What You Should Know About Extended-Cycle Oral Contraception

Originally Printed by: The Female Patient®, Reproduced with Permission

Has Menstruation Changed?

Today’s American woman has more periods in her lifetime than ever before — approximately 450 periods. Compare this to a century ago when women lived on farms or in rural areas — the had 150 periods in their lifetime. Scientists also believe that prehistoric women had only 50 periods throughout their childbearing years. Why the change? Back then, women entered puberty later in life, had more children, and breast-fed longer. Today’s woman enters puberty later in life, has fewer children, and does not breast-feed for as long a period of time, if at all.

In the United States, menstrual disorders are the most prevalent gynecologic disorder, affecting 2.5 million women from age 18 to 50 years. Approximately 65% of these women contact their health care provider because of menstrual-related symptoms, and 31% report spending about 10 days in bed each year because of menstrual-related symptoms. Surveys among women of all ages show that women want fewer periods.

Researchers have been studying the menstrual cycle for more than 70 years in order to develop therapies to treat these menstrual disorders. Along the way, they also discovered and effective way to suppress ovulation and provide safe contraception. Oral contraception, a.k.a “The Pill,” was first used in the 1960s and it changed the lives of women forever. Since then, lower doses that still provide better cycle control have been introduced and adapted. These options provided women with more choices for birth control and new opportunities for cycle control.

For scientists, the next logical step was to examine the consequences of cycle suppression. One new oral contraceptive has been approved by the US Food and Drug Administration (FDS), which not only provides safe and effective birth control but also allows women to manipulate their menses. Instead of a period every 28 days with conventional pills, this new regimen causes a period after 84 days. You will have 4 periods a year instead of 13.

Period Pros and Cons

The positive aspects of menstruation include validation of womanhood and reassurance of reproductive potential. It is a symbol of femininity and confirms that you are not pregnant. Many women incorrectly believe that monthly menstruation is necessary to cleanse or purge the body of toxins. Menstruation can be a nuisance and often causes back and abdominal pain, bloating, headache, breast tenderness, pain in the arms and legs, irritability, depression, and fatigue.

The biological purpose for having a period is to prepare the endometrium for pregnancy. If an egg is not fertilized within a certain amount of time, the levels of female hormones in your body — estrogen and progesterone — gradually lessen. When the levels of these hormones fall, the outer two thirds of the endometirum is shed —  thus, your period. The inner third stays to create a new lining in the uterus so that the cycle can begin again.

The Pill artificially induces bleeding during the placebo pill period. If you stay on an extended cycle of hormones, the hormones will prevent the endometirum from shedding and you will not have a period. The purpose of a period is to prepare your body for pregnancy. If you do not want to get pregnant, you don’t need to have an artificially induced period.

Suppression of ovulation is considered innovative and progressive. The first oral contraceptives were designed to simulate a woman’s natural cycle. The concept of a “Sunday start” was originally deigned to avoid weekend periods. Now, oral contraceptives can provide women with the opportunity to choose fewer periods.

If you are currently taking an oral contraceptive, you are on a 28-day cycle. Most packs contain 28 pills, 21 contain hormone and the other 7 contain no hormone. With the extended-cycle regime, however, instead of taking a 7-day break, you keep taking active pills for a full 84-days (7 weeks), and then use the 7 inactive pills, at which time your period will occur. The packaging has been carefully designed to keep track for you and make it as easy as possible to follow the regimen.

If you are not currently taking an oral contraceptive, then you should be aware that there are risks associated with taking oral contraceptives. These risks increase significantly if you: smoke; are obese; have a clotting disorder; or have high blood pressure, diabetes, and/or high cholesterol.

Extended-cycle contraception has been tested in clinical trials and was found to be safe and effective. Ninety-nine percent of women who take this regimen as directed will not get pregnant.

Extended-cycle contraception has been approved by the FDA and has been shown to be safe and effective in thousands of women. Most women who can safely take oral contraceptives can most likely take the extended regimen and control the number of menstrual periods they have each year. As your health care provider if the extended-cycle is right for you.