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Just over 40 years ago, the birth control pill kicked off a volcanic change in women's lives. And just last week, the story of the pill took another major turn when the FDA approved Seasonale - the first oral contraceptive specifically packaged to reduce the frequency of women's periods.
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The pill curbs a woman's periods from once a month to just four times a year -- one for each season -- hence the name Seasonale. Gynecologist Dr. Shari Brasner says she believes Seasonale is a modern option for the modern women.
"I am sort of your model busy woman, juggling the career and family and just really in the course of the normal workday, I don't have time to deal with the inconveniences of the menstrual period," Brasner said.
Seasonale, manufactured by Barr Laboratories, contains the same hormones found in traditional birth control pills -- estrogen and progesterone. The difference with Seasonale is not what's in the pills but how you take them. With monthly packages a woman takes hormone pills for 21 days in a row followed by seven days of placebo pills to cause bleeding -- a schedule the original pill designers came up with to make taking the pill feel like normal monthly cycles.
But the Seasonale package has a woman taking the hormone pills for 84 days before taking the seven-day break to induce bleeding. This means that over the course of a year, a woman will get nine more weeks of hormones versus a monthly plan.
The drug company came up with a three-month cycle -- not for medical reasons -- but because their marketing research showed that's the timing that would be most acceptable to women. The FDA approved Seasonale after just one year of study involving 682 women. Some critics say that is much too short a time to find out if there are long-term problems from taking more hormones every year.
"Until they can show me data that there is no additional harm to women, giving them nine additional weeks of hormones, until that data comes through long-term studies, I just can't recommend that women jump on this bandwagon," said gynecologist Dr. Hilda Hutcherson, assistant professor of obstetrics and gynecology at Columbia University.
But that concern wasn't enough to stop 23-year-old Kelly, who asked that only her first name be used. The young newlywed eagerly signed up for the Seasonale study after talking with her doctor about the safety of stopping her periods for months at a time.
Sending a Bad Message?
Monthly birth control pills are safe for most women and reduce the risk of endometrial and ovarian cancer. But Kelly had another reason for wanting a three-month break -- severe PMS.
"I had at times pretty severe mood swings, cramping, pain, backache, just overall discomfort for a week or two every month," she said.
But is it dangerous to skip bleeding for three months? For years, many doctors and patients have been eliminating periods long term by combining monthly pill packs and skipping the placebo.
Dr. Leslie Miller, a leading proponent of menstrual suppression, thinks eventually women will stay on continuous low-dose birth control pills for years at a time. Miller even has a Web site called NoPeriods.com that promotes period suppression.
There is another debate surrounding the approval of Seasonale, namely the social message we are sending.
Hutcherson said she's concerned young women will get a negative message about menstruation. "That your period is dirty, it's messy and it's inconvenient and it's a hazard to your health. I think that is a bad message," she said.
Others, like Brasner, say this new pill empowers women.
"I think in general, I'm an advocate for women having choice. So I'm really excited about anything added to the list of options."
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