When birth control pills were first developed the goal was to prevent pregnancy. Since that time the medical community has uncovered many non-contraceptive benefits to the pill including less blood loss, less pain as well as the prevention of certain types of ovarian and uterine cancers. When they were first developed the pills were meant to mimic an average woman’s cycle of 28 days. It was thought that a woman would be more accepting of the pill if she had what appeared to be a ‘normal cycle’. Over the years the pill has changed, as has the reasons for prescribing them. Overall, today’s birth control pills are much lower dose and better tolerated than those of the past.
As the reasons for giving the pill have changed, so has the way they are taken. For years, gynecologists have been having women ‘skip periods’ for medical reasons by rearranging the way they take their regular birth control. In the past few years the pharmaceutical companies have jumped onto this wagon and started packaging pills for this specific purpose leading women to wonder, “Is it safe to skip my period?”
When talking about the way birth control pills work most people are referring to a combination pill, one that contains both an estrogen and progesterone component. These pills mimic the normal hormones produced by the ovary and suppress ovulation to prevent pregnancy. They also contain less estrogen then most women normally produce and a low but stable amount of progesterone unlike the variation seen in the natural cycle. This combination of hormones makes it possible to suppress ovarian function while keeping the lining of the uterus thin and healthy.
Women who are not on a birth control pill do need to have a menstrual cycle at least four times each year to prevent abnormal growth of the lining of the uterus. Women who are on birth control are keeping the lining thin and healthy by taking the medication and have no medical need to have a period.
There are now several pills out that lengthen the time between periods (such as Seasonale), or try to eliminate periods altogether (Lybrel). Newer formulations are meant to shorten the period to 1-2 days but frequently result in no noticeable bleeding at all. The biggest side effect seen in women taking extended cycle pills is spotting that typically resolves with time. The good news is that a woman can use any low-dose pill to skip periods after consulting with her physician.
When birth control pills were first introduced it took several years for women to accept them as safe and effective. Now the next step is for women to accept the manipulation and even elimination of the menstrual cycle is a safe alternative and even added benefit of the pill.
This is the first in a two part series. Check back for “Part Two: Birth Control Pills and the Risk of Cancer.”