There won't be blood

Is it really OK to never get your period?

Every time I visit my doctor, the same question comes up: “When was your last period?” Considering I actively try to skip it every damn month, I can never remember when I last had my period. When I admit this, I get The Look. It’s the look that’s judging me for skipping my period indefinitely, as if it’s unhealthy. In fact, I get The Look so often I’ve started questioning my decision to live a glorious, period-free life. What if it’s not so glorious after all?

A quick Google search will yield two different answers to this question. On the one hand, article after article has been written arguing that there’s no real need to bleed. However, a handful of other articles give opposing information, telling women not to skip for more than three months. Even the Mayo Clinic website says doctors may suggest women take some time off from skipping. Nowhere does it say, “Sure, skip forever!”

I wanted to get to the bottom of this, so I reached out to several OBGYNs, the Mayo Clinic, and the the American Congress of Obstetricians and Gynecologists (ACOG) to see who’s right and who’s wrong.

ACOG gave me a wishy-washy answer, saying they don’t “have one take on what’s best,” and suggested that it’s a decision a woman make with her doctor. But even so, their response implies that this is a serious medical issue that should be discussed with a professional—as if there might be some unforeseen danger to it.

So I decided to ask some OBGYNs, and guess what? Every single one I spoke to said there’s no medically necessary reason to have a period if a woman is on hormonal birth control—but that many women simply don’t know that.

“We get this question a lot,” says Diane Horvath-Cosper, an OBGYN (who Fusion profiled) and fellow at Physicians for Reproductive Health, a national organization seeking to improve access to comprehensive reproductive health care. “Periods are not fun. People come in and they’re like, ‘Do I really need a period?’” The answer, she says, is no.

“Women have periods because the body is preparing for a possible pregnancy. If you’re on a contraception, you don’t build that uterine lining up,” she says. “There’s no need to bleed.”

So let’s unpack that, shall we? Every month a woman goes through a menstrual cycle (duh). Part of that cycle, which lasts on average 28 days, is the buildup of the uterine lining, which aids in pregnancy—essentially, the body’s welcome mat for the baby. If no baby arrives and a woman isn’t on hormonal birth control, her body will shed that bloody uterine lining (don’t need this anymore!). And that, folks, is a period.

A woman on hormonal birth control doesn’t actually build up a uterine lining. The pill controls the flow of progesterone and estrogen, and “overrides what your body would normally do,” says Michelle Berlin, an OBGYN and co-director of the Center for Women’s Health at Oregon Health & Science University. The “period” you get while on the pill is simply due to a change in level of or lack of hormones during the control week; it’s not a true period.

In fact, says Petra Casey, an OBGYN and the Mayo Clinic’s expert on birth control, there’s more of an argument to be made for not taking the placebo week of pills and continuing straight onto the next pack. This trick can also be done using the birth control ring for four weeks instead of three, or with certain extended cycle pills. Some women who use devices like implants or hormonal IUDs may also experience fewer periods as well.

“There’s no reason for taking a break,” she told me over the phone, “because every time you take a placebo week, you hit the reset button.” And resetting can cause issues since going on and off the hormones is what leads to irregular bleeding.

But this doesn’t mean you’re overloading your body with hormones—another urban legend associated with skipping periods. As all the OBGYNs explained to me, the hormones in the pill are actually less than what your body produces in a normal menstrual cycle, and way less than what your body produces when pregnant.

So if taking active pills continuously is totally safe, then why does the Mayo Clinic advise women to only take them for six weeks in a row?

It’s simple. “Some women want to have periods,” Casey says. “They want to be sure they’re not pregnant.”

But for those who do want to skip, OBGYNs will prescribe patients extra packs. “We’ve been doing that for decades,” says Casey. Other OBGYNs I spoke to said the same thing.

“OBGYNs often say to throw out the sugar pill,” says Berlin up in Oregon.

Turns out the pill is built the way it is because of men and religion. “[I]n the 1950s, when the pill was being developed, people were more comfortable with faking a normal cycle,” says Horvath-Cosper. More specifically, developers of the birth control pill felt it would be an easier sell to the public—and more importantly the Catholic Church—if contraception felt “natural.” Which is why a week of placebos was built in to simulate a period. John Rocks, a developer of the birth control pill and a Catholic, “thought if women had a period, the Pope would buy it,” explains Berlin. “That’s the only reason it’s there.”

So, ladies, if you don’t want to have a period anymore, feel free to skip it using your monthly hormonal birth control pills or the birth control ring without stressing that you’re somehow screwing up your body. You’re not.

Bottom line: The time for bleeding is over.

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