Thursday, April 3, 2003 - Page updated at 12:00 AM

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Study: The pill can avoid periods without 'spotting'

Seattle Times staff reporter

Savvy women for years have used the birth-control pill to manipulate the timing of their periods, even to skip menstruation altogether. But some skeptical doctors have warned this method could cause surprise breakthrough bleeding.

A new University of Washington study may help lay that concern to rest.

Women can eliminate monthly periods by taking birth-control pills continuously without increasing their chances of "spotting" or heavier bleeding, Dr. Leslie Miller concluded in a study reported this week in the journal Obstetrics and Gynecology.

Continuous use of the pill entails tossing out seven placebos typically packaged with 21 estrogen/progestin pills and moving on to the next active tablets.

Some gynecologists have shared this trick with select women, such as anemic patients and brides-to-be, but doctors generally have not given women the option to suppress menstruation for an extended time.

The yearlong study at Harborview's Women's Research Clinic offers some of the first science on the method.

Miller, a UW associate professor of obstetrics and gynecology, placed 32 women on a continuous dose of birth-control pills and 28 women on the standard pill cycle.

Skipping periods

For more information on continuous birth-control use, go to
Continuous patients spotted frequently at the start of the trial — an average of nine days a month. But they spotted much less often by the final three months — 1½ days per month, compared with five among cyclic pill users. Seventy-two percent of continuous pill users had no bleeding by the end of the study, Miller said.

Sonya Daria, a 34-year-old UW medical student, hasn't had a period for years. The study participant suppressed menstruation for more than two years until stopping the pill to try to get pregnant.

"For me, it changed everything," Daria said. "I used to have severe cramps, and at least one day a month I would spend on the couch with a heating pad."

Daria, the mother of 4-week-old Irene, said she plans to go back on the continuous pill after she's done having children.

Overall, there wasn't a major difference in patient satisfaction between the methods.

The study did not assess safety concerns such as increased risk of blood clots.

"Birth-control pills are incredibly safe," Miller said. "It's unlikely skipping the period week would make the pill more dangerous."

But some doctors say long-term safety studies are needed.

Although birth-control pills are considered safe for most reproductive-age women — with exceptions such as those who are older than 35 and smoke or who have certain medical conditions — they carry known risks such as a higher chance of developing blood clots, stroke and heart attack.

"This is increasing hormone levels by 25 percent," said Dr. Hilda Hutcherson, an assistant professor of obstetrics and gynecology at Columbia University. "In the end that may end up insignificant, but it's gonna take years to see."

There is no currently available oral contraceptive marketed for avoiding periods, but Barr Laboratories is seeking Food and Drug Administration approval for Seasonale, a pill that produces only four periods a year.

Miller emphasized that the continuous regimen isn't appropriate with all birth-control pills, only formulas containing constant, low doses of hormones and only under the guidance of a physician.

Julia Sommerfeld: 206-464-2708 or


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