What’s the real story behind period-suppressing contraceptives?
When Lybrel, a brand of birth control pill that stops monthly menstruation, became available in July, many women expressed skepticism that suppressing a regular bodily function could come without serious side effects. The media quickly latched onto this attitude, with headlines such as “Many Young Women Wary of a Life Without Periods.” One woman told The New York Times she was worried by “the idea that you can turn your body on and off like a tap.”
A debate over period suppression also erupted among feminists. Some worried that this new type of pill would pathologize menstruation— sending the message that a normal female bodily function is something that needs treatment, and not just if you have “problem” periods. They argued that, like everything from bikini waxes to plastic surgery, period suppression reinforces the message that women need to tame their bodies.
Yet, despite the blogging and the headlines, two-thirds of U.S. women surveyed said they are interested in such pills. More importantly, a whopping 97 percent of physicians surveyed said period suppression is medically safe and acceptable.
In fact, criticism over manipulating a woman’s period can apply to all hormonal birth control methods, because everything from the Pill to the patch to the ring to Lybrel regulates the menstrual cycle. And calling it unnatural to manipulate a woman’s cycle can be a slippery slope: What is natural, anyway? In premodern societies, women were pregnant or breastfeeding for a much larger portion of their lives—which were shorter, anyway, and often ended in death during childbirth. Today, we have between 350 and 400 times as many periods as our premodern sisters did. Furthermore, as feminist blogger Amanda Marcotte (Pandagon) pointed out, adopting the natural/unnatural framework sounds awfully similar to right-wing claims that everything from women CEOs to same-sex relationships is unnatural.
This isn’t a new conversation: The idea of “natural” birth control has been a theme of the contraceptive movement for decades, although the word has taken on different meanings. With the advent of Lybrel and other period-suppressing oral contraceptives such as Seasonale and Seasonique, it’s not surprising that we are once again considering the nature of natural.
It’s almost common knowledge that the reason the original birth control pills, approved by the FDA in 1960, attempted to mimic a woman’s 28-day menstrual cycle is that one of the men who developed the Pill, a researcher named John Rock, wanted to convince the Catholic Church that hormonal contraception could be “natural.” And indeed, that’s part of the story. But it wasn’t just to please the pope.
Rock created a 28-day regimen to convince himself. As Malcolm Gladwell wrote in a 2000 issue of The New Yorker, Rock, a devout Catholic, believed (as the church did) that the only natural method of contraception was for a woman to abstain from sex when she was fertile. During the rest of her cycle, and when pregnant or breastfeeding, a woman produces the hormone progesterone to keep her ovaries from releasing an egg (although a woman can get pregnant while breastfeeding). Rock thought that if he could simply extend this infertile period by giving women progesterone—the combination oral contraceptive also contains estrogen— he would have a contraceptive method that complied with church teachings.
There were other key reasons for keeping the 28-day cycle, says Carl Djerassi, a chemist whose research led to the development of the Pill: “At that time, giving a woman the assurance that she was not pregnant— remember there were no home pregnancy kits—was indispensable, and the only way a woman was certain was to experience the usual monthly period.”