When the birth control pill
was first formulated, it was sequenced in such a way that the hormones
would suppress ovulation for 21 days, but the last seven pills were placebo,
allowing the hormone withdrawal that brought about a period. In
this way the woman taking them would know she wasn't pregnant and would
be reassured that everything seemed to be working. She may have been correct in knowing she wasn't pregnant
by the appearance of a period, but the bleeding assuring her that everything
was working right was a false reassurance.
In the past, patients treated
for PMS or debilitating
pain during periods were offered a new way to take the birth control
pill. They would be instructed to take the 21 active pills, but instead
of proceeding on to the seven sugar pills and have a period, instead
go right into the next pack of pills. A patient who did this would
have a period after 42 days or so. A patient who did this four times
would only have a period every three months. Eight continuous packs
would keep periods down to twice a year. It was one of the best kept
secrets in gynecology, because it was feared that patients would look at
the suppression of periods as unnatural.
But isn't the suppression
of ovulation just as unnatural?
Yes.But since ovulation doesn't
have an obvious outward sign (like bleeding), this unnatural suppression
is forgiven every month by the woman doesn't get pregnant.
Now we're beginning to see
that the avoidance of pregnancy, which prehistorically would have been
the unnatural, isn't without its own trade-offs. Increased tendency
to ovarian, uterine,
and breast cancers
haunt those who have never been pregnant or who were first pregnant
later in life. It's as if evolution
is saying of the uterus, 'You better use that thing'
What is it about pregnancy that
seems to protect a woman from certain cancers? Investigators are focusing
in on how estrogen affects these tissues. It seems that pregnancy
is good for you. So is Pseudopregnancy
which is what the birth control pill is. And it may be that the non-cycling
nature of pregnancy is what is protective, not just the estrogen at all.
So now we're rethinking this
21 day on/7 day off and then a period regimen. How
about 84 days on, 4 days off, with a period about every three months?
This may be a whole lot safer, it turns out. Now that the birth control
pill has a successful track record for two generations (is that an oxymoronic
statement?), women are more likely to trust them even without the monthly
period.
The women's magazines have already
began presenting articles about suppressing the periods. But it's
still leaving a slightly anti-feminist flavor in the mouth of those who
mistakenly think that periods with the pill are the real thing. Once
that gender-correct prejudice fades away, women will wonder how life might
be with only a rare period every now and then. Most will like it
very much. And if you ask any young lady who
has just begun her periods, you'll surely get an intense opinion on
the unfairness of it all. Besides the merciful suppression of periods
for PMS and pain, it might be correct to do it out of convenience now that
weˇ¦re seeing how monthly periods year in and year out may be doing women
more harm than good, no matter how natural it seems.
If the women's magazines are
starting to espouse the wisdom of non-cyclic hormones, it won't be long
before this option is available from a woman's gynecologist just for convenience.
(Actually, besides PMS, we've been cheating with the pills like this
for honeymoons, vacations, and final exams that would otherwise be spoiled
by a menstrual period.) And there are currently birth control pills being
developed that will limit periods to once a season.
In my practice, I've offered
non-cyclic birth control pills for a couple of years now. Each individual
woman's body has its own tolerance as to how many packs she can take before
experiencing a little break-through bleeding, but most tolerate three or
four packs well.
Revisiting the four categories
for women in the past, the second group at the beginning of this article
can be amended to read: Pregnant...or continuous
(non-cyclic) pseudopregnancy.
And maybe this revision may keep women out
of the fourth group by lowering the risk of certain cancers.
