April 10, 2004

No more periods (this week).

The optimization of periods has fascinated me for several years. Since some time in 1999 I've been reading about the hypothesis that skipping periods should be healthier for modern women, given that pre-historic women spent so much time pregnant that they were presumably optimized for rare menstrual periods.

The predicted medical benefits of skipping benefits using continuous hormone doses (such as birth control pills) seem to center on reduced incidence of cervical, ovarian, and uterine cancers, which are already beneficial side effects of taking hormonal birth control in the conventional way. (I have mostly ignored the prospective convenience of fewer periods-- I would rather deal with cramps and so on in a less drastic, less systemic way.)

Period-skipping is entering full-fledged stampede popularity-- it's been all over women's mags in the supermarket racks, and the doctors I went to for my last two annual pelvic exams both advised me (unasked) that I could safely take my birth control pills back to back for up to three months if it was more convenient for any reason. Seasonale "extended cycle" birth control pills were approved in the US in September 2003, in 12 week instead of 4 week sets.

Only very recently did I come across any reasoned critique of skipping periods. While hiding from a rainstorm in the local Chapters bookstore last month, browsing the paltry women's health section, I came across Susan Rako, M.D.'s book No More Periods?. In it, she suggests that the fad to skip periods might be fueled by pharmaceutical companies who are looking to increase the market for oral contraceptives (no surprise there: taking pills in 3 month cycles requires 9 weeks more pills per year). This raises the usual biased research concerns, specifically that the public is being deprived of discussions about the risks of menstrual suppression, which Dr. Rako's research suggests include cancer, strokes, heart attacks, and osteoporosis.

I only skimmed the book, but I think it would be worth a dedicated read for anyone interested in skipping or otherwise optimizing periods. I've almost entirely lost faith in asking average doctors about recent research, having realized that I have no way of knowing whether their opinions have been "educated" by drug companies or unbiased research.

With that, I'm calling an end to period week. Even if I hadn't spent one night this week puking up my newly discovered allergen, shiitake mushrooms, and two days out of town at a funeral, I wouldn't have finished posting the mountain of period links, books, and babble I've got stashed away. We can have a blood information festival every time I bleed for a long, long time.

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