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Is menstruation obsolete?

BMJ 2007; 334 doi: (Published 03 May 2007) Cite this as: BMJ 2007;334:955
  1. Paula S Derry, health psychologist,
  1. Baltimore, MD
  1. pderry{at}

    Menstrual suppression has been recommended for medical conditions such as endometriosis, but it is also being proposed as a lifestyle choice for women who dislike menstruation or find it inconvenient. Articles in the professional and popular press have asserted that menstrual suppression is a reasonable lifestyle choice. Birth control options that reduce or eliminate periods are being developed. The oral contraceptive Seasonale, for example, combines 84 days of active pills (0.03 mg ethinyl oestradiol and 0.15 mg levonorgestrel) with seven days of placebo. Since menstrual flow occurs during the pill-free interval, a hormone-free interval every three months instead of the usual 21 days reduces the number of pill-induced periods from 13 to four annually. Seasonale's website ( states: “Fewer periods. More possibilities . . . you might want to consider asking about Seasonale if you . . . wish you had more time between periods, and less of them.”

    The long term safety of menstrual suppression cannot currently be determined with experimental data. Seasonale, for example, has been approved by the Food and Drug Administration, but long term research was …

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