If you’re sick of your period — cramps, hormonal acne, forgetting to bring tampons, oh, what fun! — then here’s some good news for you: you can opt out of having a period. Yep, it’s actually A-OK to forego having a period altogether, as long as you are working with your doctor to determine the best method of doing so for you.
Mary Ellen Wechter, MD, MPH, and Paulami Guha, MD, are gynecologists with North Florida Gynecology Specialists, which serves patients at Baptist Health and around Jacksonville. They said they talk to patients almost every day who want to skip their period. And hey, who could blame them?
Safe to skip?
Both Dr. Guha and Dr. Wechter agree, as long as it results from using some form of hormonal birth control, intentionally skipping your period for multiple months doesn’t lead to any health issues. This is because estrogen triggers the uterus to build up a thick lining (called the endometrium) to prepare for a pregnancy. Progesterone, on the other hand, acts like a brake pedal, telling the endometrium to stop growing.
“All medications we use for contraception have progesterone, and the primary function of progesterone is to keep that uterine tissue from growing,” said Dr. Wechter. “So most of our contraceptives, excluding the copper IUD and getting your tubes tied, basically keep the endometrium inactive. When a woman is on a progesterone pill, the uterus stays nice and quiet and after a period or two to empty any existing tissue, there really isn’t any substantial tissue to shed. So, in those cases, there’s no evidence you need to have a period.”
The period and the pill
It's something many women have heard before: if you don’t want your period during vacation or a special occasion, you can throw away the placebo pills at the end of one month's birth control pack and go straight to the first pills in the next month's pack. Dr. Wechter says using this method is possible, but you have to plan ahead and take your pills at the same time each day for it to work.
“It’s safe, but the warning I would give is that it does take a couple of months before you stop spotting,” Dr. Wechter explained. “For example, a bride-to-be who wants to stop her period should start the process several months before her wedding, not at the last minute. And always talk to your gynecologist beforehand.”
Pausing your period
Just about any method of birth control can stop your period, according to these experts. So, if you want to live in a period-free paradise until you’re ready to conceive (or indefinitely), the key is working with your doctor to find the right contraceptive for you.
“If you take the birth control pill continuously without taking the placebo, you will not have a period,” said Dr. Guha. “With progesterone IUDs, you’ll also not have one after a few months, once your body gets used to the IUD.”
“The progesterone implant is another example,” added Dr. Wechter. “The progesterone intramuscular injection does it as well, as does the mini pill, which is progesterone-only. One of the best studies about continuous hormone use to stop periods was done with the vaginal contraceptive ring. Normally, you would take it out and have a period on the fourth week, but if you just replace it with a new one after every three weeks, you can avoid your period. It takes a couple of months to get past that breakthrough bleeding and spotting, and you have to exchange the ring at exactly 21 days.”
Unintentional missed menstruation
If your period comes sporadically — or not at all — and you’re not on birth control, it’s best to get evaluated by a gynecologist. There are some underlying health conditions that can cause this, and in these cases, missed periods do come with some risks.
“If you take birth control continuously, it’s OK to skip your period because the progesterone has been keeping those glands and tissues quiet,” Dr. Guha said. “Patients with certain conditions, like polycystic ovarian syndrome (PCOS), might skip periods for a few months and then get one that’s very heavy. This group of patients isn’t having a period because they’re not ovulating. Patients who don’t ovulate are producing estrogen and not progesterone, so that lining keeps on growing. The uterus is filling up and skipping the phase where it empties, and that predisposes a woman to precancer and risk of endometrial cancer.”
Dr. Guha added that some women can also enter menopause as early as their 20s, so it’s important to make an appointment with your doctor if you should be having a period, but you aren’t.
When you’re ready to conceive, the MyFamily app from Baptist Health and Wolfson Children’s Hospital has tools to help parents-to-be throughout pregnancy. Its newest features include an ovulation tracker, which helps with period and symptom tracking, even for those who are not ready for a family just yet. To learn more or to download MyFamily, visit baptistjax.com/myfamily.