Harvard Women's Health Watch

By the way, doctor: Is it safe to take a pill that eliminates periods?

Q. Some of my friends are excited about the new oral contraceptive that eliminates periods. But it worries me. Does anyone know what happens when you stop menstruating for a long time? It just seems unnatural.

A. Oral contraceptives (OCs) have been available since the early 1960s and are the most common form of birth control in the United States. "The pill" suppresses ovulation, thickens the cervical mucus (which blocks passage of the sperm), and alters the lining of the uterus, preventing implantation of a fertilized egg. Most OCs come in packets of 21 pills containing the hormones estrogen and progestin, along with seven placebo pills that contain no medication. Women seeking to prevent pregnancy take a hormone-containing pill daily for three weeks, then a week's worth of placebo pills (or no pills). A menstrual period occurs during the seven-day placebo phase in response to the drop in hormone levels.

In May 2007, the FDA approved Lybrel, the first OC designed to be taken 365 days a year. Developed by Wyeth Pharmaceuticals, Lybrel comes in a 28-day pack of tablets containing 20 micrograms (mcg) of ethinyl estradiol (an estrogen) and 90 mcg of levonorgestrel (a progestin). This is about equal to the lowest level of hormones found in combination OCs today: the products Aviane, Sronyx, Lutera, Lessina, Levlite, and Alesse all have 20 mcg of ethinyl estrogen and 100 mcg of levonorgestrel. Women who use Lybrel don't have regular periods, although they can have breakthrough bleeding (spotting or light bleeding). During the last month of the one-year studies leading up to the FDA's approval of this pill, about 40% of the women taking the drug were still having breakthrough bleeding. Periods returned (or pregnancies occurred) within three months of stopping it.

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