A surprisingly large number of women 18 or older choose to
delay or skip monthly menstruation by deviating from the instructions of
birth-control pills and other hormonal contraceptives, a team of University of
Oregon researchers and others found in a study of female students at the
Most women who alter bleeding cycles do so for convenience
rather than to avoid menstrual symptoms, and many learn about the option from
nonmedical sources, according to research by the university's Department of
Human Physiology, Portland-based Oregon Health and Sciences University and
Eastern Michigan University. The study is published in Contraception, the
official journal of the Association of Reproductive Health Professionals and
the Society of Family Planning.
"These findings emphasize the need for health care
providers to carefully interview combined hormonal contraceptive users on how
they are using their method – for example, many women may be skipping pills to
extend their cycles," said researcher Christopher Minson, a human
physiology professor at the University of Oregon. "With a greater
understanding of the issues, health care providers may be able to more
effectively engage in conversations with college-aged women and educate them
about available options."
occurrence of menstruation
As research indicates that reducing the occurrence of
menstruation is safe and can even be beneficial, women are increasingly using
hormonal contraceptives to alter bleeding cycles. But there has been a lack of
information concerning why women do so and from whom they receive information
regarding this option.
In a survey of undergraduate and graduate students, 17%
reported altering their scheduled bleeding pattern by deviating from the
instructions of hormonal contraceptives, which include birth-control pills,
vaginal contraceptive rings and transdermal contraceptive patches.
Half of these women reported that they did so for
convenience or scheduling purposes. Others cited personal preference (28.9 %)
or reducing menstrual symptoms (16.7%) as reasons they altered menstruation
Among the women who delayed or skipped a scheduled bleeding
for convenience or personal choice, a comparatively large number – 53% –
indicated the knowledge was obtained from nonmedical sources, such as a family
member or friend, researchers said.
Women and their
The survey also provides new insights on the factors that
influence a woman's decision whether to alter bleeding schedules. Asians have a
7% lower probability of altering hormonal cycles and women who exercise
regularly have a 5% lower probability of doing so; another characteristic that
decreased the likelihood of the practice was preference for a monthly cycle.
"We found that it is possible to identify some of the
specific characteristics of women in a college population who may be more or
less likely to practice scheduled bleeding manipulation," said Dr Paul
Kaplan, of the University Health Center and Oregon Health and Sciences
University. "This study provides information about the motives, beliefs
and influences relating to this practice."
In a finding that surprised researchers, women who said they
would prefer no menstrual periods were less likely to alter their cycles than
those who would prefer one per year. A woman who would prefer one cycle per
year had a 17% higher probability of modifying her hormonal contraceptive
regimen than one who preferred a menstrual period every three months or never.
This suggests that health care providers could improve
education of the hormonal contraception regimen best-suited to a patient's
needs and desires, researchers said.
From an estimated 11 900 survey-linked emails sent to female
university students, 1 719 (14.4%) initial responses were received and 1 374
(79.9% of respondents) indicated that they had used a combined hormonal
contraceptive during the last six months.