Going, Going, Gone!

Seasonale - Get Your Period Only 4 Times a Year!

Nearly a decade ago, in September of 2003, the FDA gave its blessing to Seasonale, the first extended-cycle birth control pill. It cut the number of menstrual periods down from 13 per year to only four, and for women who dreaded their periods, that was the best news possible. It has 84 active birth control pills with seven days of placebo, resulting in four periods a year. The fact is that this method isn't really all that new - doctors have been prescribing this method to some of their patients for about 30 years. However, once it became official, more women took advantage of the convenience.

Paul Norris, ND, a professor of obstetrics and gynecology at the University of Miami School of Medicine noted that the safety of a woman not having her period for years at a time has been well proven. During menstruation the endometrial tissue is shed and bled out. The taking of an active hormone pill, like Seasonale, prevents the buildup of endometrial tissue, so there isn't anything to shed. He added that the future would hold even greater options for women and that Seasonale was probably just the first step in a progressive move toward yearly (or longer) periods.

How About a Period Once a Year?

As it turns out, Dr. Norris was completely correct in his assumption. In May of 2007 the US Food and Drug Administration approved for use the first, and only, birth control pill that is also designed to eliminate women's monthly periods. This birth control pill supplies an active dose of hormones every day for 365 days. The pills, consisting of 90 mcg levonorgestrel and 20 mcg ethinyl estradiol are categorized as a low dose, continuous, non-cyclic combination oral contraceptive. The product name is Lybrel.

What Is Lybrel?

Lybrel works just like any other type of oral contraceptive - it prevents pregnancy. However, these pills are taken every day over the course of a year, without stop, and the constant supply of levonorgestrel and ethinyl estradiol keep periods away for as long as the pill is taken. Once stopped, menstruation returns. A recent study of 187 women taking Lybrel found that 99% of the women started their menstrual period within three months of stopping Lybrel. Four of the women became pregnant before their periods returned and two of the women began menstruating again more than 90 days after the end of the study.

The Debate Rages

As expected, there is a debate around the idea of stopping menses entirely in a woman who is not pregnant, nursing, or post-menopausal. Opponents of Lybrel say it is not natural or it may be harmful to manipulate a woman's natural cycle by stopping menstruation. The fact is that if women are taking birth control pills at all, they are manipulating their periods because the pills put women on a 28-day cycle, regardless what their normal cycle would have been. Additionally, the bleeding that occurs during the seven days off active hormones (birth control pills) is not really menstruation because there is no endometrial lining that has built up. Rather, it is known as withdrawal bleeding, which tends to be lighter than a regular period because there is only a few days worth of build-up to be sloughed. Since women on Lybrel get continuous hormones, there should not be a build-up of endometrial tissue at all.

All In The Mind?

It is posited that including a week off from birth control pills to allow for menses is a cultural concept geared toward making women feel better about taking the pill. At least if she has some bleeding, she knows she's not pregnant, was the line of thinking. It ensured that women would be more inclined to take the pill.

The idea of not having to deal with menstruation is most appealing to many women. It makes planning events and trips, including weddings and honeymoons, much easier and, for women who suffer with intense menstrual issues not having a period is a slice of heaven.



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