NL 2013/07

Menstruation Management: Changes in How the Pill is Taken

‘Postponing your period by a few days’ was a particularly comfortable side effect of the pill in our mothers’ eyes. By talking to a gynaecologist before a school outing or air travel, these often painful and unpleasant days could in many cases be delayed until a more convenient date.

Over the past few years, experts have been discussing how much ‘menstruation’ is necessary at all when the pill’s being taken. Monthly withdrawal bleeding of women who take the pill or use contraceptive rings or patches isn’t a biological necessity; it’s brought on by a one-week interruption in the intake of hormones. The pill’s inventor developed this usage pattern in the 1950s for psychological reasons: women who took it would be more likely to accept the unfamiliar new pill if there was some way of being certain every month that a pregnancy hadn’t begun. On top of that, the US Food and Drug Administration was thought to be more likely to approve sales of the pill if the ‘natural’ rhythm were maintained.

Women are now more confident about taking the pill than in those days, regarding it as a ‘useful tool’ rather than a kind of medical intervention. This fact is reflected in the Austrian report on contraception, the Österreichischer Verhütungsreport, which reported that nearly 40 per cent of the women surveyed claimed to have had personal experiences with menstruation management: four per cent take the pill regularly over an extended period of time in order to avoid withdrawal bleeding, and 14 per cent do this occasionally. All in all, young women between the ages of 21 and 29 have fewer problems with menstruation than their mothers.

This modern method of using the pill is medically sound: women’s sense of well-being increases measurably, and the frequency of headaches and stomach ache pain decreases. Normal cycles resume quickly after the pill’s no longer taken.

Industry has reacted to this new behaviour pattern by developing a pill that’s taken for three months without interruption. As a result, women have their periods solely four times a year.


A good description of the pill’s interesting history can be found in the book “The Control of Fertility” by its main researcher, the US physiologist Gregory Pincus, published in 1965.


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