Do Women Need Periods? | KUOW News and Information

Do Women Need Periods?

May 23, 2016
Originally published on May 23, 2016 1:28 pm

Six years of your life. Or 2,190 days. That's about how long the average woman will spend having her periods.

For some women, that's too many days, too many periods.

More women in their 20s and 30s are choosing contraception that may suppress their menstrual cycles, says Dr. Elizabeth Micks, who runs an OB-GYN clinic at the University of Washington in Seattle. "In general, I think views are changing really rapidly," Micks says. "That need to have regular periods is not just in our society anymore."

With traditional birth control, a woman takes a hormone pill for 21 days to stop her cycle. Then she takes a sugar pill for a week, so she can have what looks like a period.

But Micks says, physiologically this isn't a real period at all. And it isn't necessary. "There's absolutely no medical need to have a period when you're on contraception," she says.

So why have women been having all these "fake" periods for decades? "It's actually a historical thing," she says.

One of the doctors who helped invent the pill was Catholic. He thought the pope might accept the pill if it looked like women were having periods.

But the Catholic church never came around to the pill. And when doctors actually asked women if they wanted to have these fake periods, many said they didn't.

Today women have many options if they want to try to suppress their cycles. There's the hormonal IUD, an arm implant and a hormone shot. They can also take some types of birth control pills continuously.

Use of the IUD and implant has risen nearly fivefold in the past decade, a report from the Centers for Disease Control and Prevention found.

And two top medical organizations — the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics — recommend these forms of contraception as the top choice for young women who want birth control. One study found the IUD and implant were nearly 20 times more effective at preventing pregnancies than birth control pills.

But none of these methods are a guarantee for getting rid of periods altogether. "It's not an on and off switch for menstruation," says Paula Hillard, an OB-GYN at Stanford University Medical Center.

Instead, most women have spotting or unscheduled bleeding when they first start these methods. "It can happen without a rhyme or reason, but it tends to improve over time."

For example, with the hormonal IUD, about 50 percent of women don't have periods after a year. But nearly all women will have lighter, shorter and less painful periods after about six months, Hillard says.

Even if a woman hasn't had a cycle in five to 10 years, there's no evidence that suppressing menstruation hurts future fertility, Hillard says. 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.

As with all forms of hormonal contraception, there are risks and side effects with these devices, such as an increased risk of blood clots. And some doctors think there isn't enough known about the long-term effects of menstruation suppression, especially with teenagers.

"Important studies, like what are the effects on the breast? What are the effects on bone — haven't been done," says Jerilynn Prior, an endocrinologist at the University of British Columbia.

She says women should think carefully before trying to suppress their cycle. Having a period does serve a purpose, she says: It tells you your reproductive system is working well and that you're not pregnant. It isn't a "disease" that needs to be treated away, she says.

"I think there is value in understanding and appreciating our own intrinsic hormonal cycles," Prior says. "It's our identity."

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

RENEE MONTAGNE, HOST:

Let's turn to a growing trend with women in their 20s and 30s. Many are choosing contraception that may completely stop their menstrual cycles. This brings up a couple of big questions. Is it safe? And if a woman does not want to have children right away, is there any medical reason to have her period in the first place? NPR's Michaeleen Doucleff reports.

MICHAELEEN DOUCLEFF, BYLINE: Alana Massey remembers the exact day she started her period. She was 12 years old. And right away she was worried.

ALANA MASSEY: I calculated, like, the hundreds or thousands of periods I was going to have. And I was just devastated because I hated it so much from the moment it started.

DOUCLEFF: Massey's periods were long with painful cramps. But then a few years ago, she decided to try a form of contraception that could possibly stop her periods altogether. After a few months...

MASSEY: My period went from being, you know, lighter and lighter to just absolutely nothing at all.

DOUCLEFF: Now Massey hasn't had a period for about three years, and she loves it.

MASSEY: It just profoundly improved my mobility in the world and my comfort being in the world. And then I think about getting a period again, and I dread it.

DOUCLEFF: Massey is not alone. Last year, a report from the Centers for Disease Control and Prevention found the use of contraception that may stop periods has shot up. There's the arm implant, the IUD and a hormone shot.

Use of these methods has risen nearly fivefold in the past decade. Dr. Elizabeth Micks is an OB-GYN at the University of Washington. She's seen this new trend firsthand at her clinic.

ELIZABETH MICKS: In general, I think that views are changing really rapidly. And that need to have regular periods is certainly not - that's just not part of our society anymore.

DOUCLEFF: With traditional birth control, a woman takes a hormone pill for 21 days to stop her cycle. Then she takes a sugar pill for a week so she can have what looks like a period. But Micks says this isn't a real period at all and it isn't necessary.

MICKS: There's absolutely no medical need to have a period when you're on hormonal contraception.

DOUCLEFF: So why have women been having all these fake periods for decades?

MICKS: That's a really interesting question. And it's actually more of a historical thing.

DOUCLEFF: One of the doctors who helped invent the pill was Catholic. He thought the Pope might accept the pill if it looked like women were having periods. But the Catholic Church never came around to the pill. And when doctors actually asked women if they wanted to have these fake periods, many said they didn't. Now, Micks says, the American College of Obstetricians and Gynecologists recommends long-acting contraception, like IUDs and the implant, as the top choice for young women who want birth control.

MICKS: Those should be first-line methods for adolescents because they are so much more effective than birth-control pills.

DOUCLEFF: That's because adolescents sometimes forget to take them. But do these hormones have an impact on fertility?

MICKS: No. Most women can get pregnant pretty much immediately when they stop their hormonal birth control.

DOUCLEFF: But there are side effects and risks. Jerilynn Prior is an endocrinologist at the University of British Columbia. She says women should think carefully before trying to suppress their cycle. There's just not enough known about long-term effects, especially with teenagers.

JERILYNN PRIOR: And most of the studies - like, what are the effects on the breasts, or what are the effects on bone? - have not been done.

DOUCLEFF: And Prior says having a period does serve a purpose. It tells you your reproductive system is working well and that you're not pregnant. She says it isn't a disease that needs to be treated away.

PRIOR: I think there is value in understanding and appreciating our own intrinsic hormonal rhythms. It's part of our identity.

DOUCLEFF: Because, she says, periods are one of many things that makes women women. Michaeleen Doucleff, NPR News. Transcript provided by NPR, Copyright NPR.