Photo Illustration: The Cut; Photos: Getty
When I was a teenager, I had heavy, painful periods that made it difficult for me to edit the yearbook, run the Quiz Bowl, and apply to college. Birth control pills helped, but because I have endometriosis, I still had cramps and other symptoms during my week on the placebo pill. My gynecologist recommended that I stop bleeding altogether – advice that immediately alleviated my monthly suffering.
Unless you are actively trying to get something pregnant, there is no reason why you need a period at all. “Many people have either read or heard from their families or friends that a period is necessary to cleanse the uterus or something like that,” says Dr. Colleen Denny, a board-certified gynecologist and director of family planning at NYU Langone-Brooklyn. “That’s simply not true.” When birth control pills were developed in the 1960s, researchers mimicked the prevailing cultural belief that a 28-day cycle “a sign of normal female reproductive function” by encouraging users to take 21 active pills and then go pill-free to experience a withdrawal bleed the following week. (This also helped reassure patients that they were not pregnant.) However, the reason for this decision was cultural – researchers know it a long time that placebo pills are not necessary – not medical.
Skipping your period can relieve unpleasant symptoms such as cramps, fatigue, mood swings, bloating and headaches. Not to mention more pronounced symptoms in people with endometriosis, dysmenorrhea, polycystic ovary syndrome (PCOS) or premenstrual dysphoric disorder (PMDD), a severe form of PMS that requires medical attention to treat. It can also save you a lot of money on period products, which are becoming increasingly expensive.
Here’s what you need to know about skipping your period, with advice from Denny. (And of course, be sure to talk to your doctor before trying anything new.)
The birth control pill may be the best way to control your missed period.
When Denny’s patients come up with the idea of skipping their period, she first asks them why they want to skip their period. “Is this their honeymoon or a vacation or something where they don’t want to bleed just once?” Or would they really prefer to have lighter periods or even no periods in the long term? says Denny. “If someone is just interested in skipping a period, I usually talk to them about combined hormonal birth control pills.” This gives you the most power to decide when and if you get your period.
If you are already taking the pill, you can skip your period by simply taking a new pack instead of taking the placebo pills for a week. (If you’re using hormonal birth control, you’re technically already getting your period. Natural menstruation occurs after your ovaries release an egg, which then remains unfertilized; but contraceptives suppresses the natural hormonal fluctuations that occur the four phases of the menstrual cycle, which means you are not ovulating at all. Withdrawal bleeding occurs when you stop the active form of birth control – such as taking the placebo pills in a pack or stopping a NuvaRing for a week – and hormone levels drop. This is often referred to as a “period,” but it is not the same thing. For the sake of simplicity, I will continue to refer to it as a period here.)
But don’t be surprised if your insurance makes this method difficult for you. You may need to ask your doctor to contact your insurer to ensure you get more frequent refills, as skipping a period means you will have to finish a pack of 21 active pills every three weeks instead of every four.
“Another thing to know is that there are some birth control pills that are packaged to help people skip their periods,” says Denny. “So the other option is to request a prescription with such packaging.” The Amethyst contraceptive pill, which comes in a pack of 28, contains all the active pills and can be helpful for people who want to avoid insurance problems. The same goes for long-term options like Seasonique or Seasonale, which come in packs of 84 and contain placebo pills for a week.
Other forms of contraception may be easier to use in the long term.
However, for those interested in a low-maintenance way to avoid their period – meaning you don’t want to have to think about taking your pill every day – a long-term method might be the best way.
“If someone wants to have the best possible chance of not having a period at all, I usually talk to them about the progesterone injection, which is called Depo-Provera, simply because it has the highest overall average rate of people not having a period when They are using it.” Depo-Provera is the brand name for what people colloquially call it Contraceptive injectionswhat you get every three months. However, according to Denny, with Depo-Provera it can take up to a year for your period to stop completely.
Other forms of contraception such as hormonal IUDs and Implants may stop your period within the first year of use. “It’s something you can’t control,” Denny says. “This is just a known side effect of use.”
However, nothing is perfect. For many people, no contraceptive method can completely suppress their periods or their symptoms. Monthly bleeding may be lighter or there may be minor spotting, especially when these methods are used continuously for the first time. “We haven’t found a great treatment to completely avoid this spotting period, but I tell people that it generally gets better with time,” says Denny.
You can also skip your period without constantly taking contraceptives.
If you’re not taking hormonal birth control but still want to miss your period, norethindrone acetate—a synthetic form of the hormone progesterone used in some progestin-only birth control pills—is an option. According to the The United Kingdom National Health ServiceTaking three tablets a day in the days before your period can help prevent your period from occurring. Using norethindrone acetate in this way signals to the uterus that it should not shed his lining.
“Progesterone is a type of hormone that promotes the growth of the uterine lining. In an unchanged cycle, when the hormone begins to decline, the mucous membrane is shed,” explained Denny. “A constant supply of progesterone either keeps the mucous membrane very thin or prevents it from shedding. As long as you take that progesterone, that lining stays in your body.”
Your period will begin about 48 to 36 hours after you stop taking the medication. If you are taking norethindrone acetate just to skip your period, you will also need a backup method of contraception such as a condom. Accordingly WispWith a telemedicine company that provides the medication, you can take the mini-pill to skip your period for up to 20 days.
Contraception is extremely effective at preventing pregnancy. However, it’s not a bad idea to be aware of early pregnancy symptoms.
Proper use of contraception is an extremely effective way to prevent ovulation and pregnancy. However, since you don’t have monthly bleeding that indicates you’re not pregnant, Denny recommends patients do this recognize the first signs of pregnancy and take a test if necessary.
“If they’re having really bad nausea, breast tenderness, or other early pregnancy symptoms, that might be a reason to take a pregnancy test,” she says. “Take care of your body and know the signs of early pregnancy.”