Do We Really Need to Have Monthly Periods?

The Flexibility of the Pill

Doctors have known for years that the Pill's 28-day cycle is an arbitrary one that only mimics a woman's natural rhythm. For women with debilitating cramps, heavy flow, ]]>anemia]]>, ]]>endometriosis]]>, or menstruation-related ]]>migraines]]>, some doctors prescribe the Pill to be taken every day, with perhaps the "week-off" of placebos taken every three months or so.

But healthy women, too, are using the Pill this way. Soldiers and astronauts have the option of staying on birth control pills to avoid having periods while on duty or in space. And women often turn to their doctors—and the Pill—to ensure a period-free honeymoon.

New Developments

The most recent news regarding extending cycle lengths involves the development of a new oral contraceptive specifically designed for just this purpose. The Eastern Virginia Medical School (EVMS) has patented a new extended use pill called Seasonale, which is packaged as 84 days of continuous active contraception followed by seven days of inactive pills that allow for menstrual withdrawal bleeding. This pill regimen will reduce the number of periods per year from 13 to four (or once per season, hence the name "Seasonale"). This drug, which is manufactured by Barr Laboratories, received Food and Drug Administration (FDA) approval in September 2003.

Health Benefits

Some researchers believe that interrupting the recurrence of menstruation could protect some women against ]]>ovarian]]>, ]]>endometrial]]>, and ]]>breast cancers]]>, as well as inhibit fibroids, migraine, and endometriosis. However, supporting evidence is lacking for these potential benefits, and there may be health risks as well. There is little doubt, though, that the medication would address lesser complaints like mood swings, pelvic pain, and breast pain and swelling, and could help prevent iron deficiency anemia. Currently, studies are ongoing.

The History of Menstruation

Those who argue monthly menstruation is unnecessary cite faraway tribes and pre-industrial times. In such places and times women start menstruating at about age 16, begin having several children shortly after, and breastfeed each child for years (which can prevent menstruation). American women today typically menstruate 400 times before ]]>menopause]]>. By contrast, in the lifetimes of our ancestors as recently as colonial times or of such tribes as the Dogon in Mali today, women might menstruate 100 times before menopause.

The argument is that evolution didn't make the leap when we advanced our nutrition to the point where we began menstruating around the age of 10 and controlled our fertility to the point where we have only two children, often well after the age of 30.

The History of the Pill

When the Pill was first being introduced, its makers decided that maintaining a woman's monthly cycle would engender its acceptance. But they also knew that the Pill's cycles weren't the same as normal menstruating cycles because the Pill prevents ovulation, and that a three-month-long cycle on the Pill would be just as "natural" (or unnatural).

Another Example of the Right to Choose?

Some health professionals believe that monthly menstrual cycles are a healthy, natural function of a woman's body. Some are even leery of the Pill as a contraceptive, even after all these years. They are loathe to consider continuous use of the Pill to avoid menstruation altogether. However, the idea may be intriguing. Indeed, should studies show that continued use of the Pill is good for you, or at least as healthy as the 28-day Pill cycle, many women will undoubtedly welcome control over their menstrual cycle