Lee S. Cohen, MD, and Hadine Joffe, MD, MSc, shared their expertise in reproductive health and oral contraceptives (OC) for Elle magazine’s recent article, “Against the Flow.” The article discusses Lybrel, the first continuous OC approved by the Food and Drug Administration (FDA). This new birth control pill has received attention because its continual low dose of estrogen and progestin completely eliminates monthly bleeding in women. It is 98 percent effective in preventing pregnancy, provides long-term health benefits, and eliminates what many women consider the “hassles” of menstruation.

Despite these advantages, some women are wary about eradicating their monthly “period”, an event that may feel like an essential part of being a woman. Dr. Joffe points out, however, that the standard Pill “is already messing with Mother Nature.” Bleeding during the week of inactive pills is due to withdrawal from the synthetic hormones instead of the natural cycle in which a woman ovulates, does not become pregnant, and then sheds the uterine lining. The article explains that although it may seem like a vital monthly occurrence, bleeding each month is actually not medically necessary when women are on an OC.

Continuous OCs like Lybrel may also prove to be useful for premenstrual syndrome (PMS) and/or premenstrual dysphoric disorder (PMDD). Dr. Cohen explains that premenstrual symptoms are caused by the brain’s response to fluctuating hormone levels, and women more sensitive to these fluctuations experience more dramatic symptoms. Therefore, taking a daily Pill with a constant hormone level may have the potential to reduce or even eliminate the symptoms of PMS and PMDD.

As approximately 80 percent of women use a birth control pill sometime in their life, continuous OCs appear to be a great option for women with mood or physical complaints premenstrually. But taking a Pill that appears to eliminate one’s natural cycle is a personal choice that each woman will have to make.

Katherine Donovan, BA