The Use of Non-cyclic Birth Control Pills

December 14, 2007

Radical thinking and an end to periods? Or, Pregnancy is good for you!

In the previous thousands of years, women basically fell into four groups:

1) Pre-puberty
2) Pregnant
3) Breast-feeding
4) Dead

With civilization, the spacing of children came about through knowledge of sex as it relates to pregnancy. Also, when quality of life began to include livelihood and budgets, family planning became all the more prevalent with society. And then when the birth control pill was invented, technology drove that final wedge of convenience between sexuality and reproduction.

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.

Suppressing Ovulation with Birth Control

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 we¡¦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.

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