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Contraceptive in stores this week eliminates them, but not everyone is ready to let go
By ALEXIS GRANT
Copyright 2007 Houston Chronicle
To bleed or not to bleed...
Now that a pill can eliminate menstruation, will you take it?
Yes, anything to avoid the cramps and mess
No, it seems unnatural
Yes, athletics and periods don't mix
No, my period reassures me I'm not pregnant
Yes, I'd be happy to never buy tampons again
No, my period gives me an excuse to be bitchy
WHAT TO KNOW
Wyeth Pharmaceuticals' new birth control pill, Lybrel, hits shelves this week.
• How it works: Just like regular birth control pills on a 28-day cycle, which use hormones to prevent ovulation, except without the placebo pills. It prevents women from menstruating.
• Cost: Comparable to other brand-name oral contraceptives.
• Pros: May reduce symptoms for women who suffer from menstrual cramps, migraines or other painful side effects. Allows women to avoid bleeding.
• Cons: Some users may experience unexpected spotting or breakthrough bleeding. Women who aren't expecting a period may not notice a pregnancy.
Source: Wyeth Pharmaceuticals, Chronicle research
Call it a curse, a friend, even Aunt Flo — but don't call it obligatory.
As the new birth control pill that eliminates women's periods hits pharmacies this week, some will say goodbye to menstruation. More though, it seems, are wary of eliminating the monthly bleeding that's symbolic of womanhood.
"That scares me," said Melinda Perez, 35, of League City. "It plays too much with the way your body naturally needs to work."
Lybrel, a low-dose oral contraceptive manufactured by Wyeth Pharmaceuticals, uses the same hormones as birth control pills that have been available for decades to prevent ovulation and pregnancy. But unlike traditional pills, this package includes no placebos at the end of a cycle. And that means no menstruation.
Most doctors interviewed for this story agreed it's healthy for women to skip their period for months or years at a time using the new contraceptive. The drug could be particularly useful, they say, for women who suffer from menstruation's negative side effects: painful cramping, nausea, breast tenderness, migraine headaches and mood changes. Wyeth also is marketing the product to women who would prefer not to have a period for the sake of convenience.
"If it can get rid of some of the symptoms that come along with it, cramps, achy bones ... I'd do it in a heartbeat," said Kathy Schachtner, 33, who lives in the Channelview area.
Extended oral contraceptives that reduce women's number of periods have been available for several years. Seasonale, for example, which allows women to bleed once every three months, was approved by the Food and Drug Administration in 2003.
Lybrel, which gained FDA approval in late May, is the first oral contraceptive to eliminate the period. The prescription's monthly package includes hormone pills that are to be taken every day of the year, without placebos.
Not a new concept
Although it has never been packaged that way, the regimen isn't truly new. Gynecologists have long directed women with painful periods or other medical conditions related to menstruation to skip the placebo pills included in traditional birth control packages and start a new package of hormone pills instead, thus preventing a period. Some women did that on their own to avoid bleeding on special occasions, such as a wedding day or athletic competition.
"We could do that with any old continuous pill, but it wasn't packaged that way," said Dr. Pamela Berens, a gynecologist and associate professor at the University of Texas Medical School at Houston.
Still, some women balk at the idea of eliminating the period completely, having been taught since adolescence that bleeding every month is a sign of health and fertility, as well as reassurance that they're not pregnant. To go without a period, some say, is simply unnatural.
"Not that I always enjoy my cycles, but I wouldn't want to get rid of it," said Kiara Ward, 17, of northeast Houston. "It's there for a purpose."
But gynecologists say that's not necessarily true. Women are designed to be pregnant or nursing, which causes menstruation to cease, during their child-bearing years, said Dr. Patricia Sulak, a professor at the Texas A&M Health Science Center College of Medicine. Instead, because of the availability of contraception and women's modern roles in society, they're having periods every month, year after year.
"Women are having too many periods today," said Sulak, who specializes in menstruation suppression.
In a different time
When doctors first created the birth-control pill in the early 1960s, she said, they included a week of placebos to allow for a period because they worried women otherwise wouldn't use it. Back then, pregnancy tests weren't as simple or cheap as they are today, and bleeding was the best way for a woman to confirm that she wasn't pregnant.
For women who don't take oral contraceptives, it's necessary to menstruate to shed the lush lining of the uterus that builds up during the cycle, Sulak explained. But women on the pill grow only a thin lining — which is why their periods often are lighter — so they don't need to menstruate, she said.
The cost of the drug varies depending on the pharmacy and whether a woman has insurance, but a spokeswoman for Wyeth said it's comparable to other brand-name oral contraceptives. At Kroger on Montrose, the drug is about $53 per month, several dollars more than other brand-name contraceptives on the shelves.
Sending wrong message?
In a study of Lybrel that examined the return to menstruation after stopping the pill, more than a third of 187 participants got their period within a month, and nearly all menstruated or became pregnant within three months, Wyeth reported. (The other women got their periods more than 90 days after stopping the pill.)
Some experts worry about the long-term effects of the drug since the study was conducted over only one year. Others argue a longer study isn't necessary because the hormones aren't new, only the way they're given is.
The pill also has become a topic of discussion among sociologists and anthropologists, who worry about the social implications of eliminating menstruation. It can be liberating, as the name of the drug is intended to suggest, to have the option of whether to menstruate. But some academics say suggesting that healthy women may want to get rid of their monthly period simply because it can be messy or embarrassing only furthers society's perception of menstruation as shameful.
"By telling young women there's something wrong with a natural menstrual cycle," said Jean Elson, a sociologist at the University of New Hampshire, "we're really giving them the message that there's something wrong with women's bodies."
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