Repunctuate Your Life...Or Not

“Who says? Who says ‘that time of the month’ has to be every month? Who says?”

So starts the commercial for Seasonique, a newer birth control that allows women to “repunctuate their lives” by having only 4 periods a year. Seasonique is not the only birth control of its kind on the market. Another birth control, Lybrel, allows women to banish their period completely by taking a low dose combination birth control pill continuously for 365 days with no placebo breaks.

The idea of having less frequent or completely nonexistent menstrual cycles has become very attractive to women, and many women have opted to take this kind of birth control over other standard kinds. But are these types of birth control safe? And is it true that monthly periods are not necessary in order for women to be healthy?

In 2007, a chain e-mail about the death of a 31-year old woman, Nicole Dishuk, started circulating. Dishuk died on the 29th of August in 2006 after suffering from a stroke. The e-mail attributed her stroke to the birth control she was taking, Seasonique, claiming that the lack of a monthly period caused a blood clot to form in her brain. It was later proven that there really was a Dr. Nicole Dishuk McKeon from North Coventry, Pennsylvania who did indeed die from a stroke at the age of 31. But the cause of the stroke was never actually disclosed.

To this day we still don’t know if Dishuk’s stroke was due to the birth control she was taking or due to a previously existing medical condition that put her at a higher risk for stroke. Regardless, this e-mail raised questions and worry in the minds of women all throughout the country.

Today there is still not a clear answer to the question of whether or not periods are important. According to WebMD, the American College of Obstetricians and Gynecologists takes no official position on menstrual suppression. Individual doctors, however, voice a range of different opinions.

Says Sharon Mass, MD, an ob-gyn in Morristown, N.J. “Menstrual suppression can often ease troublesome periods or conditions that worsen around that time of month. Initially, it was for patients who had medical indications, for example, a history of endometriosis, menstrual migraines, symptomatic periods with bloating, breast tenderness -- things like that.” Leslie Miller, MD, associate professor of obstetrics and gynecology at the University of Washington, discusses the convenience factor of suppressing menstruation, and how women often want to skip periods for special events, such as honeymoons or vacations. Moreover, Miller explains that women who are on standard birth control aren’t actually having a normal period. What it is, is actually “withdrawal bleeding” that results from the drop in hormones during the placebo week.

Some doctors believe that a monthly period, is in fact, healthier. Jerilynn C. Prior, MD, professor of endocrinology and metabolism at the University of British Columbia, believes that a normal menstrual cycle is absolutely crucial to women’s health. She says that normal menstruation has beneficial effects on women's bone and cardiovascular health, and "to reduce it to 'periods don't matter' is totally unscientific.” The Society for Menstrual Cycle Research acknowledges that menstrual suppression may be useful for severe menstrual problems such as endometriosis, but its web site states, "We do not believe that continuous oral contraception should be prescribed to all menstruating women out of a rejection of a normal, healthy menstrual cycle."

The reality is, there’s not enough information to declare whether or not menstrual suppression is safe. However, we do know that there are many risks involving menstrual suppression and birth control in general, including effects on bone health, risks for blood clots and strokes, effects on fertility, and an increase in risk for breast cancer.

So ladies, talk to your doctor. And maybe think twice before deciding to “repunctuate your life.”