Study reveals women like idea of skipping periods but want more information

November 17, 2004

JACKSONVILLE, Fla. — Women like the idea of menstrual suppression — skipping or eliminating monthly periods — but want their health-care providers to tell them more about it, according to a report co-authored by University of Florida researchers.

In a national multicenter study published in the current issue of the journal Contraception, the UF scientists describe women’s and clinicians’ attitudes toward menstrual suppression — a subject few researchers have explored, according to the Association of Reproductive Health Professionals, which co-sponsored the study with Barr Laboratories. The study shows that the concept of changing menstrual patterns is popular among patients and practitioners alike, but their awareness of the topic differs significantly.

“Surprisingly, we found out that most women have never heard of using birth control pills to skip a period, while eight out of 10 clinicians — 90 percent of whom were female — have heard of it and seven out of 10 of them have prescribed it to suppress menstruation,” said co-author Dr. Andrew M. Kaunitz, a professor in the department of obstetrics and gynecology at the UF Health Science Center Jacksonville.

“We also found out that women and providers disagree on the need for having a period every month,” said Kaunitz. “Fifty percent of the women surveyed and only 7 percent of providers think a menstrual period is necessary every month. This translates to a big information gap between what the providers know about menstrual suppression and what they tell — or don’t tell — their patients.”

Even though the women and clinicians surveyed said they believe menstruation is a natural event and should not be treated like a disease, the researchers found that women were intrigued with the notion of not menstruating every month for various reasons, including not enjoying getting their period every month and feeling that men have a real advantage by not having the monthly interruption. Two-thirds of them reported they wouldn’t miss their period if it disappeared and would be interested in stopping their period if it were safe and free.

In fall 2003, the U.S. Food and Drug Administration approved the first extended-course oral contraceptive, which providers prescribe for menstrual suppression. A 91-day regimen reduces the number of a woman’s expected menstrual periods from once a month to about once every three months.

The study was spearheaded by researchers at Boston’s MGH Institute of Health Professions. Kaunitz also collaborated with UF Jacksonville obstetrics and gynecology research manager B. Lynn Musselman and researchers at the University of Southern California Los Angeles, Planned Parenthood of West Michigan, the Allentown (Pa.) Women’s Center and Planned Parenthood of New Mexico.

Researchers conducted the study in three parts using written surveys from 1,470 women, clinician interviews of 18 women and written surveys of 512 health-care providers. The women surveyed were between the ages of 18 and 40, had a uterus and ovaries, and were neither pregnant nor attempting to conceive.

Nearly three-fourths of the women sampled had never heard of menstrual suppression with oral contraceptives. Nearly two-thirds of them would be interested in not menstruating every month, and one-third would choose never to have a period. Nearly half the clinicians thought that menstrual suppression is a good idea, with only 7 percent of them thinking it was physically necessary to have a period every month.

One thing women and providers agree on is the need for more research on menstrual suppression to determine whether the practice has long-term effects on health, Kaunitz said. Both clinicians and women reported that the possibility of long-term health effects has the greatest influence on whether they prescribe or take oral contraceptives for menstrual suppression. Other concerns cited were short-term side effects, future fertility and cost.

“We have years of safety data on the long-term effects of taking birth control pills from studying women who have been taking much higher-dosed pills since the 1960s,” said Kaunitz. “I have no safety concerns about women taking today’s lower doses on an extended basis.

“Short-term side effects of the extended-course pills include spotting or breakthrough bleeding – especially after being on the pills after nine to 12 months,” he added. “Women who cannot tolerate unpredictable bleeding probably are not the best candidates for this regimen.”

The study results demonstrate that clinicians should discuss this option with their patients, Kaunitz said. “ARHP sponsored this study because we focus on educating health-care providers and the public about the latest innovations in reproductive health practice and technology,” said Wayne C. Shields, ARHP president and chief executive officer. “Since all women are unique and their needs change over time, ARHP advocates for as many safe, effective contraceptive options as possible. Extended and continuous regimen contraceptives are good choices for many, but not all women, and are an important part of the mix.”