Using the pill to stop periods — Is it really a good idea?

Dr. Jolene Brighten Hormones Comments

 

The birth control pill is used for many symptoms and conditions outside of just preventing pregnancy. But when it comes to using the pill to stop periods all together we should really ask — is that a good idea?

In 2015 the American College of Obstetricians and Gynecologists recommended that physicians evaluate every woman’s menstrual cycle as a vital sign — just like they do with blood pressure, temperature, respiration, and pulse. They also recommended teaching every woman how to understand and track their menstrual cycle.

This is smart. A woman’s period can provide great insights into her health.

But often, when a woman expresses that her periods are difficult, painful or all around bothersome, her doctor is quick to offer up a magic pill that can make periods go away all together. It really does sound delightful, but there are some problems that come with this approach. 

Your Period Symptoms are a Clue

When doctors encourage women to suppress their menstrual cycles, they’re also concealing important symptoms that give us clues about deeper underlying conditions. This is a dangerous game that can raise the risks of women developing even more debilitating conditions in the future.

As a doctor, I ask every woman in my clinical practice about her menstrual cycle as part of her complete health screening. It is truly that important.

Women’s periods are not just a monthly nuisance — they provide incredible insights about hormones, nutritional status and overall health.

For example, brown discharge at the beginning of menses is a sign of of low progesterone levels and left over blood from the period before. When there are clots in the menstrual blood estrogen levels may be too high. Conversely, low estrogen creates short, scanty periods. As you can see, there is a lot your period can reveal about your health.

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Your period provides a great deal of insight about your hormones and the rest of your body. When it is suppressed, we run the risk of missing vital clues about your health.

As an example, menorrhagia, or heavy periods, which are commonly treated with oral contraceptives, can be a sign of iron deficiency anemia.  

Sure, some would argue that stopping this patient’s menses would prevent iron loss and is therefore a “treatment.” But what if the iron deficiency is due to intestinal malabsorption, which can occur in those with celiac disease?

Jumping to a period suppressing prescription could delay a celiac diagnosis and keep the patient from getting appropriate treatment. And worse, it could lead to further damage in the body, like the development of neurological symptoms or osteopenia, the beginning stages of osteoporosis.

It is important for doctors to ask “Why does this patient have these symptoms?” before reaching for their prescription pad. It can be incredibly harmful to your health to only be handed a prescription without at least some investigation into why you are experiencing these symptoms.

Suppression without question is dangerous.  

Are heavy, painful periods inconvenient and at times disabling? Of course, but these inconveniences are a signal from your body that something is off and that you need to pay attention.

Silencing these signals with continued hormone suppression can do further damage and allow for even more troubling conditions and diseases to go undiagnosed.

Prescribing continuous birth control pills to suppress periods without giving attention to what may be causing a woman’s symptoms is a disservice to women and keeps them from receiving proper treatment.

In addition, the birth control pill comes with many side effects — some of which your doctor may not be aware of.

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What many women don’t know about birth control

I was once a young woman who bought into the conventional narrative that periods are unnecessary and that all of your symptoms could be resolved by taking one little pill a day.

What no one told me is that birth control comes with side effects that are damaging, some of which are irreversible.

Migraines Increase the Risk of Clots

Many women are familiar with the increased risk of blood clots. However, very few are aware that these synthetic hormones should never be prescribed to a woman who experiences migraines with auras because of the increased risk of stroke.

Over 40% of women are estimated to have migraines. This is not an insignificant number, especially when talking about elevated stroke risk.

Post-Birth Control Syndrome

Approximately 37%  women with irregular periods lose their periods for good when they stop the pill—a phenomenon of Post-Birth Control Syndrome. Post-Birth Control Syndrome is a very real condition that few women are told about.

Birth Control Pill Associated with Depression

A recent study of over 1 million women showed us that there is an 80% increased relative risk of depression in women who use hormonal birth control, a symptom many women have been suspicious of since the pill was introduced to the public. 

There has yet to be as extensive of a study on the long term effects of continuous birth control use and depression.

Birth Control Pill is Nutrient Depleting

Many patients are not informed of the numerous studies showing the nutrient depleting effects of oral contraceptives.

In 2013, the European Review for Medical and Pharmacological Studies called for all women to be on a multivitamin while taking oral contraceptives due to the known nutrient depletions, most notably magnesium, zinc, selenium, folic acid, vitamins B2, B6, B12, vitamin C and E.

Birth control depletes the body of folic acid, which is vital in many metabolic processes and is absolutely essential should you become pregnant. Folic acid is necessary to prevent neural tube defects in a developing fetus. Unfortunately, the critical window for folic acid in development occurs before the majority of women know they are pregnant – in just those first few weeks.

