ARE PERIODS HOLDING WOMEN BACK?
For many years, women taking a daily birth control pill have been advised to go pill-free for a week every month, and experience a monthly bleed that is akin to a normal period. However, when using other methods of hormonal contraception (such as the implant), some women have experienced an entire cessation of monthly bleeding, and the medical community is now embracing the idea that women needn’t go through periods at all.
This change in thinking has raised some interesting questions. Is it a truly healthy choice for women to forgo periods unless they are trying for a baby? Do periods hold women back through inconvenience, expense, and pain? Or should our society be more accommodating to the daily experiences that any person with a womb is likely to go through?
* While we refer to women within this article (as a generalisation) it’s important to acknowledge that trans men and gender-nonconforming people can also experience menstruation.
Stopping periods through hormonal birth control
The bleeding women go through when they take hormonal birth control isn’t true menstruation, as this form of contraception prevents the womb lining from thickening as it usually would during a monthly cycle. Instead, it is what’s known as a “breakthrough bleed” – which comes about through the withdrawal of hormones during a week within the month that women are told not to take their pill.
At its inception, the creators of the pill thought that mimicking natural cycles would be reassuring to women unused to the idea of hormonal birth control, and there’s also been a theory that failing to bleed at all might be unhealthy and cause a potentially problematic build-up within the uterus.
However, women quickly realised that they could manipulate the pill to avoid periods entirely, with many choosing to skip the pill-free break whenever bleeding would be inconvenient. As time has gone on, research has increasingly indicated that this behavior has no adverse health impact, and medical professionals are moving away from traditional advice regarding the pill-free break.
Why are periods a problem?
For some women, menstruation represents inconvenience, expense, and discomfort that they would rather live without. Period pain, while not taken particularly seriously, can be genuinely incapacitating – interfering with the daily lives of around one in five women. Very heavy menstruation can also lead to dizziness and anemia, while women and girls in poverty can struggle to afford sanitary products. Those that can afford them are then burdened with the inconvenience of being tethered to the nearest sanitary bin in while out and about in order to regularly change their products.
In certain careers, the monthly cycle can also be a genuine barrier to success. Female athletes can experience changes in certain aspects of their physiology and performance at different points of their cycle, and sometimes feel disadvantaged if they come on their periods during key competitions.
This issue also extends to women who work in physical or combat roles and is an extra inconvenience to anyone traveling to areas without modern infrastructure (for example, research teams and aid workers). More broadly, over half of female workers said they’d experienced period pain that affected their ability to do their job – affecting both their performance and their ability to attend work on certain days.
Having the option to live without periods – or to only have them when they choose – is a positive option for some, whether it’s to ensure their sports performance or simply to skip the hassle of a monthly bleed. It’s often easy to believe that the best thing for people is what is most natural, but while the evidence shows no ill effects, there’s no need to mimic a natural process while taking hormonal contraception.
The need for caution
While in many ways the option to forgo periods is a beneficial one – especially as it gives women more control regarding their own bodies – it is important that it remains a choice, and not an expectation.
Many women would still be reluctant to say period pain was the reason for their work absence, no matter how severe, and access to sanitary items is still by no means guaranteed for all. There is still a strong argument to say we still need to make a conscious effort in society to support women rather than expect them to either silently persevere or stop their periods entirely.
Significant hormonal intervention is not a solution for every woman, and there are many who report side effects that they would rather not live with – from low mood to decreased sexual desire. There is a danger that with the knowledge that periods are something it’s possible to opt-out of, women begin to feel compelled to delay their periods in a similar way that they currently feel compelled to take the leading responsibility in birth control.
Women may not want to use hormonal birth control, and while it’s a fantastic option for those it works well for, we don’t want to create an atmosphere where women’s bodies are expected to be pruned and streamlined so they fit better into our working (and social) culture. There are also women who don’t have the option of taking the pill – for example, if they are prone to blood clots, or they are over 35 and have a family history of heart attacks.
While natural doesn’t always equal ideal (which women who experience extreme period pain would attest to), we should also take care not to medicalise and “solve” something which is a normal part of being a woman of reproductive age. Many women experience their periods with very little discomfort or inconvenience, and the menstrual cycle isn’t something they need to be cured of.
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