Raise your hand if your period has ever been a total pain, emotional or physical? Raise your hand, again, if you ever wondered what life would be if you did not get the monthly visit from the crimson brigade? Truth is, you won’t be the only one if you have considered this on several occasions - before a trip, intense traveling, an athletic event, a religious ceremony, a sleepover with friends, a romantic date or simply because you didn’t feel in the mood for it. And it doesn’t end there - if contemporary medical science is to be believed, getting rid of your period entirely without too many drastic effects on your body, is very much within the realm of possibility.
A Life Without Menstruation?
Menstruation 101: The female body gets ready for pregnancy every month with the uterus lining getting thicker to prepare for a fertilised egg. But if the egg doesn’t fertilise, that it doesn’t mate with a sperm, the uterine lining is rejected as it is no longer needed to support a foetus. That lining is released as blood through your vagina. Once this lining has been completely shed, your next cycle begins.
It’s painful, it’s uncomfortable, it’s messy and leaves many women wondering - why do I have to go through this every month? And is there a way to do away with them completely?
At first glance, it appears to be a complex medical task - how can one simply choose to not bleed?
But according to doctors, the answer is quite simple.
First off, is it even ‘normal’ for the body to not bleed? Dr Nozer Sheriar, a senior gynaecologist and obstetrician and leading voice in the space of women’s reproductive rights in India, says, it is indeed. In fact, having your period regularly might be the ‘abnormal’ thing, according to him.
"“If you really think about it, regular menstruation is something which is a very recent phenomenon in human history. In human history, women spent their entire lives either being pregnant or breastfeeding. All regular menstruation harks back to the last 40-50 years when family size went down dramatically. I’ve often wondered what is more normal - a woman in the year 1900 who hardly ever menstruated, or a woman in 2000 who menstruates throughout her life?”" - Dr Nozer Sheriar
There is more, the doctor adds. Regular menstruation has coincided with several problems of the reproductive system that did not exist in the previous generations.
"“Regular menstruation that has happened in women all these years has also coincided with a lot of medical conditions that have created gynaecological problems. For example, endometriosis, or fibroids, these didn’t happen as much in the past when women were pregnant for a larger part of their menstruation cycle.”"
Dr Sheriar calls this “almost a justification for thinking about change.” He adds, “For example, we do know that if a woman is on birth control pills for a very long time, she will have a reduced risk of ovarian cysts and cancer.”
Eliminating Menstruation is a Normal Choice for Many Women: Doctors
These views may sound pathbreaking to an average woman who indeed considers a regular menstruation cycle as an essential part of her good health. However, within the medical community, several doctors are of the opinion that if a woman chooses to skip her period entirely, to remove them from her lifestyle for a long period of time, and to not simply delay it for a particular event, it is perfectly normal.
Dr Sonali Gupta, Senior Consultant, Obstetrics and Gynaecology, Max Multi Speciality Hospital, Greater Noida, agrees with Dr Sheriar on this and says:
"“We are living in a world and an era where we wish to control everything which applies to our menstrual cycle. Hence, in a perfectly healthy woman menstruation can be controlled by different modes like implants, pills and an intrauterine contraceptive device (IUCD), depending on her choice.”" - Dr Sonali Gupta
Dr Gupta further adds that period suppression can be easily achieved without any major negative consequences.
Wait, the consequences of stopping menstruation might not be major, but what are they?
Are There Side-effects of Skipping My Periods Voluntarily?
The first concern that many women have is if it would affect their fertility. What if at some point in the future they want to have a baby, would it be possible? The simple answer is - yes, it would be.
"“Stopping your menstruation voluntarily has no long term side-effects for future fertility. Regular periods are not mandatory for an eventual pregnancy. Sometimes the endometrial lining can become less receptive to pregnancy, but effects reverse with due course of time.”" - Dr Sonali Gupta
Dr Sheriar also emphasises that any changes that are brought about in the body are completely reversible.
"“Most methods that we use do not have significant side-effects in a healthy woman. Some of them have been reported to affect the bone density, though over a large period of time it was observed that it doesn’t seem to be so. They are all reversible, some of them very quickly, some take a little more time (the injectables might take more time, the IUD and tablet would go almost immediately), and none of them affect fertility.”" - Dr Noser Sheriar
It is to be noted, says Dr Sheriar, that an IUD device will not automatically remove periods entirely. They might make them scanty. How an IUD affects a woman’s body is a very individual experience. He adds that in his experience, since many women have come for help as a consequence of a regular heavy period, even scanty bleeding is a much more welcomed possibility. Several women also opt for medication that makes their period seasonal, that is, they bleed four times a year, once every season.
