Life cycles

Do women need to have periods?


Women in their 20s and 30s are increasingly opting for contraception that can repress their menstrual cycles, a trend that’s opening an interesting discussion about why the pill is designed to mimic a normal menstrual cycle, and what skipping it means for future fertility.

With traditional birth control, a woman will take a hormone pill for 21 days of the month to stop her cycle, then sugar pills for a week so she will have what appears to be a period. Interestingly, Dr. Elizabeth Micks, who runs an OB-GYN clinic in Seattle, told NPR this “fake” period is just a historical convention. “There’s absolutely no medical need to have a period when you’re on contraception,” she said, explaining that a Catholic doctor who participated in the development of the pill hoped (in vain) that the pope might accept the contraception if it appeared women were having periods.

Now if women wish to suppress their cycles, they can choose from the hormonal IUD, an arm implant or a hormone shot, or — in some cases — can take some kinds of birth control pills continuously. The implant and hormonal IUD are recommended as the top choice for young women wanting birth control, and one study found them nearly 20 times more effective than birth control pills at preventing pregnancy.

Although doctors do not understand all the effects of menstruation suppression on teenagers (on bones and breasts, for example), there is no evidence that the fertility of women who miss their cycle, for five or even 10 years, is affected. With the exception of the hormonal shot — which can decrease fertility for months after it is discontinued — most women can get pregnant right after they stop using contraception.

Endocrinologist Jerilynn Prior told NPR women should exercise caution before aiming to suppress their cycles. There is value in having a period, she advises: It tells you your reproductive system is working well and that you’re not pregnant.

Read the full story at NPR.


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