When I was a teenager, I had heavy, painful periods that made it hard to juggle editing the yearbook, captaining the Quiz Bowl, and applying to college. Birth control pills helped, but because I have endometriosis, I still had cramping and other symptoms during my placebo pill week. My gynecologist suggested I skip the bleeding altogether — advice that immediately relieved my monthly suffering.
Unless you’re actively trying to get pregnant, there’s no reason you need to have a period at all. “Many people either have read or heard from their families or friends that a period is necessary to clean out your uterus or something like that,” says Dr. Colleen Denny, a board-certified OB/GYN and the director of family planning at NYU Langone-Brooklyn. “That’s just not true.” When birth control pills were designed in the 1960s, researchers mimicked the prevailing cultural belief that a 28-day cycle was “a sign of normal reproductive female function” by encouraging users to take 21 active pills and then go pill-free to experience withdrawal bleeding the following week. (This also helped reassure patients that they weren’t pregnant). But the rationale for this decision was cultural — researchers have known for a long time that placebo pills aren’t necessary — not medical.
Skipping your period can relieve inconvenient symptoms like cramping, fatigue, mood swings, bloating, and headaches. Not to mention more pronounced symptoms for people who have endometriosis, dysmenorrhea, polycystic ovarian syndrome (PCOS), or premenstrual dysphoric disorder (PMDD), a severe form of PMS that requires medical treatment to manage. It can also save you big bucks on period products, which are only becoming more expensive.
Here’s what to know about skipping your period, with advice from Denny. (And of course, be sure to talk with your doctor before trying anything new.)
The birth control pill may give you the most control over skipping your period.
When Denny’s patients raise the idea of skipping their period, she’ll first ask them why they want to skip. “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 a lighter, or even absent, period long-term?” says Denny. “If somebody is just interested in skipping one period, I usually talk to them about combined hormonal birth control pills.” This will give you the most decision-making power over when or whether you have a period.
If you’re already on the pill, you can skip your period by just starting a new pack instead of taking the week of placebo pills. (In fact, if you use hormonal birth control, you’re already technically not getting your period. Natural menstruation occurs after your ovaries release an egg that then goes unfertilized; but birth control suppresses the natural hormone fluctuation that occurs during the four phases of the menstrual cycle, which means you don’t ovulate at all. Withdrawal bleeding occurs when you stop taking the active form of birth control — like when you get to the placebo pills in a pack or take out a NuvaRing for a week — and hormone levels dip. This is often called a “period,” but it’s not the same thing. For the sake of simplicity, I’ll keep referring to it as a period here.)
But don’t be surprised if your insurance company gives you a hard time with this method. You might have to ask your doctor to contact your insurance provider to ensure you get more frequent refills, since skipping a period means you’ll go through a pack of 21 active pills every three weeks rather than every four.
“The other thing to know is that there are some birth control pills out there that are packaged in a way that they are designed to help people skip their periods,” says Denny. “So, the other option is to ask for a prescription with that kind of packaging.” Amethyst birth control, which comes in a pack of 28, contains all active pills and may be helpful for people trying to avoid insurance hiccups. Same with extended-use options like Seasonique or Seasonale, which come in packs of 84 and include one week of placebo pills.
Other forms of birth control might be easier to manage over the long term.
For those interested in a low-maintenance way to not to have a period, however — meaning you don’t want to think about taking your pill every day — a long-term method might be the best way forward.
“If somebody wants the best chance of having no periods at all, I usually talk to them about the progesterone injection shot, which is called Depo-Provera, just because that has the highest average rate overall of people having no period when they’re using it.” Depo-Provera is the brand name for what people colloquially call birth control shots, which you get every three months. But it can take up to a year on Depo-Provera to see your period fully stop, according to Denny.
Other forms of birth control like hormonal IUDs and implants can potentially stop your period within the first year of use. “That’s not something you can control,” says Denny. “That’s just a known side effect of the use.”
Nothing is perfect, however. Many people don’t have a complete suppression of their period or their symptoms with any birth control method. Monthly bleeding may just be lighter, or there might be minor spotting, especially when first using these methods continuously. “We haven’t found a great treatment for avoiding that spotting phase altogether, but I do tell people that, generally, it gets better with time,” says Denny.
You can also skip your period without continuously taking birth control.
If you aren’t taking hormonal birth control but still want to skip your period, norethindrone acetate — a synthetic form of the hormone progesterone that’s used in some progestin-only birth control pills — is an option. According to the U.K.’s National Health Service, taking three pills daily in the days leading up to your period will prevent it from showing up. Using norethindrone acetate in this way signals to the uterus that it shouldn’t shed its lining.
“Progesterone is a type of hormone that makes the uterus lining grow. In an unaltered cycle, when that hormone starts to drop, the lining sheds,” explained Denny. “A constant supply of progesterone will keep the lining either very thin or keep it from shedding. As long as you’re taking that progesterone, that lining will stay in your body.”
Your period will happen about 48 to 36 hours after you stop taking the medication. If you take norethindrone acetate solely to skip your period, you’ll also need a backup form of contraception like a condom. According to Wisp, a telehealth company that provides the medication, you can take the mini-pill to skip your period for up to 20 days.
Birth control is incredibly effective at preventing pregnancy. But being aware of early pregnancy symptoms isn’t a bad idea.
Using birth control correctly is a highly effective way to prevent ovulation and pregnancy. But because you won’t have monthly bleeding to indicate that you aren’t pregnant, Denny recommends that patients be able to recognize the early signs of pregnancy and take a test if needed.
“If they have really bad nausea, breast tenderness, or other early symptoms of pregnancy, that might be a reason to take a pregnancy test,” she says. “Pay attention to your body and know the early-pregnancy signs.”
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