For years, gynecologists have been quietly telling their patients who take birth control pills that they can avoid menstruating while on their honeymoon or on vacation simply by skipping the seven placebo pills and starting right in on the next packet.
Now, however, some women are going far beyond this onetime, "special occasion" skipping of a period and opting to have just three or four periods a year. Still others are stopping menstruation altogether.
Although the Food and Drug Administration has not approved hormones for this purpose, doctors are prescribing them to reduce or eliminate periods for women suffering from heavy bleeding, severe PMS, debilitating cramps or other menstruation-related maladies. Still others may be helping their patients avoid the hassle of monthly menstruation.
Debate over this practice, and interest in it, heated up with the publication earlier this year of Brazilian gynecologist Elsimar M. Coutinho's provocatively titled book, "Is Menstruation Obsolete?" Coutinho notes in the book that "the attitude that menstruation is a 'natural event,' and therefore beneficial to women in some way, has no basis in scientific fact."
Women today, Coutinho says, have three times as many periods in their lifetime as their female hunter-gatherer ancestors did, due to first menstruation at a younger age and giving birth to and breast-feeding far fewer children. He says this can help explain the higher rates of endometrial and ovarian cancer compared with those of a few generations ago.
Although critics say it's not normal for a woman to skip her periods, a woman is fooling herself if she thinks she's having "normal" periods while taking birth control pills, some experts say.
Even when a woman takes such pills the old-fashioned way, she's really having "artificial periods," says Dr. Anita Nelson, professor of obstetrics and gynecology at UCLA School of Medicine. Birth control pills stop a woman from ovulating and shut down her ovaries, so going off them every 28 days, just to cause hormone levels to drop and the uterine lining to slough off, "is an artificial exercise and a waste of metabolic energy," Nelson says.
For some women, a good case can be made for stopping menstruation altogether, Nelson says. "It comes down to a quality-of-life issue. The No. 1 cause of lost work days for women under age 25 is painful periods," she says, adding that for one in five female migraine sufferers, the pain worsens during menstruation.
