The idea of menstrual suppression offends some women ("what's wrong with women's bodies the way they were meant to be?") and frightens others ("Doesn't that cause cancer?") but women's health professionals are generally pretty blasé about it and many practice it themselves.
The Association of Reproductive Health Professionals, which ought to know, offers a number of fact sheets explaining why it isn't likely to be bad for you (women have been skipping the placebo week and thus their periods for as long as there have been pills to take or skip, to no demonstrated ill effect) and how indeed it might even be good for you.
There's no question that "the experts" have an established pattern of being very very sure one week that something will save your life, only to announce the next that that very something will kill us all in short order, but there is a good deal of science on this.
In response to the question of endometrial cancer raised by several of the women I talked to, Laura, who is not only a woman, but a doctor as well, responded: "The endometrial cancer risk happens with unopposed estrogen — estrogen causes the lining to differentiate (make channels and stuff so it can support a pregnancy if necessary) which is a risk for cancer because there are all those cells dividing away.
With progesterone in the mix as well, that doesn't happen. This is why only women who've had a hysterectomy should get estrogen-only HRT; if you have a uterus you need progesterone as well. Since OCPs [oral contraceptive pills] have the two hormones in combination, there's no reason to think that they'd raise risks for endometrial cancer (and the safety is borne out by data)."
While I had her, I asked Laura to explain another mystery, where the hell that stuff goes if it isn't busy mortifying us by running down our legs on the subway or indelibly staining in our favorite pale-celery-colored Thai silk pants or otherwise ruining our lives.
Laura said: "The lining slowly and gradually builds up when you take the pill back-to-back. For some women eventually it builds up to the point that it overflows and you spot; for others apparently it gets gradually reabsorbed to balance out the gradual buildup and so they never spot. I've been taking OCPs back-to-back for years; I'm in the first category so I can only do three to four packs at a time. Once I start to spot, I take the placebos to have a full fake period and then start over. My doctor told me that she does the same thing."
If you're dating and it's take the new pills (or the old ones back-to-back, or get a Mirena IUD, which has a similar effect) or spend the rest of your single-girl life rinsing out bloodied underpants in some guy's shower (not that I've ever done such a thing), suppression doesn't seem like a bad choice to me, as long as you're not in one of the risk groups (it's a "talk to your doctor" thing, not a "oh, what the heck" thing).
Even if you're way too evolved yourself to think "monthlies" are anything to be ashamed of, there is the mess to consider, not to mention the increased societal sensitivity to the sight of blood in these AIDS-aware days, which has been known to put a damper on whatever festivities one had in mind.
Suppression is not going to be everyone's cup of raspberry leaf tea, but looking just a bit ahead, I can see the day coming when I find it just a little bit shocking that my daughter (now a toddler) wants to join the cyclists.
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