Don’t you like your period? Hormonal birth control is more than just preventing pregnancy. This is also a popular method that has become popular in less than months or years.
Continuous use birth control involves taking hormone pills without what is called placebo week or using other methods such as injections without implants, rings, or rest. This method can end normal bleeding associated with periods, as well as menstrual cramps, migraines and other symptoms.
When social media becomes a hotbed of amateur medical advice and personal anecdotes, apps like Tiktok post about preventing pregnancy and preventing pregnancy in non-hormonal ways with thousands of views every day. Reproductive experts say there is an increase in myths and misinformation about hormonal birth control as influencers share fears about infertility and the harms that may suppress your body’s natural processes.
To get a better understanding of the risks, rewards and science of using birth control to abandon menstruation, I chatted with reproductive expert Dr. Kavita Nanda. As an obstetrician and clinical researcher at the North Carolina-based human development nonprofit FHI 360, Nanda has spent more than 25 years studying ongoing contraception and other forms of birth control.
This conversation is condensed for length and clarity.
CNN: How does hormonal birth control work?
Dr. Kavita Nanda: Combined contraceptives use synthetic forms of estrogen and progesterone together. The combination method works to prevent pregnancy by preventing ovulation, which is the release of eggs from the ovaries. Other methods use synthetic progesterone Includes pills, implants, injections, intrauterine devices, or IUDs. Both the combined and progestin-only methods make the mucus thicker in the cervix, making it difficult for sperm to enter the uterus, and the lining of the uterus remains thin.
CNN: What is continuous use? And how does that differ from the other methods?
Nanda: The standard method of taking combined contraceptives is performed cyclically for three weeks each day, followed by a hormone rest for a week. There is something called withdrawal bleed because you are not taking the pill or taking a placebo for a week. The lining of the uterus falls off. That’s what people call “period,” but in reality, hormone-free withdrawal is bleeding. But when you talk about continuous use, you don’t take a break. The uterine lining remains thin and intact, meaning that the user can go for weeks, months, and even longer without a “period.”
CNN: How safe can I go without monthly bleeding?
Nanda: There are studies comparing continuous and cyclical use, which are just as effective and safe. There is no medical reason for bleeding period or withdrawal when taking hormonal contraceptives. There are no contraindications for the continued use of pills unless there is a contraindication (a condition) of birth control pills.
Historically, prior to birth control, women were spent either pregnancy or breastfeeding, so they did not always bleed. In both of these conditions, there is often no monthly bleeding for several months.
Now, if you are not pregnant or breastfeeding, you are not using hormonal birth control and you do not have a monthly period – that is what you need to discuss with your provider.
CNN: Are there any side effects inherent to continuous use?
Nanda: Side effects are generally similar to those of cyclical use. For example, you may have nausea, breast tenderness, or a headache (anytime). Continuous use causes unexpected breakthroughs or spots, especially at first, but this usually improves over time, with many people achieving amenorrhea or (stopping menstrual periods). For some, it can take 3-4 months.
CNN: How does continuous use affect fertility after cessation?
Nanda: Long-term use of hormonal contraception, whether combined with hormone blockade, causes infertility, whether continuous or cyclical sampling, and there is no evidence that fertility usually returns within a month. Essentially, when stopped, the (synthetic) hormones disappear from the blood very quickly, ovulation is no longer suppressed, and the resume of normal estrogen and progesterone production is resumed. Assuming you had a normal menstrual cycle before, you resume. (One exception) if you are taking something like a depo provera birth control injection. It does not cause infertility, but it may take some time for the birth rate to return after injection.
CNN: Why was the placebo pill invented when skipping was harmful?
Nanda: When oral contraceptives were combined in the 1950s, the current standard 21-day active tablet followed by a 7-day hormone-free interval was based on cultural and strategic reasons, not medical necessity. At the time there was a widely believed belief that menstruation every 28 days was a sign of normal female reproductive function.
To meet that expectation, the regimen is designed to mimic the natural menstrual cycle, with the aim of reassuring that both the user and the doctor are not pregnant. It was important in the days before the home pregnancy test.
CNN: Who can consider contraception ongoing use?
Nanda: It’s really a personal preference and a debate between a person and their provider. Someone may not want to spend years, and some people may prefer to bleed three times a year. Some people feel relieved by the monthly bleeding. Continuous use may be particularly useful for painful periods, severe periods, endometriosis, migraine, iron deficiency anemia, physical or intellectual disability, and transgender individuals.
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