Most women live comfortably with monthly menstruation and even appreciate the predictability of a cycle that reassures them their bodies are working as they should. But for some, menstruation is so painful and debilitating that it disrupts daily activities.
Birth control pills, also known as oral contraceptives" was introduced in the United States in 1962 and signaled a new era for women and their ability to control their fertility. The pill remains the leading birth control method used by women younger than 30 years of age, according to the Centers for Disease Control and Prevention.
Birth control pills are used to treat irregular menstrual periods. Women can manipulate the cycle to avoid a period during certain events, such as vacations or weekends by extending the number of intake days of hormonally active pills or by skipping the nonactive pill week. Birth control pills prevent certain conditions, such as benign breast disease, pelvic inflammatory disease (PID), and functional cysts. Functional cysts are reduced by the suppression of stimulation of the ovaries. Ectopic pregnancies are prevented by the cessation of ovulation. Birth control pills have been known to prevent certain ovarian and endometrial cancers.
When you take traditional 28-day oral contraceptives, you experience monthly bleeding — but it's not the same as having a regular period. Nor is the bleeding necessary for health. Oral contraceptives mimic a natural menstrual cycle. Some women find them more acceptable that way. Predictable monthly bleeding also reassures women that they aren't pregnant.
Birth control (contraceptive) medications contain hormones (estrogen and progesterone, or progesterone alone). The medications are available in various forms, such as pills, injections (into a muscle), topical (skin) patches, and slow-release systems (vaginal rings, skin implants, and contraceptive-infused intrauterine devices [Mirena]).
Choosing which estrogen and progesterone dose, type, and administration method is highly patient specific, meaning that the choice greatly depends on factors unique to an individual. General goals are to choose a product that provides good menstrual cycle control with the fewest adverse (side) effects and to use the lowest hormone dose possible. After beginning birth control medications, it may be necessary to adjust the dose or to choose a different product.
Continuous treatment with an oral contraceptive combination of levonorgestrel and ethinyl estradiol (LNG/EE) can safely eliminate menstruation in most women, according to a study recently.
"This is the first large study of a continuous low-dose combined oral contraceptive regimen with daily dosing for 365 days per year," Dr. David F. Archer, from the Eastern Virginia Medical School, Norfolk, Virginia, and colleagues note. "The regimen was shown to an effective contraceptive and was also effective in inhibiting menstrual cycle bleeding."
The study involved 2134 healthy women, between 18 and 49 years of age, who were treated with LNG/EE daily for 1 year.
While using LNG/EE, 19 women became pregnant. However, in 15 of these cases, the pregnancy was related to human error, such as missing one or more daily pills and not properly compensating with increased doses subsequently.
During the last month of treatment, 59 percent of women reported no menstrual cycles and 79 percent reported an absence of bleeding. The number of bleeding and spotting days decreased progressively as the study went on.
Continuous use of the pills was generally well tolerated with side effects similar to what is seen with cyclic oral contraceptives.
"The continuous LNG/EE oral contraceptive offers women a contraceptive option with several noncontraceptive benefits, one of which is a reduction in the number of uterine bleeding days per year," the investigators conclude.
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