Why Periods? False Hopes, Popes, and the “Grandfathered” Withdrawal Bleed

The birth control pill and other hormonal contraception are popular. Menstrual periods are not. Hormonal contraception can be used to suppress menstruation — so why isn’t this method, called “continuous contraception,” more popular?

For decades, packets of birth control pills have typically contained 21 “active” pills and seven “placebo” pills. These placebos — sugar pills — trigger bleeding (which most people think of as a menstrual period, even though it’s technically called a withdrawal bleed). Because menstruation is natural, some people think this withdrawal bleed must somehow be healthier. But there are actually no health benefits — and it might also increase risk for pregnancy.


There is no reason to have a period when on the birth control pill — unless you want one.


Last month, British medical guidelines were revised to recommend continuous use of the birth control pill — that is, with no week-long “break” designed to trigger a withdrawal bleed. We could have been skipping our periods since the Pill was introduced in 1960 — so why is it only now that we are coming to see them as optional?

A flurry of recent articles has touted a rather conspiratorial claim: that the monthly bleed was included in an attempt to make the Pill more palatable to the pope. The Telegraph quoted reproductive health expert John Guillebaud: “John Rock devised [the week of placebo pills] because he hoped that the pope would accept the Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.”

Many journalists, pundits, and bloggers have expressed outrage that we’ve been putting up with decades of unnecessary bleeding (and all the attendant pain, headaches, and missed work) just because of an unsuccessful attempt to appease the pope before most women of reproductive age were even born. But the history of the placebo week is more complicated. Continue reading

Let’s Talk Contraception: NuvaRing, Another Contraceptive Choice

Would you like an alternative to a daily pill for contraception? NuvaRing is a flexible vaginal ring containing a combination of two hormones used to prevent pregnancy: a progestin and an estrogen. It is placed inside the vagina where it releases a continuous small dose of these hormones, and is left in place for three weeks. Then you remove it and wait one week, during which you usually will have your period. After this ring-free week, you insert a new ring.


The vaginal ring is an excellent alternative for people who don’t want to take a daily pill for contraception.


Used properly, it is nearly as effective as oral birth control pills, is easily reversible and frees you from having to remember to take a pill each day. You can use tampons, vaginal yeast medications, and spermicides when wearing the ring, but you should not use a diaphragm because it may not fit properly. In some vaginal conditions, such as a prolapsed (or falling) uterus, you may not be able to use the ring because it might slip out more easily. The NuvaRing can only work when it’s inserted properly in order to release its hormones. Most women report they cannot feel the ring once it’s inserted.

Most of the side effects of the NuvaRing are similar to birth control pills. Cigarette smoking is definitely not recommended because it may increase your risk for strokes or heart attacks, especially if you are older than 35. There have been several reports that the ring may put you at an increased risk for blood clots, and this is still being studied. If you have concerns about this or have a personal or family history of blood clots, heart attacks, or strokes, it’s important to talk with your health care provider before using the ring. Continue reading