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Is it possible to stop your period?

Menstruation is an inevitable fact of life for women. For a young girl, getting her period is a sign that her body is preparing her for adulthood. Most women take their monthly menses for granted. Some welcome the event as a reassuring sign of health and fertility. Others find it inconvenient – and for some, painful – to bleed every few weeks.

We may complain about getting our period every month, but as a biological fact of life, the menses serve important psychological and cultural purposes to many women: some feel reassured by their periods that they aren’t pregnant, some find satisfaction in the ritualistic aspects of their monthly cycle, and some prefer to wait until menopause for a period-free life.

No more menses

 There is a general belief that if a woman does not have her menses, something “unclean” will be left behind, stored somewhere in her body. What is most surprising about the menses cycle is that so few women really know much about it. For those who take oral contraceptives (OCs), for example, what occurs each month is not an actual menses, but rather withdrawal bleeding. And to learn that monthly bleeding has no health benefit is a great surprise to many.

In fact, not bleeding on a monthly basis may have enormous health benefits especially so for women who have painful,  heavy or irregular periods, or severe premenstrual symptoms like migraines, can go to their gynaecologists for hormonal contraception to stop their periods. Among these are women who have endometriosis (a painful condition in which tissue that normally lines the inside of the uterus grows outside of the uterus), dysmenorrhoea and menorrhagia.

Nowadays, it is not unheard of for some women to opt for menstrual suppression.  Over the years, I have helped several of my patients to stop or delay their periods for a few days, weeks or for many months at a time, for a variety of reasons; because they did not want to have a period during their vacation; because they were going camping with less than adequate sanitary conditions; or because they wanted to avoid menses during their honeymoon, or because they wanted to perform their pilgrimage at the Ganges river or the Umrah and Haj, to name a few.

Menstrual suppression is also an option for women with disabilities who cannot maintain menstrual hygiene, or female athletes who find it more convenient not to have periods when they are competing.

How to suppress menstruation

A hysterectomy (major surgical procedure to remove the uterus) used to be the only method to stop menses for women with severe menstrual problems. However, there are many kinds of alternative therapies available today, thanks to medical advances. Contraceptive pills are a non-invasive way to reduce or stop periods. The “Pill” works by preventing the ovaries from releasing an egg very month. It also alters the mucous secretion from the cervix.

Contraceptive pills that consist of 21 pills contain 14 active pills and the last seven are placebo pills, after which a “withdrawal” bleed that mimics normal menstruation occurs. This bleeding is due to the shedding of the lining of the uterus, due to the lower levels of hormones. These so-called “periods” are lighter and last fewer days.

To suppress menstruation , a woman  can just continue taking  the active pills of the birth control pills, skipping the placebo pills, and starting with a new pack which means discarding the seven placebo tablets packaged with every 21 active pills and taking the active tablets daily for months on end.  This helps regulate her hormonal fluctuation and eliminates bleeding. However, breakthrough bleeding – unplanned days of spotting or bleeding – can occur if you take birth control pills continuously for more than several months. It is advisable to go off birth control pills for one week every three to four months, so that there is less breakthrough bleeding.

Knowing the risks

 Since menstruation is regarded as a natural phenomenon for women, symbolising fertility and feminism, there is the perception that suppressing it may be “unnatural” and “unclean” for the body. There is nothing wrong with having no periods and it is certainly not unclean. However, there are risks related to taking birth control pills – and this is applicable for women who take it with the seven-day break, as well as those who take the active pills continuously to suppress their period.

 Hormonal contraception is linked to higher risk of blood clots, hypertension, stroke and heart attack, especially among women who are obese and smoke. However, risks can be managed with good medical advice.

What should you do as a patient?

So do not try to control your periods by taking birth control pills yourself without consulting your doctor. Discuss your situation with your doctor and weigh the risks and benefits before deciding whether you should suppress your menstrual cycle. Playing around with the pill without adequate and proper knowledge may increase the risk of side effects or an unwanted pregnancy.

The Star Newspaper,02/03/2008
By Dr Nor Ashikin Mokhtar