Is Skipping Your Period Safe?

Most pill-takers have a single goal in mind: Remember to pop one a day, as directed, to prevent pregnancy. Others, however, have learned to wield the little white pills strategically, to keep Aunt Flo from barging in on hot-and-heavy weekend plans. And why not, when skipping a period is as simple as taking two 21-day courses of pills back-to-back? It's also quite safe, say experts such as Dr. Leslie Miller, associate professor of gynecology at the University of Washington School of Medicine, who thinks we should be able to stop our periods altogether. "A woman should be able to ask, 'How much progestin and estrogen do I need to turn off ovulation until I want to have a baby?' or say, 'I want to have a period every three months, or maybe I don't want any at all.' That's my vision," says Dr. Miller, a leader in continuous menstrual suppression research. "We need to learn how to dose the pill to get that effect."

Most physicians—and the FDA—haven't quite caught up with Dr. Miller, but her research found that Alesse, a low-dose pill by Wyeth Pharmaceuticals, is an effective continuous menstrual suppressant. It also comes in a generic, Aviane, and Dr. Miller suggests that continuous use of similar pills, such as Levlite or Loestrin 1/20 (or their generics, Lessina and Microgestin 1/20, respectively), could work, too.

If you're interested, first find out exactly what hormone combination is in your existing prescription, and work with a doctor or pharmacist to modify it. You need a monophasic pill—every pill in the package should be the same color—and you also should consider a lower dosage, because you'll be taking it daily, without any breaks. Irregular bleeding is common, especially at first, so you'll need to be patient while you experiment.

And it may take several tries to find the right pill. There's no go-to formula that will continuously suppress menstruation for most women. Seasonale, a relatively new pill taken 84 days in a row to get four periods a year, is the closest thing on the market. Rebecca Banks d'Andrea, a 32-year-old culinary student in New York, tried Seasonale. "I thought it was kinda cool," she says. "I didn't have to worry about carrying tampons around. But there's something about getting my period that I definitely like. It's just a reassurance that everything's going well."

Is there any reason to worry that things might not be? Critics of menstrual suppression do fear that the everyday risks associated with hormonal birth control—blood clots, heart attack, stroke, and a potential loss in bone density—will increase with continuous use of the pill. But proponents of the practice say we could be doing our bodies a favor, since nature never intended us to menstruate so often.

"Is [skipping your period] natural? No, of course it isn't!" says Dr. Lauri Romanzi, a urogynecologist at Cornell University-New York Presbyterian Hospital. "But it's also unnatural for women to live until they're 100 and have only one or two children throughout their lifetimes."

What about that other little reason to take birth control pills?

Although it is unlikely that a lower-dose pill taken daily will be less effective in preventing pregnancy, reports have suggested that heavier women require a higher dosage to avoid failure. And all women who are suppressing should pay close attention to their bodies' signs.

The payoff for that vigilance is short-term freedom—and potential long-term health benefits. "I'm very confident that the suppressive birth control methods will significantly decrease rates of ovarian cancer in the future," says Dr. Romanzi.

For more information on menstrual suppression and Dr. Miller's work, go to www.noperiod.com.