Seasonique, Lybrel - Is it Safe to Miss Your Period?

Shellyann emailed wanting to know, “Are there any studies on the long term side effects of having only 4 periods per year??”

This question stemmed from my blog: Beware: Information About the Latest Lybrel and Seasonique Email Scam. The short version: there is a fraudulent email chain going around declaring that the death of 31-year-old Nicole Dishuk was due to “a birth control she was taking that allows you to only have your period 3 X's a year...They said it interrupts life's menstrual cycle, and although it is FDA approved, it shouldn't be.” Additionally, it warns that one can go to the Lybrel website and find 26 pages of information, and the Seasonique site and read 43 pages of information – concluding that “the warnings and side effects regarding both pills are horrible”.

It is important to remember drug manufacturers must disclose all information about their products, so – yes, you may find all those pages worth of information; however, if you check, you will read information ranging from ingredients to possible side effects (which may include potential deaths – as with many types of medications.). Emails like this are usually the attempt of anti-contraception groups aiming to scare women from using these medically-proven safe and reliable forms of birth control.

That being said, I return to Shellyann’s question. Yes, there have been studies done, and the FDA would not approve these extended-cycle pills if there was not enough data to back up their safety. The truth is, when birth control pills were first introduced, they were marketed to be sold as 21 days of active hormone pills and 7 days of placebo pills to minimize the perception that these pills changed the menstrual cycle. Many women do not realize the “period” they have on birth control pills is not a REAL period – it’s actually called withdrawal bleeding. Withdrawal bleeding is NOT necessary to maintain gynecologic health (some women hold the misconception that if they do not have a period, blood or other toxins may excessively build up).

Some research studies (found in medical journals):

1. Anderson, F.D., Hait, H., & The Seasonale-301 Study Group. (2003). A multicenter, randomized study of an extended cycle oral contraceptive. Contraception, 68(2), 89-96: Was the first large-scale controlled study of the effectiveness and safety of an extended cycle OC regimen in women up to age 40. This study demonstrated that extended cycle oral contraceptives are effective, safe and well tolerated. When taken daily for 84 days followed by 7 days of placebo, the extended cycle regimen was effective in preventing pregnancy and had a safety profile that was comparable to that observed with the 28-day OC regimen that served as the control. Extended cycle pills represent a change in the paradigm of OC therapy by allowing women the option of decreasing the number of withdrawal bleeding intervals from 13 to 4 per year.



2. Henzl, M.R., & Polan, M.L. (2004) Avoiding menstruation: a review of health and lifestyle issues. Journal of Reproductive Medicine, 49, 162-174: Found that eliminating withdrawal bleeding through extended or continuous use of oral contraceptives may actually have health or lifestyle-related benefits.



3. Anderson, F.D., Gibbons, W., & Portman, D. (2006). Long-term safety of an extended-cycle oral contraceptive (Seasonale): a 2-year multicenter open-label extension trial. American Journal of Obstetrics and Gynecology, 195(1), 92-96: The primary objective of this study was to demonstrate the safety of Seasonale for up to an additional 2 years. The results presented in this study are from the first long-term study with an extended-cycle OC. The researchers found that the negative side effects reported in this study are typical of all birth control pills. This study demonstrates the long-term safety of the 91-day extended cycle OC Seasonale.

There is no evidence that shows women need monthly withdrawal bleeding, and no health problems are linked to skipping or eliminating bleeding. Studies conclude that continuous use of the pill to eliminate monthly withdrawal bleeding is as safe and effective at preventing pregnancy as using the more traditional 21 or 28 day oral contraceptive pill regimen.

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_{Extended Cycle Birth Control Pill Photo © 2007 Dawn Stacey licensed to About.com, Inc.}