The latest incarnation of the birth control pill is scheduled to hit pharmacy shelves this month and with it, a chance for women to forgo their monthly periods as long as they take the drug.
Lybrel, developed by Wyeth Pharmaceuticals, is being billed as a pill that provides convenience for active women who want to “put their period on hold.” The low-dose oral contraceptive is taken 365 days a year, with no placebo, as is common with traditional birth control pills.
It might seem like a dream drug for women who’ve struggled with painful menstrual cycles or roller coaster premenstrual syndrome, but some women question whether monthly periods should be rejected wholesale as a matter of convenience. Instead, women should embrace the natural cycles of their bodies, they say.
“Do you really want to do that? Do you really want to not have a period?” said Anna Yang, director of the California-based Red Web Foundation, which promotes a positive societal view of women’s menstrual cycles. “The reality is, this isn’t happening to me. It’s part of me. It’s a very natural thing.”
Still, for a lot of women, a monthly period is a nuisance, and birth control pills are a way to get around “the curse.” In fact, the medicine in Lybrel is not new; it’s simply a repackaging of existing birth control medication for continuous use.
For decades, doctors have known that a continuous course of birth control pills – without the traditional placebo or break between courses of medication for a week each month, when the period occurs – would halt the monthly bleeding that many women have come to dread. Doctors often advise patients to skip the placebo pills in order to skip a period, and not just to make their lives easier.
Dr. Jeffrey Martin, an obstetrician-gynecologist for Kaiser Permanente who practices in Oxnard and Ventura, Calif., will suggest the alternative to patients who have certain medical conditions such as endometriosis or side effects that would be lessened by skipping periods.
“If they’re coming to me with a problem, I can recommend they do it that way,” he said. “I don’t think it’s a huge number that are doing it for convenience’s sake.”
Leslie Miller, an obstetrician-gynecologist and clinical professor at the University of Washington, even established a Web site, www.noperiod.com, to answer questions about skipping or halting periods using birth control pills. Along with advice on how to get a prescription to cover the additional pills, or extend the time without a period, Miller’s site includes tales from women who talk about the mess, inconvenience and discomfort of periods.
One woman wrote: “I have struggled with the worst case of PMS on the planet. I have quit hundreds of jobs, rocky relationships, ruined my own life all because of PMS. I WANT IT TO STOP!” Another asked about skipping periods while she went on an extended trip: “I am very worried about how I would buy tampons in Nepal.”
Skipping periods became a little easier four years ago when the birth control pill Seasonale debuted.
Seasonale and a similar drug called Seasonique, both by Duramed, are three-month supplies of birth control pills, with 84 active pills and seven inactive pills, that limit periods to once every three months.
Lybrel and Seasonale may not be as convenient as they sound, though. Most women taking the drugs experience occasional and unpredictable bleeding or spotting during the first several months; the spotting tends to slow or stops after a year, according to the manufacturer’s warnings.
That might be too much for women looking toward Lybrel for convenience, said Aimee Brecht-Doscher, an obstetrician-gynecologist at the Mandalay Women and Children’s Clinic in Oxnard. “It’s irregular bleeding, which most women don’t like,” she said. “I think a lot of people will get frustrated before that” year is up and the irregular bleeding stops.
Health and medical effects aside, drugs such as Lybrel or Seasonale also have cultural implications, said Adina Nack, a medical sociologist and professor at California Lutheran University.
“There’s a push to market this as just another birth control option,” she said, “but it’s also an opting out of what it means to be a female human being.”
The negative image of women’s monthly cycles has become part of Western culture, Nack said, but other cultures embrace and celebrate the process as an essential aspect of becoming a woman.
“Too many aspects of natural femininity have been construed as dirty or unpleasant, a nuisance, something to be ashamed of,” she said. Having a period “hasn’t been valued. It’s not seen as a great bonus.”
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