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Monday, May 22, 2006 - Page updated at 12:00 AM

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Menstruation becomes optional with new drugs that block periods

The Associated Press

TRENTON, N.J. — For young women with a world of choices, even the menstrual period is optional.

Thanks to birth-control pills and other hormonal contraceptives, a growing number of women are taking the path chosen by 22-year-old Stephanie Sardinha.

She hasn't had a period since she was 17. "It's really one of the best things I've ever done," she says.

A college student and retail worker in Lisbon Falls, Maine, Sardinha uses Nuvaring, a vaginal contraceptive ring. After the hormones run out in three weeks, she replaces the ring right away instead of following instructions to leave it out for a week to allow bleeding. She says it has been great for her marriage, preventing monthly crankiness and improving her sex life.

"I would never go back," said Sardinha, who got the idea from her aunt, a nurse practitioner.

Using the pill or other contraceptives to block periods is becoming more popular, particularly among young women and those entering menopause, doctors say.

"I have a ton of young girls in college who are doing this," says Dr. Mindy Wiser-Estin, a gynecologist in Little Silver, N.J., who did it herself for years. "There's no reason you need a period."

New products block periods


Women have long been manipulating hormonal contraceptives to skip or block menstrual periods. Now new and upcoming products will make things even easier. Here are a few:

Seasonale: Launched in November 2003 by Barr Pharmaceuticals of Woodcliff Lake, N.J. A standard birth-control pill taken for 84 days, followed by a week off for withdrawal bleeding.

Seasonique: A successor to Seasonale expected to reduce breakthrough bleeding and hormonal fluctuations even more, likely will get federal approval at week's end.

Lybrel: The first daily birth-control pill designed to be taken indefinitely, made by Wyeth of Madison, N.J., is expected to get U.S. approval by late June.

Implanon: A one-rod, three-year contraceptive implanted in the upper arm that stops menstruation in many women, also could get U.S. approval in June. Made by Organon USA of Roseland, N.J.

Berlex of Wayne, N.J., is developing its own birth-control pill for menstrual suppression. It makes Mirena, a progestin intrauterine device, and in March got approval for Yaz, a pill with only four days off hormones, reducing hormone fluctuations and PMS.

Source: AP interviews, manufacturers

Such medical jury-rigging soon will be unnecessary. Already, the Seasonale birth-control pill limits periods to four a year. The first continuous-use birth-control pill, Lybrel, is expected to be on the U.S. market soon, and drug companies are lining up other ways to limit or eliminate menstrual periods.

Most doctors say they don't think suppressing menstruation is riskier than regular long-term birth-control use, and one survey found a majority have prescribed contraception to prevent periods. Women have been using birth-control pills for nearly half a century without significant problems, but some doctors want more research on long-term use.

For some women, periods can cause debilitating pain and more serious problems.

Two recent national surveys found about 1 in 5 women have used oral contraceptives to stop or skip their period.

"If you're choosing contraception, then there's not a lot of point to having periods," says Dr. Leslie Miller, a University of Washington researcher and associate professor of obstetrics and gynecology whose Web site, www.noperiod.com, explains the option. She points out women on hormonal contraception don't have real periods anyway, just withdrawal bleeding during the break from the hormone progestin.

Today's birth-control pills contain far less estrogen and progestin than those two generations ago but still increase the risk of heart attack, stroke and blood clots. The pill should not be used by women who have had those conditions, unexplained vaginal bleeding or certain cancers, or if they are smokers over 35.

But there are benefits from taking contraceptives too, such as a lower risk of ovarian and endometrial cancer, osteoporosis and pelvic inflammation. And forgoing periods means no premenstrual syndrome and a lower risk of anemia and migraines, says Dr. Sheldon Segal, co-author of "Is Menstruation Obsolete?" Segal has been involved in research for several contraceptives.

Almost since the first pill arrived in 1960, women have manipulated birth control to skip periods for events such as a wedding, vacation or sports competition.

The idea gained momentum after Barr Pharmaceuticals launched Seasonale in 2003. It's a standard birth-control pill taken for 12 weeks, with a break for withdrawal bleeding every three months. Amid wide acceptance by doctors, sales shot up 62 percent last year, to $110 million.

Publicity for Seasonale made women wonder, if just four periods a year are OK, why have any at all?

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