February 16, 2019

Do I really need to have a menstrual period? Info on the art of menstrual manipulation.

Gilbert Obgyn Tamar Gottfried discusses menstrual manipulation;

Although the monthly menstrual period is essential to the reproductive process, it can easily become a burden for women not interested in becoming pregnant.  Many women ages 12-55 experience problems with their periods ranging from too far apart to too often to too heavy to too long. This raises a common question: If I’m not trying to become pregnant or if I’m done having babies, do I really need to have a period?

From puberty to menopause, the monthly period bleed is a means to shed the lining of uterus that builds up each month and, in the absence of a pregnancy, is not needed. While an average cycle is every 4 weeks, the range can be from every 3 weeks to every 8. Some women have very infrequent periods and wonder if this is healthy. In women that are not on some kind of hormonal manipulation (the pill, the shot, the IUD), it is important to bleed at least every 3 months. Without some kind of shedding of the uterine lining, the lining can build up and cause pre-cancerous changes. Some women don’t have periods because they are very skinny or are athletes with low body fat percentages. They are at risk from having low estrogen levels and can develop problems such as weak bones. Therefore, in women who are naturally not having regular periods (especially those with polycystic ovaries or are over or underweight), it is best to start some kind of hormonal medication to bring on a regular or more frequent period.

For women who have medical problems associated with their periods (menstrual migraines, irritable bowel syndrome, anemia, horrible cramps, etc) or for women that would prefer not to menstruate, there are ways to safely minimize or skip the period. The birth control pill was originally designed with a placebo or sugar-pill week so that women on the pill would have a monthly bleed and know that they weren’t pregnant. However, there is no medical need for this monthly bleed on the pill or on other methods of hormonal therapy. Therefore, women who want to skip a period can skip the sugar pills in their pill pack each month. Alternatively, they can use a medication like Depo Provera or the Mirena IUD to minimize monthly bleeding.

Women who have seen or heard ads in the media for “stop the flow” often inquire about surgical means for avoiding periods. While a hysterectomy will definitely stop bleeding, it is not necessary for most women. Endometrial ablation, such as the Thermachoice procedure,  is an in-office surgical procedure that can minimize and sometimes eliminate monthly bleeding. However, it is designed to lighten bleeding and cramps for women with extremely heavy and/or painful periods, not to eliminate them for women with normal flow. Complete absence of periods after this procedure can never be promised. It is a wonderful, minimally invasive option for improving periods in women who suffer with their cycles each month.

In conclusion, periods are a necessary event for women not on medication, but can definitely be controlled or eliminated temporarily by medical or surgical means. To further discuss menstrual control or the in office Thermachoice procedure, contact my Mesa Ob Gyn office for a consult.

Tamar Gottfried is a Board Certified Obstetrician/ gynecologist  practicing  general Ob/gyn in Mesa Arizona and affiliated with Banner Desert and Banner Gateway Medical Centers. She can be contacted at 480-545-0059. This is a general interest article only and is not intended to be medical advice. See a medical professional before making medical decisions


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