March 2003 · Vol. 15, No. 3Using contraceptives to alter bleeding patterns
Most women want shorter, lighter, less-frequent menses. Modern contraceptive methods offer options for manipulating the menstrual cycle.
PATRICIA
J.
SULAK,
MDDr. Sulak is professor, department of obstetrics and gynecology, Texas A&M Health Science Center, and director, division of ambulatory care and director, sex education program, Scott and White Memorial Hospital, Temple, Tex. She also is an examiner for the American Board of Obstetrics and Gynecology and serves on the OBG Management Board of Editors.
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KEY POINTS
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Women prefer to menstruate less often, and modern contraceptive methods give them that choice.
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Among the contraceptives that can significantly alter menstruation patterns are depot medroxyprogesterone acetate, levonorgestrel implants, oral contraceptives (OCs), and the levonorgestrel intrauterine device (IUD).
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The levonorgestrel IUD is one of the most effective means available of reducing menstrual blood loss.
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To manipulate bleeding patterns and manage hormone-withdrawal symptoms, the duration of active OC pills can be extended.
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Given the problems associated with menstruation, it is not surprising that women prefer to menstruate less often—and modern contraceptive methods give them that option. This article describes current options and factors to consider in counseling patients.
Compared with today’s women, who have access to effective birth control, past generations had earlier and more frequent childbearing, longer periods of breastfeeding, later menarche, and earlier menopause. During their reproductive years, they were more likely than today’s women to be pregnant or breast-feeding than to be menstruating, and they had far fewer total menstrual episodes during their lifetimes.
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