“These pills are not only cleared by the US FDA, but the return to fertility after discontinuing their usage is almost immediate”, says Dr Sheriar.
Benefits of the No-Menstruation Life
What could be better than a reality where there are no spells of melancholia, not tearing up at the smallest provocation, mood swings or unhealthy cravings, cramps nausea or indigestion? The list of symptoms linked to your monthly cycle could just simply go on. However, along with comfort, there might be medical benefits of getting rid of your periods too.
"“Skipping and postponing periods can be useful for patients who are suffering from anaemia due to excessive bleeding.”" - Dr Sonali Gupta
However, the doctor emphasises, it’s important to have your own individual evaluation thoroughly done by a doctor.
Dr Sheriar reiterates his earlier point about endometriosis and related concerns.
"“There is no doubt that most of these methods, when taken over time, will actually reduce incidences of endometriosis. When women stop the medication, I believe they may be better off than someone who has never used them because the latter may have developed some of these conditions in the interim. Choosing not to have your period might have a protective effect rather than a detrimental one.”"
Taking a Pill to Delay Your Period Has Significant Side-effects, How is This Different?
Taking a pill to delay your period temporarily is different from the point we are trying to make here. Women often do the former to delay their cycle by a month or so. This comes with its own set of side-effects which may range from mild to severe.
However choosing to cut menstruation out of your life entirely is different. Dr Sheriar explains:
"“Doing it as a one-off thing is different from doing it on a regular basis. In the former method, we are using a short course of progesterone to push a period by sometime which is why when women finally get it, there are unpleasant consequences. Here she is regularly taking it which keeps the lining of the uterus suppressed over long term. As a result of this, the side-effects are much, much less.”" - Dr Noser Sheriar
So, how does one go about achieving the no-period life?
There are several ways of achieving this and only your doctor can guide you best on it. The list includes pills, injectables and IUD devices. Each body will respond to them differently which is why it’s best to have a health expert on board at every step of the process.
Are Periods Redundant?
When you hear such a proposition, of course there is the instinctive hesitation. As a woman, a life without menstruation goes pretty much against all that we have associated with a healthy female reproductive system. On the other hand, there is also the sense of liberation, of not being tied down to a medical phenomenon that can be erratic, unpredictable and difficult to control. So, where does this leave menstruation? Is it truly redundant?
"“We define everything on the basis of benefits and returns. This is why we might feel the need to label periods as redundant if we are not planning to have a baby. But I believe every natural process has it own role, if not always the obvious role of let’s say, having a baby. Hence it should not be written off as being useless or redundant.”" - Dr Sonali Gupta
But how does one even begin to prepare themselves mentally and emotionally for such a reality?
"“You have to completely flip the way of seeing things. Women have not menstruated for hundreds of years and done well. Suddenly around the 1960s, we told women you have to menstruate every month to be healthy. We conditioned them into believing this, to be uncomfortable if they are not menstruating regularly. Now we really have to just decondition them, to go back to what their great-great-grandmothers were doing. Maybe it was a healthier time then than what it is right now.”" - Dr Nozer Sheriar
Conclusion: How Should Women Look at the Alternative of No Periods?
Dr Sheriar lists it down for us:
“It has to be two things - firstly, I would evaluate what my patient wants. If she is very uncomfortable with having periods, I would guide her with the suitable methods. If she is indeed comfortable with the idea of no periods, I would counsel her and say many of these methods may not guarantee no periods. She has to accept that she might sometimes have periods which are disturbed as compared to conventional periods. They might be lighter, scantier, less frequent, there might be intermittent spotting. And secondly, it depends on whether the doctor is convinced that is the best option available for her. He has to listen to her and then individualise her needs and then decide on the most suitable option.”
He further adds that the biggest hurdle in achieving a no-period lifestyle is a matter of mindsets.
“We are still at a point where more women want to menstruate regularly than those who are choosing to skip it.”
If all of this information has gotten your brain cells in a knot, here’s a potentially useful tidbit by Dr Sheriar:
"“When I want to catch my patient’s attention, my opening line is that it’s unhealthy to menstruate regularly. Then I give them this explanation and they can make the choice they want. In the context of evolution and history, what do you think is better - what happened to women over millennia or what happened to women since the 1960s - is it period or no periods?”"
(Rosheena Zehra is a published author and media professional. You can find out more about her work here.)
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