Do you really need your PERIOD?
Ditching your period can lead to better mental health, less pain and more productivity. If you could safely stop yours, would you? Laura Sampedro puts it to the test
‘HOW DO YOU FEEL ABOUT YOUR PERIOD?’ The question, posed by my neurologist as she dutifully explored new ways to treat my migraines, sent me down a spiral that landed me in the early 1990s. My period debuted when I was in Year 8, and made quick work of turning my favourite pair of jeans into a crimsonhued Rorschach test. I spent the rest of my first day as a woman wearing my PE kit from the waist down, learning the true meaning of shame. At school, I feared my heavy flow so intensely that I never left home without a backpack full of maxipads so large they could double as water skis. By the time I was at university, brutal cramps, intense back spasms and cold sweats ushered in my biblically heavy period each month. My housemates took turns handing in my work whenever I was too ill to go in, and I leaned into my tutors’ assumptions that I was just another hungover student. The truth, somehow, felt worse. By my mid-thirties, migraines became the checkered flag that signalled the arrival of my period. And while medication helped lessen my migraines’ frequency and severity, there was still one particularly paralysing headache that always showed up on race day. ‘It’s my Waterloo,’ I whined in response to the doctor’s question. To my surprise, she responded by asking if I’d feel comfortable just eliminating my period and, hopefully, the migraines that came with it. ‘I can do that?’ I asked, in the excited pitch usually reserved for the recently engaged or children opening Christmas presents. ‘You can do that,’ she replied, setting aside a prescription pad. ‘It’s not that hard.’ Addressing period elimination (or ‘menstrual suppression’) is impossible to do without wading into the mysteriously murky waters of hormonal contraception, some forms of which (the Pill, patch and ring) remain the most effective medications for regulating periods and their side effects. Contraception provides the body with synthetic versions of progesterone and oestrogen, the ovarian
hormones released when the body is pregnant. Think of progesterone and oestrogen as the bouncer and clipboardwielding door attendant for Club Uterus, working to keep the ovaries from releasing any new eggs and strengthening the endometrium so that additional sperm never make it inside. When an egg is not fertilised, the bouncer and door attendant go off duty, causing the drop in progesterone and oestrogen that leads to the uterine shedding its lining (your period). Avoiding that hormonal dip by taking continuous contraception is the key to turning off your period, and could provide a significant degree of relief for women suffering from conditions as wide-ranging as asthma, rheumatoid arthritis, endometriosis, diabetes, polycystic ovary syndrome, anaemia and depression, among other mental health issues. People with physical and developmental disabilities who have difficulty coping with the hygienic needs of periods – or who may be dependent on others for care – have had the option of suppressing their period for decades with no record of sustained physical side effects. So why is it not more common for people dealing with other physical and mental hardships? Or those of us who simply can’t take it any more? ‘If you’re not trying to make an embryo, there’s no point to bleeding,’ says Dr Sophia Yen, CEO and co-founder of contraceptive mail order service Pandia Health. ‘This incessant menstruation is a modern construct.’ It’s only in the past 100 years (ironically, with the advent of contraception) that women have come to experience an estimated 350 to 400 periods in their lifetime. As contraceptive pioneers Elsimar M Coutinho and Sheldon J Segal noted in their 2001 book Is Menstruation Obsolete?: ‘As recently as [the 19th century], women had an average of eight children, with long periods of lactation between frequent pregnancies.’ Putting that into context, Yen asks, ‘How many periods do you have when you’re pregnant? Zero. How many periods do you have when you’re exclusively breastfeeding? Zero.’ Prior to the industrial revolution, a woman may have only experienced perhaps 100 periods, because she was either pregnant or breastfeeding for the majority of her fertile years. ‘Relatively speaking, [these women] were menstruation-free compared to their descendent daughters just a few generations later, who average fewer than two children,’ Coutinho and Segal wrote. If history has given us the precedent for eliminating periods, science is now backing it up with evidence that it’s beneficial – the less frequently we menstruate, the lower our chances of developing reproductive cancers. ‘Why are we building and sloughing, building and sloughing? Every time we build, we risk endometrial cancer,’ Yen says. ‘When we pop out an egg, we’re risking ovarian cancer. And why are we doing this for 10 [to] 20 years pre-baby, then another 10 to 20 years post-babies – if we’re not trying to make a baby?’ Even John Rock, Gregory Pincus and Min Chueh Chang, architects of the modern contraceptive pill, acknowledged in
“If you’re not TRYING to make an embryo, there’s no point to BLEEDING”
1958 that women could presumably create a menstrual cycle of their own desired length while on the Pill, yet chose to introduce the idea of a hormone-free ‘placebo’ week to the cycle, believing that women would be reassured by the arrival of their period. Rock, a devout Catholic, hoped that by preserving menses he could finally obtain the Catholic Church’s approval of the Pill, arguing that married couples could partake in church-sanctioned ‘natural’ birth-control practices like the rhythm method by using a woman’s cycle as their guide. But in 1968 Pope Paul VI declared that all ‘artificial’ methods of contraception, including the Pill, were against the church’s values. Despite improvements, the 28-day cycle with a placebo week remains the template for most Pill iterations, leaving the Catholic Church’s fingerprints all over the medication it continues to reject more than 60 years later (despite its potential to minimise pain and suffering). For Yen, who specialises in adolescent medicine, turning off your period has another upside: it gives women and girls a greater opportunity to succeed where they may otherwise be held back. ‘I ask any parent of anybody with a uterus, “Is your young person going to do better [in exams] bleeding or not bleeding? At football, bleeding or not bleeding? At their Olympic swimming competition, bleeding or not bleeding?”’ she says. ‘It’s about competitiveness. It’s about equality.’ The divide does appear to fork around the time that periods come into play. ‘Starting at puberty, boys and girls start to separate in terms of their mental health experience,’ says reproductive psychiatrist Dr Uma Lerner. ‘Girls and women have higher incidences of depression and anxiety, and all of that begins with puberty, which shows that women’s hormones and their repression make a big difference in our mental health.’ These early experiences can have a lasting impact. When I had my debilitating periods, I often skipped parties and other opportunities to socialise with my peers (to say nothing of missed classes and the constant fear I harboured of accidentally unleashing a flotilla of sanitary towels while pulling out a school book). ‘So much is missing when we talk about girls’ academic performance compared to boys’ and girls’ confidence rates, but we don’t account for the fact that girls are dealing with a lot of physical issues that [are still shrouded in] stigma,’ Lerner adds. In my case, it took three years of migraine treatment before my doctor even mentioned the possibility of eliminating my period – and only after I’d tried multiple medications, altered my diet, taken supplements, had vitamin injections, taken thrice-yearly blood tests and begun keeping a weather journal. It was another two years of experimenting with contraception and going head-to-head with my period before I started to feel better. And, while my neurologist is still diligently working to make me 100% migraine-free, I’m happy to report that my life’s biggest headache – my period – is finally in my rearview mirror.