Do Women Need to Have Menstrual Periods?

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If you talk to a bunch of women about whether they need to have a menstrual period, you are likely to get strong opinions from both ends of the spectrum.

The medical consensus is that women can take continuous hormones in the form of birth control pills, implanted hormones, rings, patches, injected hormones or from a hormonal IUD without suffering additional health risks other than those already associated with hormonal birth control methods.

According to the Association of Reproductive Health Professionals, “there is no evidence that shows women need monthly withdrawal bleeding, and no health problems are linked to skipping or eliminating bleeding. Studies have found that using the pill continuously for two or more cycles before having withdrawal bleeding is as safe and effective at preventing pregnancy as a traditional regimen.”

The irony is that according to NPR, the seven dummy (non-hormone) pills that cause a withdrawal period were incorporated into BCP packets because it was thought that the Catholic Church might condone the use of BCPs if women had a monthly period.

The church never approved the use of the BCPs, but the dummy pills were never removed and for decades now, women have been taking BCPs in the same manner.

In 2007 the FDA approved Lybrel, a birth control pill to be taken 365 days a year. Lybrel is intended to completely eliminate monthly menstrual cycles, though some women still have some unscheduled bleeding or spotting during the first year.

Women in favor of getting rid of their menstrual periods include those who suffer from conditions such as fibroids, endometriosis and polycystic ovary disease, particularly if they are done with childbearing or they do not plan to have children at all.

In addition, there are times when excessive bleeding can be life-threatening if the woman has a bleeding condition or aplastic anemia.

Paula Hillard, an OB/GYN at Stanford University School of Medicine , said in the same NPR article, “Even if a woman hasn't had a cycle in five to 10 years, there's no evidence that suppressing menstruation hurts future fertility. Most women can get pregnant right after they stop using the contraception, except for the hormonal shot — which can decrease fertility for months after it's discontinued, or even a year.”

However, some health professionals are not convinced that avoiding menstrual periods is the best practice, particularly for younger women. They voice a concern of long-term bone density changes or a breast tissue influence but the evidence for these is not consistent enough to point to a specific health care problem.

Women opposed to using hormones to stop their menstrual cycles entirely include those who do not want to introduce additional outside hormones into their body in order to control their menses.

They find this to be unnatural. They resent the idea that their bodies are controlled by pharmaceuticals and drug companies, which they have to give money to in order to maintain a no-period state.

According to Science Alert, women were originally asked when the pill was being developed if they wanted to have a monthly menses. They said they did because it would let them know that they were not pregnant.

BCPs are 91-95 percent effective if used reliably, which means, never missing one and taking them at the same time each day.

So it comes down to a personal choice. A woman can be relieved to not have that monthly “visitor” which can get in the way of many physical activities, especially if your menses brings with it heavy flow and pain.

There is no right or wrong way to think about whether you should or should not have a monthly period.

Share your thoughts on how you feel about having or not having a monthly period in the Comments section below.

Michele is an R.N. freelance writer with a special interest in woman’s health care and quality of care issues.

Edited by Jody Smith

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