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Dr. Caroline Morgan, St. Luke's Hospital

Women can choose to delay period with oral contraceptives

Do you wish your period didn't come every month or last so long? It doesn't have to. Extended regimen oral contraceptives offer a number of excellent options for women who wish to delay or have more control over their menstrual cycles for medical or personal reasons.

A common misconception is that monthly menstrual bleeding is medically necessary. It is not. With most traditional oral contraceptives, a woman takes 21 active pills containing versions of the female hormones estrogen or progesterone or a combination of the two. These hormones prevent the ovaries from releasing eggs and prevent tissue buildup in the uterus. After 21 days, a woman takes an inactive pill (containing no hormone) for seven days. Menstrual bleeding and symptoms are the body's response to that hormone withdrawal.

Extended regimen pills offer the benefits of shorter or less frequent bleeding and some relief from menstrual symptoms. They can be especially appealing for women who have heavy, prolonged or frequent periods; experience breast tenderness, bloating, mood swings, migraines and painful cramps during their cycle; suffer from anemia; have endometriosis (a condition that can cause pain, infertility or very heavy bleeding); or develop frequent ovarian cysts that rupture and cause pain. In other cases, women may choose to delay their period for convenience.

There are two basic types of extended regimen pills. With one, a woman takes 24 active pills followed by four inactive pills. The shorter hormone withdrawal period lessens menstrual symptoms and causes lighter or no bleeding. With the other type, women take an active pill for three months straight, followed by an inactive or low-dose hormone pill for seven days.

There are some conditions which may make any oral contraceptive use, traditional or extended regimen, risky, including high blood pressure; a personal history of stroke, heart attack or liver disease; a personal or family history of blood clots; and uterine or breast cancer. It may also be risky for women over 35 who smoke. Together with your doctor, you should consider your individual medical and personal issues when deciding whether to use oral contraceptives of any kind.

Dr. Caroline Morgan is an OB/GYN at St. Luke's Hospital. Call 314-576-0930 or visit her Physician Referral page.

This article was published in the St. Louis Post-Dispatch on July 29, 2010.