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No more periods?

"Menstruation is not medically necessary." That's the quote that jumped out at me from a press release that recently crossed my desk.

Not medically necessary? I thought. What odd phrasing.

The Pennsylvania doctor who made the comment was speaking at a national conference of the Association of Reproductive Health Professionals held in the Twin Cities. He was urging other doctors to talk more aggressively with their female patients about the convenience and safety of the new birth control pills that completely eliminate monthly menstruation.

Apparently, women aren't buying it. The press release cited a national survey in which two-thirds of women said, sure, not having any more menstrual periods is an interesting idea, but is it safe?

Perfectly safe, said 97 percent of the doctors questioned for the same survey.

Ah, but doctors used to be equally gung-ho about hormone therapy for menopause -- until clinical trials found it increases women's risk of breast cancer, heart disease and stroke.

The new Pill
Decades down the road, will we discover that the no-more-periods Pill is also riskier than initially promised?

I decided to call Amy Allina, program director of the National Women's Health Network in Washington, D.C., a group that's been at the forefront of women's health issues for more than 30 years. They were one of the few early voices warning women of the risks associated with menopausal hormone therapy.

I asked her what the Network thinks of the new Pill -- and was surprised by her response. "In terms of health, it's not all that different than using a regular Pill," she said. The menstrual suppression products are chemically identical to traditional oral contraceptives, she explained. The only difference is that the menstrual suppression Pill eliminates periodic withdrawal bleeding.

Many women are unaware that withdrawal bleeding is not a natural menstrual cycle, she added. So if you're using traditional oral contraceptives, you're already suppressing menstruation.

Of course, Allina added, all oral contraceptives carry a small risk of stroke and blood clots. And we don't have years of experience with the new products to be sure their safety profile is similar to the old ones. "There's a possibility that there will be long-term health effects that weren't predicted," she warned.

Earlier this month, Belgian researchers reported that using traditional birth control pills makes women more likely to develop artery-clogging plaque, a risk factor for heart attack and stroke. That data has yet to undergo the peer-review process for publication, Allina pointed out, so it's difficult to evaluate it yet. She doubted, however, that the study will reveal any new information about continuous contraceptives.

One problem women are having with menstrual suppression products is, ironically, irregular bleeding. "The claim is that these products will give you freedom from your period," Allina said, "but that can take quite a while." In early trials, women reported months and months of unpredictable bleeding -- the probable reason behind the trials' high dropout rate.

'Forever young'
Allina's biggest concern about menstrual suppression products, however, is the way they're being marketed to women. "I'm particularly worried about how it's going to be sold to young women, especially as the age of menstruation drops," she said. Suggesting to young women that their periods are "a terrible, awful thing is not a good introduction to how your body works," she explained.

The National Women's Health Network has been documenting on their website some of the outrageous claims doctors and drug manufacturers are making for the new products. One doctor, for example, said these contraceptives would improve high school girls' SAT scores! Others have claimed (with no evidence) that suppressing menstruation and ovulation might lower the risk of breast, endometrial and ovarian cancers, or even extend how long a woman remains fertile.

Reminds me of the "forever young" claims once made for menopausal hormones.

So women, be wise and beware. "Make sure you understand what you're getting into," said Allina. "Women who are well informed when they choose their method [of birth control] are the ones who are going to be happy."

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