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Choosing Whether and When
Some women regard monthly periods as a reassurance that their body is healthy. Others, especially those with heavy periods or bad cramps, dread its arrival. For most women, periods can be an inconvenience at times, such as during vacations and special events. For women with heavy painful periods, or women with special circumstances, such as athletes, performers, and those serving in the military, having extended cycles, with more time between cycles, is especially convenient.
What is a Period?
About once a month, your uterus prepares to nurture a fertilized egg by building up a thick lining with a rich blood supply. If you do not become pregnant that month, the lining breaks down and the blood and tissue exit through the cervix and vagina. Some women have periods like clockwork - every 28 days - but it is normal to have periods anywhere from every 3 to 6 weeks. It is also normal to have irregular periods or to occasionally skip a period, especially if you are traveling, under unusual stress, or ill. Women in Western societies have about 450 menstrual periods in their lifetime.
Methods to Change Your Menstrual Cycle
Birth control pills, created in the 1950s were designed to mimic the normal menstrual cycle by giving women a period every 28 days. There is no scientific evidence to suggest that this timing is necessary; in fact, it was done to make the birth control pill more acceptable to women and clinicians. The familiar 28-day pill cycle consists of 21 days of hormone containing pills and 7 days of no hormones. Scientific studies, during which women were given a chance to use a longer cycle of pills, showed that most women preferred a longer cycle of 6 to 12 weeks between periods and had fewer menstrual-related symptoms by doing so.
Is it Safe?
Is it safe to extend the cycles of birth control pills to have periods less often? Yes. If you take the hormone pills for 12 weeks before taking the 7 "blank" pills, with no hormone, your uterine lining would get very thin. When you stop taking the hormone pills, the uterus gets the signal to shed its lining, so you will still have a period, only lighter and with more time in between periods. In addition, women who take these pills every day for 12 weeks may be less likely to forget their pills, making this birth control method less likely to fail.
How Will I Know if I am Pregnant?
As with the "regular" way of using birth control, if you miss a pill, you should have emergency contraception available to you, and you should also take a home pregnancy test. If you take pills irregularly or miss pills frequently, you should consider changing birth control methods. Even if you take your pills consistently, you may still wonder how you will know whether or not you are pregnant, without the monthly reminder of a period. Birth control pills are very effective, if you take them correctly; you are not likely to become pregnant. If you have pregnancy symptoms, such as unusual daily fatigue, breast tenderness, nausea or weight gain, take a home pregnancy test. If the test is negative and the symptoms persist, call your clinician.
Other Methods Available, Too
Women with medical conditions that affect periods, such as endometriosis and fibroids, often have the choice of being treated with birth control pills, injections of the "birth control shot" (DMPA), or a new intrauterine device (IUD) that contains hormone (levonorgestrel). These methods can decrease the number of periods per year and the amount of bleeding per period. In addition, most of the methods will provide birth control to women who need it.
Ask Us About It
If you want to use extended cycles of pills to decrease the number of periods you have every year, discuss it with the clinical staff of the Student Health Service. Certain pills work better with this regimen, and we will need to create a pill schedule for you. In addition, we will need to prescribe a few extra packs of pills per year.