Is menstruating still necessary? It’s also possible to delete your periods with hormonal contraception. A lot of women do this, sometimes even without knowing. Here’s how.

When using hormonal contraception (the contraceptive pill, vaginal ring, contraceptive plasters, injectable contraception or intrauterine contraception), you don’t actually menstruate anymore. Synthetic hormones, like levonorgestrel in the Mirena-IUD and progestin in the contraceptive pill, suppress the growth of the endometrium (uterus lining), resulting in hardly any or no periods at all.

With a coil or birth control implant (like Implanon) you can’t influence the blood loss, but with a birth control pill, plaster or Nuva-ring, you can more or less manage it by either having a week off or not. From a medical point of view, having a pill-free week isn’t necessary. That’s why more and more women keep on taking the pill without break. This also reduces the chance of an unwanted pregnancy, which is highest when forgetting the pill in the first week after the pill-free week. Also a vaginal ring can be worn without taking a break. The disadvantage of continuous using (both with the pill, patches and the ring) is a higher chance of breakthrough bleedings (spotting), which can be minimised by scheduling in a week off.

Most common contraceptive method: the birth control pill

What hardly anybody realises: the bleeding that occurs during the break week is a withdrawal bleeding, not a natural menstruation. Even though it may feel like one. And that’s exactly the reason why it has been invented in the first place. Scientists who created the first generation contraceptive pills thought this natural rhythm of bleeding every fourth week would appeal to women, seeing as they were used to it.

It’s estimated that nowadays about 100 million women worldwide use combined oral contraceptives. A study that was published in Reproductive Health in 2013, has researched contraceptive methods of women between 25 and 44 in the USA, UK, Germany, Italy and Spain. The most common method was the pill; use varied between 35% in Spain and 63% in Germany. (Numbers two, three and four were the male condom, the Mirena IUD and the implant). Also in the Netherlands, the birth control pill is the preferred method of contraception, with 27.3% of Dutch women choosing the pill and 7.3% going for the Mirena IUD in 2017, according to research by Rutgers Kenniscentrum Seksualiteit. All in all, using hormones to prevent pregnancy is quite popular.

Period pain, PMS, menorrhagia, endometriosis: all reasons to press the escape button

Is it bad to delete your menstruation with hormones? Or is choosing for a life without periods perhaps even healthier for your body? Some people think it is. Fact is that we menstruate more than ever before. Nowadays, getting around 500 monthly bleedings during your lifetime is the norm, rather than the exception. It wasn’t always like that. A few hundred years ago, women only menstruated about 50 times in their lives. That’s because in the Middle Ages women spent a lot of time either being pregnant or breastfeeding. Also they died often long before menopause.

Due to a combination of factors, nowadays we menstruate about ten times more often than a couple of centuries ago. Spending around 2,500 days of your life (which is 6.8 years if you’d have all those periods back-to-back) bleeding from your vagina and yet only producing 1.7 children on average; it doesn’t seem very efficient. It can also be really annoying – of course Aunt Flo always visits at a bad time- and exhausting, as every menstruation drains energy and important nutrients such as iron. Let alone the fact that for a lot of women, being on their period means pain, cramps and other troubles.

It’s estimated that 1 in every 10 women suffers from endometriosis, a chronic condition where tissue that looks like that which lines the inside of the womb, grows outside the uterus. Heavy blood loss (menorrhagia) affects 1 in 5 women above the age of 35. It’s estimated that PMS and/or the more extreme version, PMDD, troubles 1 in every 4 women. And of course the very common period pain: something half of all menstruating women have to deal with.

Is choosing for a life without periods perhaps even healthier for your body?

There are definitely some reasons to press the escape button, like all hormonal contraception users actually already do. A 2005 study of the Association of Reproductive Health Professionals discovered that women aren’t that attached to their monthly cycle: 40% of the participants would prefer to never have a period again and 55% of the more than 1000 women who filled out the survey expressed an interest in menstrual suppression. Back to the big question: is this harmful? Or could menstruating less perhaps even come with health benefits?

‘Not menstruating can prevent endometriosis and also leads to a smaller risk of endometrial cancer,’ agrees Prof. Dr. Judith Huirne of the Department of Obstetrics and Gynaecology at the VU Medical Center (Amsterdam, Netherlands), in Women’s Health. But that doesn’t mean deleting your menstruation is always better for your health, as using hormonal contraceptives also comes with health risks. Huirne: ‘The matter just hasn’t been researched well enough yet.’

Risks and side effects of hormonal contraception

Do the advantages of tricking your menstrual cycle outweigh the disadvantages? That’s something every woman has to decide for herself. Preferably together with a medical professional, as not only the severity of your menstrual complaints should be considered, but also your personal health. Obesity, a higher than average risk of developing thrombosis, breast cancer running in the family; all these things have to be taken into account.

For now, deleting your menstruation will have to be done with hormones. And these hormones come with health risks and side effects. The contraceptive pill, for example, increases the risk of deep vein thrombosis (DVT) and also leads to a slightly higher chance of developing breast cancer. Common side effects of the birth control pill include headaches, tender breasts, weight gain, mood changes and a decreased libido.

Logical that the idea of using hormonal contraception to suppress your cycle is more and more met with resistance. But this leads to another issue: how to manage contraception?

Editorial note: Period! Magazine is a journalistic platform and is NOT intended as a substitute for the advice of medical practitioners. If you’re suffering from any medical complaints, always visit your doctor or GP. 

Also read:
Pills & Periods
No more periods. Help?
Not now!
When is a lot, too much?
Endometriosis awareness