Menstrual cycle stoppage debated

Tuesday, May 29, 2007 - 12:07 AM
A birth-control pill that lets a woman skip monthly menstrual periods sounds like a good idea to Sarah Kimball.
"If my doctor recommends it for me, I would be more than happy to give it a whirl," said Kimball, 27, of Glen Allen. "The idea of never having a period is nice."
Federal officials last week approved Wyeth Pharmaceuticals' Lybrel, a birth-control regimen that eliminates monthly menstrual periods.
Lybrel's approval has gotten folks talking. Not all the discussions are favorable -- a question on many minds is whether this is a good thing or is it messing with Mother Nature with uncertain long-term consequences.
We contacted local experts to answer a few questions about Lybrel, which will be available in July. The experts are:
Dr. JoAnn V. Pinkerton, an associate professor of obstetrics and gynecology at the University of Virginia School of Medicine, and director of The Women's Place Midlife Health Center at U.Va.
Dr. Vienne K. Murray, an obstetrician-gynecologist at Virginia Women's Center, in the Richmond area.
Dr. Sulola Denloye Adekoya, an obstetrician-gynecologist at the Richmond Department of Public Health.
1. Women are already doing this, right?
Pinkerton: "Many women have been utilizing continuous cycles just by not taking their placebo pills. This pill is now providing a mechanism for something women are already doing, having a period when it suits them. . . . There is no need to bleed unless women want the security of having a monthly period."
2. Why would woman want to eliminate their periods?
Murray: "For women with debilitating, painful periods, heavy periods, this is a good idea."
Pinkerton: "There are some women who would be excellent candidates, such as women with [some types of] migraine headaches, women who have problems premenstrually. Certain medical problems will be helped: people with premenstrual syndrome, endometriosis, women with heavy bleeding. . . . Some women prefer not to have a monthly period, [including] athletes like swimmers, ballerinas."
Adekoya: "For convenience - summertime, when you go on vacation; women who have high-powered jobs and they don't want a cycle."
3. Who should not take Lybrel?
Pinkerton: "Women in general who should not take pills or women at risk for blood clots, stroke, who have had breast cancer or other estrogen-sensitive tumors, or migraines worsened by estrogen. Women who are comforted by regular cycles. Women who won't or can't be compliant with taking the pill every day. Smokers. Women who desire pregnancy."
4. What are the disadvantages? Side effects?
Adekoya: "The downside, for a couple of months you may have unscheduled bleeding. Some women will experience irregular spotting every now and then. You eventually get to a point where you don't have a [menstrual] cycle."
5. Is Lybrel safe? Are similar continuous dosing regimens safe?
Adekoya: "It's safe theoretically. The only caution is that you have to speak to your health professional. If you have medical problems, the same contraindications would apply - high blood pressure, blood clots."
Murray: "My only concern is how long can we put women on it. If indefinitely, I think the main issue would be future fertility. It would be extremely important for women to consider their future fertility."
Pinkerton: "We are lacking long-term safety data."
6. The pill is effective if taken correctly, but many women often forget to take a pill? Will this be a problem?
Adekoya: "It's really no different than with the other pills - you have to take it every day."
7. How soon after stopping Lybrel will periods resume?
Pinkerton: Fairly quickly, within about three months.
Contact staff writer Tammie Smith at tsmith@timesdispatch.com or (804) 649-6572 .

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