'Extended Cycle' Contraception Garners More Interest

But many women still question safety of skipping monthly bleeding

By Karen Pallarito
HealthDay Reporter

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SUNDAY, Aug. 24 (HealthDay News) -- With new "extended cycle" and "continuous" oral contraceptives on the market, women today can choose to have monthly withdrawal bleeding just four times a year -- or not at all.

To many American women of childbearing age, these options have tremendous appeal. In fact, more than two-thirds of women said they are interested in suppressing monthly bleeding, according to national survey results presented at an Association of Reproductive Health Professionals (ARHP) reproductive health conference.

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"In the last 10 years, there really has been almost a revolutionary change in the opinions and the views of women regarding menstruation," observed Dr. Lee P. Shulman, professor and chief of reproductive genetics in the Department of Obstetrics and Gynecology at Northwestern University's Feinberg School of Medicine in Chicago.

"It's not just the more mature reproductive women desiring fewer withdrawal bleeds," said Shulman, immediate past chair of the ARHP. "Now that's becoming a more common desire among even younger women seeking hormonal contraception."

Oral contraceptives were initially designed to mimic the natural experience of menstruation. Women took 21 days of "active" pills, containing hormones, and seven days of placebo pills. During the hormone-free week, women experienced withdrawal bleeding, much like a true period.

Today's generation of oral contraceptives includes Seasonale and Seasonique, extended cycle products that reduce bleeding to four times a year, and Lybrel, a continuous-use product that stops monthly bleeding altogether. With Loestrin 24 Fe and Yaz, women still have a monthly bleed, but those "periods" are shorter.

Extended cycling, though, is not a new phenomenon. For years, doctors have being tailoring birth-control regimens to women's needs by having them skip the placebo week of traditional oral contraceptives and go on to a new pack. A woman going on her honeymoon, for example, or being deployed by the military, might seek to avoid bleeding and the need for sanitary protection. Extended regimens have also been used to treat women with endometriosis.

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