Monday, August 11, 2008

What Aunt Flo?

The Weddingbee post"Letter to Aunt Flo" inspired me to write a post that I have been sitting on for awhile now. I (happily) could not identify with anything she was saying because I haven't had a visit from my Auntie darling for almost 10 months now.


It's techincally called Period Suppression and it all started when I read this article in the September 2007 issue of Glamour magazine. The article had two different doctors facing off against each other, one arguing for suppression, and one arguing against.

First let's cover the argument against the idea. Christine Hitchcock, Ph.D., research associate, Centre for Menstrual Cycle and Ovulation Research, University of British Columbia in Vancouver makes three distinct points. 1st that periods are normal and ordinary and that we shouldn't be ashamed of what our body can do. 2nd is that the newest no-bleeding pill (at the time), Lybrel, didn't completely suppress bleeding in all women. 3rd is that the long-term effects of taking period suppression pills still hasn't been studied enough.

I won't address the 1st and 2nd parts of her argument (because I think they are kind of ridiculous), but as far as the 3rd part, the the period suppression supporter in the article, Leslie Miller, points out on her website that the original birth control dosages contained about 10,000 mcg of progestin and 150 mcg of estrogen, compared to the 100 to 1000 mcg of progestin and 20 mcg of estrogen that daily continuous use pills have now. So 40 years ago women were taking much much higher doses than we are today, and I haven't heard of any horrendous side effects yet, have you?

In her piece arguing for period suppression, Leslie Miller, M.D., clinical associate professor of obstetrics and gynecology, University of Washington, Seattle, Washington states that she hasn't had her period in almost 12 years. Doesn't that sound glorious? Her argument succintly states that there is no medical reason any woman needs to have a period, unless she's trying to get pregnant. The last week of pills in the traditional 28-day pack are just sugar pills to help the user keep track of which pills they have taken, and when you skip those on a regular basis, your uterine lining will not build up, so you will have nothing to bleed out.

What originally got me was her argument that period suppression not only cleans up the messy side of things, but it can help with menstrual migrains, mood swings, reduce the risk of anemia and vaginal infections, and of course, eliminate those horrendous cramps I was enduring. It doesn't have to be expensive because all you have to do is ask your gynecologist for any low-dose oral contraceptive (and make sure and explain what you are planning to do). The American College of Obstetricians and Gynecologists has said it is safe, and so far no published papers in scholarly journals have indicated that there is any danger.

Before I went in to see my gynecologist, I tried to arm myself with a little more information (from the internet of course). The only other arguments I could find against the idea stated that it could be dangerous because a woman could be pregnant and not know it (because she isn't having a period at all, and most women figure out they are pregnant because of a missed period) and then spend her time smoking and drinking and potentially harm her baby before she even knew she had one developing inside of her. This does not apply to me, as I do not ever smoke or drink, and I am not sexually active, so not only is there no chance of me harming my baby, there is no way to get impregenated in the first place.

Yes, it is more expensive over time because I have to buy more packs of pills, but That Groom is more than willing to pay for it. He LOVES That Bride with no period, and I know he has tried to convince several of his guy friends to get their girlfriends to suppress theirs as well. I don't get really really tired for a week before like I used to, I don't have those weird mood swings where nothing can be done right, and I don't have those horrible horrible cramps that sometimes had me moaning in pain.

Anyone else a period suppression advocate? If you are going to argue against the idea, please go ahead and point me towards any scholarly criticism that can help change my ways. Those of you that say I am denying the very essence of my womanhood, you should know that I never felt very excited about being a woman when Aunt Flo was hanging around. I plan on having many many children to surround myself with in Poland someday, I want to enjoy a few years without the monthly visit while I still can.


ley said...

You know, I've never really been for nor against it. I've considered trying the sppression method, but my biggest concern is one that I've heard about from friends but never really seen mentioned in articles: problems with your period once you stop the birth control/suppression. Several of my friends have gone the suppression route, then when they have wanted to start their period again for different reasons, it would take them a really, really long time before their period would come back normal, if at all. One of them didn't have an actual period for a year after stopping their birth control regimen, and even after that year it was really irregular. I haven't heard any medical advice about this, though...just saw my friends' experiences with it. Just something to think about.

