Drugs make menstrual periods optional

updated 12:24 p.m. ET May 22, 2006

TRENTON, N.J. - For young women with a world of choices, even that monthly curse, the menstrual period, is optional.

Thanks to birth control pills and other hormonal contraceptives, a growing number of women are taking the path chosen by 22-year-old Stephanie Sardinha.

She hasn’t had a period since she was 17.

“It’s really one of the best things I’ve ever done,” she says.

A college student and retail worker in Lisbon Falls, Maine, Sardinha uses Nuvaring, a vaginal contraceptive ring. After the hormones run out in three weeks, she replaces the ring right away instead of following instructions to leave the ring out for a week to allow bleeding. She says it has been great for her marriage, preventing monthly crankiness and improving her sex life.

“I would never go back,” said Sardinha, who got the idea from her aunt, a nurse practitioner.

Using the pill or other contraceptives to block periods is becoming more popular, particularly among young women and those entering menopause, doctors say.

“I have a ton of young girls in college who are doing this,” says Dr. Mindy Wiser-Estin, a gynecologist in Little Silver, N.J., who did it herself for years. “There’s no reason you need a period.”

Demise of 21-7
Such medical jury rigging soon will be unneeded. Already, the Seasonale birth control pill limits periods to four a year. The first continuous-use birth control pill, Lybrel, likely will soon be on the U.S. market and drug companies are lining up other ways to limit or eliminate the period.

The idea gained momentum after Barr Pharmaceuticals launched Seasonale in November 2003. It’s a standard birth control pill taken for 12 weeks, with a break for withdrawal bleeding every three months. Amid wide acceptance by doctors, sales shot up 62 percent last year, to $110 million.

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Publicity for Seasonale made women wonder, if just four periods a year are OK, why have any at all?

Users of Pfizer Inc.’s Depo-Provera, a progestin-only contraceptive shot lasting three months, usually are period-free after a year or two. There’s now a generic version, but the drug can thin bones.

And many women have been getting extra prescriptions so they could continuously stay on birth control pills, the Ortho Evra patch or the vaginal ring, rather than bleeding every fourth week. That schedule was set by the original birth control designers to mimic normal menstrual cycles. But the extra prescriptions have led to insurance company hassles.

“What Seasonale did is get rid of that nuisance,” says Dr. Peter McGovern of University of Medicine and Dentistry of New Jersey.

New extended-cycle contraceptives will do the same. Wyeth is hoping by late June to get Food and Drug Administration approval to sell Lybrel, its low-dose, continuous birth control pill; approval also is pending in Canada and Europe.

Also in June, the FDA should decide whether to approve Implanon, a single-rod, three-year contraceptive implanted in the upper arm that maker Organon USA has been selling it in Europe for a decade.

Berlex Inc. is developing its own birth control pill for menstrual suppression.

Barr, aiming to be a leader in extended contraception, last November bought the maker of ParaGard, an intrauterine device that blocks periods in some women. Barr’s new product Seasonique, a successor to Seasonale, likely will get federal approval at week’s end.

Dr. Patricia Sulak, who researches extended contraception at Texas A&M College of Medicine, applauds this new trend. The doses in standard pills are now so low, she said, that having seven days off them raises the risk of pregnancy.

“This redesign is way overdue,” she says. “It’s going to be the demise of 21-7.”

Most doctors say they don’t think suppressing menstruation is riskier than regular long-term birth control use, and one survey found a majority have prescribed contraception to prevent periods. Women have been using the pill for nearly half a century without significant problems, but some doctors want more research on long-term use.

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