Do Women Need to Have A Period Every Month?

menstruation calendar with sanitary pads and tampons, close-up

I recently came across an interesting article in The Atlantic, about women using contraceptives to not have a menses.  My colleagues and I have similar conversations with our patients on a daily basis.

Many times we will prescribe oral contraceptives so that patients will not have a period, and the Mirena IUD many times will eliminate monthly menses.

Patients will inquire if  this is ‘natural’, and if it is okay. It might not exactly be natural, but medically there is no reason that a patient has to have a menses monthly. There is plenty of medical evidence supporting the use of continuous OCPs (oral contraceptive pills) so that patients don’t have menses. To clarify, continuous means skipping the pills without active ingredients that just keep patients on track. Most people are familiar with OCPs, there are generally 28 in a pack, 21 hormonally active pills and then 7 inactive pills that when taken will induce a period.   Skipping the 7 days of inactive pills and taking the hormonally active pills throughout the month, i.e. everyday and continuously, patients should not have a menses.

As Obgyns, we have long advised patients to skip the inactive pills and just start their next pack.  There are some pills out there that do just that too. e.g. Seasonique.

As an anecdote, when birth control pills first came out, some of the side effects were nausea and other symptoms that mimicked pregnancy. So the thought was that the having the pill free period every month so that patients have a menses, would help patients know that they are not pregnant.

If you are thinking of using a contraceptive to eliminate your monthly periods, speak to your healthcare provider.

Dr. Anthony P. Shaya, MD, MPH, FACOG