Now imagine if you do become pregnant while suppressing your period — you’ve depleted your nutrients, are oblivious to the early signs of pregnancy, and the damage has taken place before you ever realized you were pregnant.

And yes, pregnancy does occur while taking birth control pill.

It is the doctor’s’ responsibility to provide a true informed consent and guide women in understanding the pros and cons of the medical decision they are faced with. This is the only way in which women can make the best decision for their body and it is their right to know that while the pill may help relieve symptoms, it may also have unwanted side effects with long term consequences. 

Is It Safe to Use the Pill to Suppress Periods?

In a 2014 Cochrane Review of continuous versus cyclical birth control use they concluded that, “…the studies were too small to address efficacy, rare adverse events, and safety” regarding the continuous use of birth control.

Or in other words, there’s not enough information. I think this is something worth mentioning to women prior to writing a prescription.

By comparison, the findings regarding extended birth control use versus 21 day with one week of withdrawal were favorable. But keep in mind the comparison is based on using the pill for 21 days or continuously. They did not compare the effects of extended use to that of a woman not using any hormonal birth control.

And as we know, birth control already comes with a hefty load of side effects as is. I think we should at least acknowledge that it could possibly harmful to dose continuously and at minimum women should be told that the evidence to assess the safety is limited.

The Pill and Your Fertility

In my clinical practice, I’ve worked with countless women who were given the pill to treat symptoms like acne, irregular periods, migraines, PMS, amenorrhea (absence of menstruation) only to find themselves infertile later in life.

How does this happen? The symptoms that arise early in life are pointing to greater imbalances. Underlying conditions, such as PCOS, can go missed for decades!

When a doctor hands a woman a pill for symptom relief, there should be –  at minimum –  an acknowledgment that the pill is meant to treat only her symptoms.

The Pill and Quality of Life

Despite all of what has been discussed above, many will argue that taking the pill relieves monthly pain and  therefore, improves quality of life. However, for some women quality of life may actually be diminished where mood and libido are concerned.

Loss of libido and inability to achieve orgasm, well-known side effects of birth control, have a serious impact on a woman’s quality of life. This should be discussed with women considering the birth control pill.

There is data supporting a correlation between birth control and depression, which is a symptom women have complained about since its adoption in medicine. With a significant increase in the number of Americans currently taking anti-depressants (an increase of 400% between 1988–1994 and 2005–2008), it should at least give us pause before beginning the birth control pill.

For many women, resolving the underlying cause of their menstrual symptoms is a far more favorable option compared to the considerable impacts birth control would create in their intimate relationships, not to mention their long-term fertility.

The birth control pill isn’t necessarily an upgrade in quality of life for many women. It is important for women to weigh these risks before opting in.

So is using the pill to stop periods really a good idea?

Some women will not want to dig deeper to understand the underlying cause of their PMS. Some women want the perceived freedom of not having a monthly cycle – despite knowing the short and long-term consequences. And some women absolutely can not get pregnant and the pill is what they have chose for contraception. 

It is important to recognize that this is 100% their choice and our reproductive health should be our choice.

My philosophy is that you are the only one living in your body and that no one, not even a doctor, knows how to live your life best for you… and that you deserve to have ALL the information before making this decision. 

But period suppression to escape symptoms is not healthy or necessarily what’s best for your body. And you should have a doctor who is willing to ask why and help you get to the root of your problems before opting to mask them with the pill. The first step toward this is demystifying menses, hormones and women’s health so that every woman can make the absolute best decision for her body and her life.

If you’re ready to start your journey to understand how to eliminate your unwanted symptoms, hormone free download
the Hormone Starter Kit for free.

 

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Citations:

Edelman A, Micks E, Gallo M, Jensen J, Grimes D. Cochrane Fertility Regulation Group. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Fertility Regulation Group, 29 July 2014, DOI: 10.1002/14651858.CD004695.pub3

Edlow, A, Bartz, D. Hormonal Contraceptive Options for Women With Headache: A Review of the Evidence. Rev Obstet Gynecol. 2010 Spring; 3(2): 55–65.

MacClellan LR, Giles W, Cole J, Wozniak M, Stern B, Mitchell BD, Kittner SJ. Migraine with Aura Stroke Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke. 2007;38(9):2438.

Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e143–6.

Pratt, L, Brody, D, Qiuping G. Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008. NCHS Data Brief No. 76, October 2011

Skovlund C, Morch L, Vedel Kessing L. Association of Hormonal Contraception with Depression.
JAMA Psychiatry. Published online September 28, 2016. doi:10.1001/jamapsychiatry.2016.2387

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten is a licensed Functional Medicine Naturopathic Doctor, best selling author, speaker, and mother. Dr. Brighten specializes in women’s health, from fertility to postpartum care, adrenal and thyroid support, autoimmune conditions, and digestive disorders. In her patient centered practice, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness.