October 18, 2016
For many women, periods are just a monthly nuisance. But for some of us, periods are painful and disabling, causing us to miss out on school and work and life.
For the majority of my teenage years, my monthly period triggered a migraine and cramps so severe I might throw up or even blackout. I spent a lot of time lying in bed with a heating pad and popping prescription ibuprofen.
I was in my early 20s before a doctor finally told me that I could stop my period altogether. It’s called menstrual suppression and typically involves continuous use of birth control pills. The hormones trick the body into acting like it’s pregnant, and periods stop. My quality of life improved within two months.
Women suppress their periods for a variety of reasons. Athletes use the method to avoid the hassle of periods and cramps during important competitions. Brides and vacationers use period suppression so a special event or trip isn’t ruined by a difficult period.
(Related: How periods might affect a woman’s athletic performance)
Researchers are also studying how fewer periods can help improve quality of life for women in extreme employment situations. In 2011, the Jacobs Institute of Women’s Health published a study of menstrual suppression among military women deployed to combat zones. The researchers found that interest in continuous contraception among deployed women was high — 66 percent wanted to try it out. But only a third of the women actually put the method into practice. And a study released in January of this year shows that continuous contraception has been a common alternative to periods among female astronauts for years. (Because who would want to have a period in space?)
And there are women like me, who do it to avoid painful periods, and others who simply want the better quality of life that comes from not having a monthly period. Dr. Shari Lawson, an assistant professor of obstetrics and gynecology at Johns Hopkins University School of Medicine, said that “looking at this continuously as a lifestyle is often the next step up” from occasional period suppression.
Research shows that the idea of never having periods appeals to women. In 2005, the Association of Reproductive Health Professionals surveyed more than 1,100 women and 55 percent said they’d be interested in learning more about suppression.
But one of the reasons many women don’t try period suppression is that they’ve been conditioned to believe that a monthly period is a sign of good health. In the A.R.H.P. survey, 89 percent of women said they worried that there might be long-term health effects, and 66 percent said that period suppression just didn’t feel natural.
It’s true that women who don’t have regular periods should see a doctor. But many women don’t realize that if they are using a hormonal form of birth control, their monthly period is already artificially induced by stopping the hormones for seven days a month.
Other women worry that suppressing their period might lead to an unnatural buildup of the uterine lining. Dr. Erin Saleeby, the chairwoman of OB-GYN at Harbor-U.C.L.A. Medical Center, said that using continuous birth control prevents that from happening.
“You don’t have a proliferation of that tissue,” Dr. Saleeby said, “and it’s just not there at the same level that you would quote-unquote ‘need to bleed.’”
A woman who wants to suppress her periods should talk to her doctor about her options. One method involves standard oral contraceptives, which are still the most popular method of birth control. To skip a period, a woman can just skip the placebo week and start a new pack without a break. Since this will require using 17 packs a year instead of 12, Dr. Lawson said that doctors can write the prescription in a certain way to make sure the extra pills are covered by insurance, Dr. Lawson said.
Dr. Lawson added that one birth control brand, Seasonale, is designed for period suppression — this method is designed to produce about four periods a year — and doesn’t require extra packs.
Other options include NuvaRing, a vaginal ring that releases a low dose of two hormones, estrogen and progestin, and can be used continuously to stop periods. Similarly, the Mirena intrauterine device releases progestin and helps lighten the uterine lining. Dr. Lawson said this is a method she often recommends because women can leave it in for years without worrying about pregnancy or heavy periods. She said about 25 percent of women who use this method will experience induced amenorrhea — or the absence of menstruation — after one year, and 50 percent after two years.
Depo-Provera is an injectable form of birth control that contains a time-release dose of progestin to prevent pregnancy, but also lowers the frequency of periods.
But regardless of the method, making the choice to stop a period doesn’t necessarily mean the transition will be perfect: Breakthrough bleeding or spotting can be common, Dr. Saleeby said.
Hoping to hear more about the secrets of period suppression, I conducted an informal poll among my Facebook friends. I heard from a dozen women, from co-workers to my oldest friends, who all told me that they had suppressed their periods either occasionally or for a matter of years.
Abi Wood, a 32-year-old law student who lives in St. Louis, told me that she opted for Mirena three years ago, after trying pills and the NuvaRing, to cope with an irregular and painful period.
“I would get terrible mood swings, cramps, night sweats,” she said. “I basically felt like I was going through early menopause in my late 20s.”
Before Ms. Wood started Mirena, she dreaded school exams and going to work during her period. After about a year of using the device, her period stopped.
“Everyone is different, but honestly, it just lifted a lot of stress off me not to worry about it,” she said.
I also heard from women who are still trying to find the method that is right for them. One friend told me that she’d tried period suppression, but birth control pills made her feel too depressed. Another said she occasionally suppresses her period when she has work trips. And another friend, Suzy Piper, a 31-year-old who works in communications and lives in St. Paul, Minn., told me that she’s been trying different types of oral contraception to suppress her periods because of monthly migraines. The results, she said, have been mixed.
Ms. Piper said she has “stuck with the pill because I’ve always taken it.” She said the pills have resulted in lighter periods and less cramping, but monthly headaches are still an issue.
In my informal survey, I found that period suppression can be a complicated process that requires some research and testing, but one that ultimately outweighs the more negative symptoms that can be associated with having a period.
Dr. Lawson said the key to successful period suppression begins with telling your doctor that you’re interested in safely stopping menstruation. Then, keep working together until you find a method that feels right for you.
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• The 8 health habits experts say you need in your 20s