Is it healthy for woman to be free of periods?

A new pill which stops women menstruating is due to arrive here next year. Do women really want to be free of periods? And is it healthy? Julia Stuart asks the experts

Prof John Studd, consultant gynaecologist, on why women should use this new pill...

At last, a licence has been obtained in the US for what we have been doing for decades. Women have been taking a tablet daily to prevent periods for years. We gave the Pill continuously in the past because in the week off, the plunge of hormones would cause bad headaches, and the treatment for that was to use the Pill daily. This has just legalised what we have been doing for decades anyway.

Why should there be health implications in taking a contraceptive pill continuously? I think women in Britain will love Anya if it is licensed here next year: birth control without periods.

When oral contraceptives were first devised, the Pill was taken continuously without a break. The Pill-free week was only introduced because women thought it was more natural to have a period; it also reassured them that they were not pregnant.

The period on the Pill is artificial anyway. It is not the shedding of the thick lining of the womb prepared for implantation: it's part of the thin lining. These periods are less painful and less heavy than usual. And some women on the Pill don't want a period. They don't want mood changes. The advantage of this pill is that it's a low dose of oestrogen and progestogen.

There is no evidence of side effects. The Pill decreases the risk of ovarian cancer. There is also a decrease of uterine cancer and probably a decrease in bowel cancer. The stroke risks are almost non-existent. There is small evidence that it might increase the risk of breast cancer, but it's unconvincing. If there is a risk - and it's unlikely - a week off will not modify that.

As for the argument that periods are "natural": it's "natural" for women to have 15 children, many of whom will die, so they're left with just two or three. And when they're 40, these women are past it. Female contraception is a massive health advantage, and the Pill has more benefits than any other contraceptive.

www.studd.co.uk

Dr Marilyn Glenville PhD, fellow of the Royal Society of Medicine, on why women shouldn't use it...

This pill would artificially change things. There is always a trade-off when we go against nature. Hormones that control the menstrual cycle act on the brain, skin and the bones, and nobody knows what the long-term effects of continuous hormones are.

Women are already using the Pill as a lifestyle choice to eliminate the inconvenience of periods. When taking the Pill for 21 days with a break, women do at least get seven days off. Periods have a purpose and hormones go up and down in a cycle, which is different from taking a continuous level of hormones every day. The Society for Menstrual Cycle Research in Canada has stated that it does not believe continuous oral contraception should be prescribed just because a woman sees hernormal menstrual cycle as a nuisance.

We know that with the Pill, there is a risk of breast cancer and cervical cancer. Are we then going to see an even greater risk with no break?

A study published in the medical journal Contraception found that 21 per cent of the women on continuous contraception were still having bleeding after taking it for a year. That can be even more inconvenient, as there is no pattern. In that trial of 2,400 women, more than half the women who took at least one dose did not end the trial, 17 per cent stopped due to an adverse effect and 87 per cent reported one or more adverse effects. Nineteen got pregnant and it is thought that 15 were as a result of the contraception failing and four were due to how the women took it.

Many women would miss their periods since it gives them a sense of their health. There is also an issue of fertility. Some women struggle to get their periods back when they come off the Pill. They can go for years before their cycle kicks in again. That could have even more serious implications for women who delay having children and whose fertility is already compromised because of their age.

www.marilynglenville.com