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: Birth Control and Travel — How to Stay on Schedule

beachIt’s summer and time for a much-needed vacation. But will crossing time zones require you to recalculate when you need to take your daily birth control pill? With a little pre-planning, you can enjoy a trip far away and still keep on schedule with your contraception.

If you use birth control pills, it’s important to take them on a regular schedule, usually one pill every 24 hours. But what do you do if your travel schedule has you in another time zone where your 9 p.m. dose is now due at 3 a.m.? You do have a few options.


Planning ahead can keep you on schedule with birth control and reduce stress while on vacation. Bon voyage!


One idea is to use a time zone calculator to keep taking your pill every 24 hours regardless of the local time. You may need to take it at 3 a.m. while on your trip, but when you return home, you will still be on your regular schedule of 9 p.m. A good way to keep on schedule this way is to have a clock or watch with you set to stay on your time zone at home so you are able to keep track of the correct time to take your pill. An alarm at the right time can be extremely helpful if you do have to take it in the middle of the night. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 21: Contraception

World Contraception DayWelcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

Birth control is about so much more than just one type of pill. First of all, there are dozens of varieties of the Pill, and beyond that even more types of contraception! With so many options available, you’re bound to find the birth control option that’s right for you, and Planned Parenthood can help you find it.

Birth Control Pills: The Pill is probably the first thing people think of when they think of birth control, and it’s no wonder: Since its introduction in 1960, it has become an iconic symbol of women’s liberation. Taken at the same time every day, the Pill is an incredibly effective form of birth control that works by suppressing ovulation. And there are many different types, from those that are specially designed to reduce the number of periods you have in a year, to progestin-only mini-pills, from name brand pills to generic pills, and more!

Vaginal Ring: Not everyone likes taking a daily pill; some people are naturally forgetful, while others have hectic schedules that don’t make it easy to dedicate a time of the day to pill-taking. That’s where contraceptives like NuvaRing come in: This flexible ring is inserted into the vagina, where it releases a low dose of daily hormones. Leave it in for three weeks, remove it for a week, and then start the cycle anew with a new ring!

Birth Control Patch: Ring not your thing? Maybe a patch is where it’s at. It works a lot like the ring, only instead of inserting it into your vagina, you pop the patch out of its wrapper and stick it to your skin, where it stays in place for a full week, releasing hormones all the while. Continue reading

Eight Great Heat-Friendly Contraceptives

heat friendlyI don’t know if any of my fellow Arizonans have noticed, but it’s hot. It’s been hot. And all sources tell me that it’s likely to remain hot for a couple of months yet.

There are, of course, things we can do to make the heat more manageable for ourselves, such as drinking plenty of water and relegating intense outdoor activity to the early morning or late evening hours. There are also things we can do to help our contraceptives beat the heat if necessary, such as storing condoms or birth control pills away from extreme heat.

Still, some types of contraception require more intervention during the summer than do others. So — our top eight types of heat-friendly birth control!

Quick disclaimer: I made this list based on the single criterion that these methods are unlikely to be affected by the heat of an Arizona summer. When selecting a contraceptive method, there are loads of other factors to consider. So the methods on this list are not necessarily the most effective or appropriate methods for every person needing birth control.

8 Birth Control Vaginal Ring (NuvaRing)

  • Why It’s Heat Friendly: In terms of storage, it’s technically not; NuvaRing comes with the same temperature recommendations as oral contraceptive pills. However, since the ring is only inserted once per month, folks getting their rings one at a time don’t have to worry about longer-term storage.
  • Cons: In addition to the same risks and side effects of estrogen-containing contraceptives, NuvaRing isn’t the heat-friendliest choice for users getting more than one month at a time. 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

Let’s Talk Contraception: Do Birth Control Pills Cause Blood Clots?

Alarming ads urge you to call a lawyer if you’ve been “injured” taking certain birth control products, such as Yaz, Yasmin, or NuvaRing. These injuries include venous thromboembolisms (VTEs), heart attacks, and strokes. It’s frightening to wonder if you are endangering your health by taking a pill to prevent pregnancy or treat dysmenorrhea (painful cramps).

Should you stop taking your pills? What is a VTE and why should you worry? VTE is a blood clot that usually starts in your leg, but may break loose and travel to your heart or brain and cause a heart attack or stroke. It can be life-threatening, so it is a serious side effect to be concerned about. All birth control pills may increase your risk for a VTE, but it has always been considered so small that most women can safely take the pill. About 3 to 9 women in 10,000 who use birth control pills for more than one year may have a VTE compared to 1 in 5 women out of 10,000 who are not pregnant and not on the pill.


Birth control pills are considered very safe for the majority of women, but all medications carry some risk of adverse effects.


When oral birth control pills were first developed, they contained much higher doses of estrogens and progestins — types of hormones — especially estrogen. It was also noticed that there was a higher risk for developing a blood clot while using birth control pills than in nonpregnant women who didn’t take the pill. It was thought that the high dose of estrogen was responsible for this risk. So, with continuing research and development, eventually the dose of estrogen was decreased to the lower level used today to minimize the chance of a clot. The type of estrogen in pills today is almost exclusively ethinyl estradiol. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 8: Hormonal Option without Pelvic Exam (HOPE)

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.


I remember sitting in the exam room, fidgeting with my paper gown and nervously explaining to the doctor that my boyfriend and I had come very close to having sex already, and I would please like to be on birth control pills when it actually happened.

“Sure,” he said, swinging open the stirrups. “Just as soon a we do a pelvic exam.”

I didn’t want one. I really didn’t want one.


While it’s common for health care providers in the United States to require or routinely perform a pelvic examination — with or without a Pap test — prior to prescribing hormonal birth control, several health organizations state that a pelvic exam isn’t necessary in order to be safely prescribed hormonal contraceptive pills, patches, shots, or rings. For instance, the American College of Obstetricians and Gynecologists advises, “A pelvic exam is not needed to get most forms of birth control from a health care provider except for the intrauterine device (IUD), diaphragm, and cervical cap.” In such cases, HOPE (Hormonal Option without Pelvic Exam) may be an appropriate alternative. Continue reading