Blablover5 said...

I completely agree with the argument for it that women used to be pregnant all the time so they really didn't have menstruation as often as they do now.

Not to mention the fact that the placebo pills were first put into the birth control pack as doctors figured women needed it to feel healthy and safe not because it was actually a requirement.

Skywalker said...

I'm not not for or against suppression. I use it when neccessary - as in skip a week of the placebo and go straight to the next pack of pills. But its not a regular thing.

I'm marrying a Catholic and will become one next year - they don't do birth control (yeah?)...wish me luck.

At some point, I will get off the pill for a while then jump back on (we have a history of fibroid cysts in our family) before I have to get the big H done (I have never seen my mom so happy until she had her H surgery - she danced!).

Kelli said...

*These are my opinion and what I've heard and what I won't do, and they all refer to the pill in general.* The side effects I've *heard* are that it will be harder to get pregnant and it seems like I've heard that you're more likely to get some kind of cancer. The side effect I KNOW about with the pill is that often women lost their sex drive while on the pill, but sometimes they lose it FOREVER (happened to some family members, one was on the pill that you don't have a period for 4 months, and several acquaintances). But both those things refer to the pill in general, not just the type that you're talking about, so I'm scared of them all, for me anyway, but other people can do whatever they want. Oh, other things I've heard from people, that the pill makes some women gain weight and that the 'back-up plan' of the pill is to prevent implantation of a fertilized egg (moral issues for me, definitely not for everyone).

Autumn Witt (future Autumn Witt Boyd) said...

I've been doing suppression for about a year and a half and I love it. My dad is an OBGYN and I asked him about it and he gave the go-ahead. My GYN isn't as crazy about it, she recommended quarterly periods. I'm pretty lazy about having one since I've gotten so used to not having them, probably more like every 6 months. The first one I had while suppressing them happened all on its own-- I was still taking the pills, after about 6 months. It was pretty heavy and uncomfortable, cramping, etc. But since then I haven't had any spotting, and have had to take about a week off from the pills to have one.

I do wonder about the sex drive suppression, mine is pretty low-- but I've been taking the pill to avoid horrible cramps since I was 14, so I don't really know what my sex drive will be like without it. I'll probably stop suppressing about 6 months before FI and I start trying to conceive, so that will be interesting. I'm hoping it will go up!

Stefanie said...

I haven't ever really had difficult periods. I've been on the pill since I was 15, originally to regulate my periods, reduce my cramps, etc. and since then, I haven't had really bad problems. I suppress when I need to...I've already charted out my period compared with my honeymoon, for example, as I'd prefer it not be around then...but since it's not a really big deal for me either way, I just go ahead and take my pills as "normal." I'm totally for it though...maybe I'm one of those women that feels like I need it just out of habit and what feels "normal" to me...kinda I can't figure out why I don't suppress...I have nothing against it...hmmm...

purplewedding said...

I was on the pill for 9 years straight and usually did the period thing, though from time to time I did do a few packs back-to-back if there was a special occasion which I didn't want Auntie to be at.

I've now been off the pill for 10 months (for various reasons) and I am STILL waiting for my periods to be regular! There are huuuge gaps in between and then barely anything. Honestly, it's making me quite worried though the docs keep telling me it's no biggie. It's definitely something to think about. That said, there is an upside: I concur that there's an increase in sex drive!

At the end of the day, every gal has to weigh the pros and cons for herself and do what's right for her/the relationship. ;-)

Guilty Secret said...

I'm with you, lady!

You were right not to address her first point because it was so ridiculous, but personally I can't resist!

"periods are normal and ordinary and that we shouldn't be ashamed of what our body can do"

Erm, sorry lady, I don't suppress my periods because I'm ashamed of them! I do it because it's well known amongst medical professionals that it's a completely unnecessary inconvenience.

