The Life-Changing Birth Control Advice I Wish I’d Heard Earlier

When I was 12, I got the worst migraine of my life. It lasted an entire week, and at the end of that week, I got a present: my first period. And every month after that, for years, I was treated to a horrific week-long migraine directly preceding my period. If you’re doing the math, that means approximately half of my life was spent dealing with either cramps, head pain, or blood. But hey, at least I wasn’t alone. All of my friends complained about their periods, too, so I just assumed that popping pills to deal with the pain was a part of being a woman. After all, research shows that 84% of women have menstrual pain, and 43% have that discomfort with every single period. For at least 25% of women, it hurts badly enough that, without medication, they'd have to stay home from work or school. I put up with my own pain for the better part of two decades, until three years ago, when I moved to the suburbs at age 33 and I switched gynecologists. I summed up my life for him: I’m a writer, I’ve got two kids, I don’t smoke, I try to exercise, the week before my period is hellish, and by the way, I need a new prescription for birth control. He smiled and brought me back to the part about my hellish period. “You know you don’t have to be in pain,” he said, nonchalantly, as if his words weren’t about to completely change my entire world. “You can just skip your period.” Say what? I should take my birth control pills like I always do, he continued, noting my look of shock and intrigue, but instead of taking the placebo pills, I could skip them, and start right away on a new pack. My period wouldn’t start; my migraines and cramps wouldn’t come, and I’d get to just...live. This sounded too good to be true, but I didn’t ask any more questions at the time. I got my new birth control script filled and haven’t had a period since. I’d like to say that my migraines stopped completely, but since my periods were simply one trigger, they are still in my life, though they’re less frequent now. Still, I definitely don’t have cramps, and I don’t need tampons anymore. After a steady, period-free three years, I’ve started to wonder why anyone still gets a period. Is opting out a new idea, and my doctor is just ahead of the curve? Nope. It turns out that menstrual suppression has been used since the 1960s for women who want to improve their quality of life, according to one 2014 paper published in the International Journal of Women’s Health. It has also been used to help women when their bleeding is medically life-threatening, such as in patients with bleeding disorders, and it has also helped improved menstrual symptoms for plenty of others. Historically, this has been accomplished with continuous use of the pill, but other, newer hormonal methods like the vaginal ring or the birth control patch can also work. So, why isn’t every person who gets a period doing this? Carrie Coleman, MD, an obgyn at Massachusetts General Hospital in Boston, tells me that she is not shy about recommending it to her patients, but it’s such a foreign concept to them that only a few have taken her up on it. The menstrual cycle is a perfectly natural phenomenon, so it makes sense that women might feel uneasy about skipping it. When faced with the opportunity to do so, women often worry that forgoing the period is "unnatural" or that you need a period for some health reason. But the truth is, getting your period is actually not medically necessary, says Karen Meckstroth, MD, professor of obstetrics, gynecology, and reproductive sciences at San Francisco General Hospital. “There is no benefit to your body cycling, compared to taking the pill or vaginal ring continuously,” Dr. Meckstroth says. “Some women think of this differently when they consider the natural process that happened before modern times, which would be pregnancy or breast feeding throughout all of your reproductive life.” In that sense, she says, getting a period is actually a fairly modern (arguably unnatural, even) experience. In fact, if you’re using a hormonal form of birth control, you’re already not getting a “real” period, anyway. If you’re not on the pill (and you’re not pregnant or breast feeding), your body builds up your uterine lining during the first half of a normal menstrual cycle, and sheds it if you don’t get pregnant. But the pill — or other hormonal methods like a non-copper IUD or the ring — keep the lining thin, so there’s no need for any shedding. (According to the Association of Reproductive Health Professionals, or ARHP, 20% of users of the Mirena IUD, which is placed in the uterus for up to five years, stop bleeding completely within a year.) When you start taking the pills in your birth control pack that don’t contain hormones, the bleeding you experience is really just a reaction to not having the hormones — it’s technically called "withdrawal bleeding," says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale Medical School.

Beyond what's "natural," another common worry is the possible effect on fertility. According to a 2005 survey done by the ARHP, 75% of women said they thought stopping your period altogether could impact the odds of getting pregnant later on. But the research doesn't support this. There are fewer studies on continuous birth control use (in part because fewer women do it), but one review from 2009 concluded that despite limited research, “the data suggest that subsequent return to fertility is generally comparable to that of cyclic [oral contraceptives].” In another small study, 81% of women who stopped their continuous birth control pills got pregnant within 12 months. (Other studies show that between 72 and 94% of women who quit the 28-day pill will become pregnant within a year; for women not using any contraception, 85% will become pregnant within that same amount of time.)

Dr. Coleman says she thinks the main reason more women don’t opt to skip is that doctors simply don’t mention it as an option — unless there’s a problem, like my migraines. “Unfortunately, it’s a low percentage of women who do [menstrual suppression],” she says. But if you are healthy and you’re a candidate for hormonal birth control (meaning you don’t smoke or have a history of stroke, blood clots, or breast cancer), you can get on the period-skipping bandwagon. If your periods don’t really bother you, I can see why you may not feel like it’s worth having to take a pill every day. But if you ask me, life without a period is a wonderful thing. I feel better and I can have sex whenever I want without worrying about the mess. Blood never ruins my underwear, and I do not feel the urge to invest in price-y period panties. The only downside I can think of is that a period alerts you to the fact that you’re not pregnant, and one of my biggest fears is ending up on one of those “I didn’t know I was pregnant” shows. Recently, I was sure that I felt a baby moving in my belly. I panicked for a few minutes, took a pregnancy test, and then relaxed when it came back negative. I’m on birth control, I reminded myself. That wasn’t a pleasant experience, I admit. But I’ll take a once-every-three-years bout of paranoia over a reliably horrific monthly period any day.