Lady T said...

i've never known anyone whose taken them so thank you for sharing this.

i just started the Nuvaring i'm due for my first cycle this week. i'm not looking forward to it and have been feeling less than stellar for a few days now.

i'm not sure if i will try suppression in the future, my fi and i have decided to make the birth control decision together so he might need to do a lot of research to feel comfortable with the idea.....i doubt it would take him much convincing once he realized that the "fun park" won't be "closed for repairs" once a month. lol....

Lady T said...

ahhh...after reading thru other replies, it reminds me that when i quit the birth control a couple years back, i definitely noticed a difference in my sex drive. though i no longer needed that, lol.

i wanted to find something non hormomal other than condoms to avoid the dip in sex drive, but we weren't 100% comfortable with the IUD so, the Nuva-ring will have to be it until we come up with something else.

i'll pray over the sex drive. ;)

Riley (aka Rachel) said...

I've taken the pill off and on for many many years. Many. I'm 32, people.
Anyways, I've tried the suppression method with normal pills, and they worked okay. I will say that I noticed more spotting here and there with that. Now, I'm taking the Seasonale pill - it's 3 months of pills and at the end of the 3 months you have a placebo/period week. Since taking those, even with the placebo week, I don't get my little enemy. The first few times it happened, I ran out and got pregnancy tests, just to be sure. But it was just a side effect of the pills.

I really like not having to worry about Aunt Flo... no mess, no worries, no physical pain, etc. And as far as cost goes, the Seasonale is the same price as other pills. Plus, with suppression, you don't have to buy tampons or pain meds! ;-)

As far as getting off of the pill, I did that for about 6 months a few years ago, and after a month or two my period came back to somewhat normal (albeit, lighter). And my sex drive was definitely higher.

Since we are planning on starting a family pretty soon, I'll probably need to stop the pills fairly soon after the wedding... With ANY birth control, it CAN take you a little longer to get pregnant, even if you do get your regular period.

hwong14 said...

I've suppressed mine, but not through the regular route of skipping the placebo week. I'm on Loestrin24, which has 24 days of active (low dose) pills and 4 days of iron-containing placebos (instead of 21 and 7). The shorter placebo time doesn't give my uterus a chance to produce a withdrawal bleed, so I haven't had a period in months. It's great! (All women will have much shorter periods with this brand, but not all will have complete suppression.) As a medical student and future Ob/Gyn, I'm a complete advocate of it. Having a period while on the pill isn't real anyway -- it's a fake period, just a withdrawal bleed, to help you keep track of time. You're not ovulating. So the fake period is totally unnecessary. Women will all react different once they stop the pill, whether they were suppressors or not -- some will return to regular cycles quickly, and some won't.

Jenna said...

hwong-I have a gyno appointment on Monday. This Loestrin sounds like something I want to try.

Kait said...

My only real concern with the suppression pills is that I like that my period is like a built-in monthly pregnancy test. I mean, I take my pill very responsibly but it's only 99% effective. I have this fear that if I took the suppression pill I might end up pregnant and not even know it. Is that silly?

twobrides said...

I have a bleeding disorder so I have been on the depro shot to eliminate my period for several years now. I l-o-v-e it. I had sooo much pain/bleeding it was horrible. I had to go to 4 diffrent gyn's to take my pain seriously- only after going to a bleeding specialist and getting my diagnosis did they take me seriously and put me on a med to stop my periods. I say GO for it totally and keep doing it.

Jenna said...

Kait-I don't drink, smoke, or even have sex, so I don't have any reason to have a period to tell me if I am pregnant :) If I did have sex and smoke/drink, I would definitely say it was a bad idea to suppress, as you could potentially harm your baby with those activities.

twobrides-My experience with bleeding was never that bad, but it sounds like it is definitely something you needed!

katier10381 said...

I know I'm a bit late on the uptake here, but I haven't had my period for over two years. I use the Nuvaring to suppress my period. You are supposed to wear the ring for three weeks and take it out for one week to get your period. However, the ring actually has four weeks worth of hormones in it. So I leave it in for four weeks and then just change it out for a new one. I can't imagine going back to getting a period every month. I'm definitely keeping this up until I'm ready for kids!

Jenna said...

katier-I'm going to ask my Dr. about it the next time I go in!