# Anya/Lybrel birth control: no more periods... ?



## SamanthaNY (May 22, 2007)

All year, every year, and supposedly this is safe. 

Wth? I don't get it. The female body's method of cleansing itself via a menstrual period every month is pretty much essential, or so I thought. This is the chief reason why fat women are put ON the pill to begin with - to force and regulate their periods. To go without a period for extended lengths of time can cause buildup in the uterine lining, and increase the risk of some cancers. 

At first there was Seasonale, the pill where you only get your period 4 times a year... okay, so perhaps it doesn't need a housecleaning _every _month, that could make sense. But how can it be healthy to go all year without having a period? According to a website, Lybrel/Anya also thins the uterine lining, so perhaps that's where they think this will be okay... but I dunno, I have to wonder what the rates of blood clots will be with this new pill.

Call me old fashioned, but I'm still having Aunt Flo visit regularly.


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## persimmon (May 22, 2007)

The 'period' women get when they're on regular 28-day packs with a placebo week is not a true period; it's a withdrawal bleed. It mimics the regular menstrual cycle but it is due to the abruptly lower levels of both estrogen and progestin. The only reason one would need a 'housecleaning' is if there is regular endometrial buildup--as there is during a menstrual cycle. While on the pill the estrogen promotes endometrial proliferation, so with today's lower-dose estrogen pill there is very little build-up; the endometrium becomes atrophic and there is really no need for a withdrawal bleed except sheer preference.

This is a boon for women who have estrogen withdrawal symptoms such as migraines, or who have conditions such as endometriosis, and getting FDA approval makes it more difficult for insurance companies to deny payment on continuous-dose oral contraceptives--or indeed any oral contraceptives (If you think they don't, hahahahaha.) It also opens the door to generics that cost less than US$35 a pack, because if women are taking the same dose every day it can come in a regular stock bottle like every other tablet instead of a stupid little dial pack with flowers on it. Hopefully it will also decrease confusion and increase use of the therapy as prescribed. (If you think people don't get confused about how to take it, hahahahhaha.)

I would not expect the coagulation cascade to change significantly during the placebo/withdrawal bleed week. Platelet aggregation maybe, but most thrombotic events in younger people are venous, and most platelet-heavy thrombotic events are arterial. Circulating proteins, such as the coagulation factors, have a pretty long half-life. So do most steroid hormones. Given that, I wouldn't expect a low-dose pill to cause significantly more clots when used continuously than when used cyclically. Overall estrogen exposure from a continuously-used 20-microgram pill is still lower than cyclic use of a 35-microgram pill. People also forget that young women have a basal rate of thromboses and that while estrogen-containing birth control can increase the risk, it is not responsible for all such events that occur during use.

Also I should point out that the "minipill", the progestin-releasing IUDs, Depo-Provera and Implanon (the successor to Norplant) don't have withdrawal bleeds either. Do what you want with your own cycle, but menstrual suppression is nothing new in either the evolutionary or the pharmacological sense. The withdrawal bleed week was built in from the beginning to make the pill more palatable to (among others) the Catholic Church.

persimmon

long-winded pharmacy student


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## SamanthaNY (May 22, 2007)

Wow, impressive knowledge there, persimmon! 

Glad you're here


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## Esme (May 22, 2007)

I was on Seasonale when I got my blood clot.... so I'm going to just stay away from this one. EEEEEEEEEEEEEEK!!!


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## persimmon (May 22, 2007)

For women who are prone to clotting, staying away from this (as well as from other estrogen-containing hormonal contraceptives like the patch and the ring) is reasonable and advisable. For everyone else, this is a lower-dose pill than Seasonale/Seasonique and the format of the the regimen--which is what everyone is wigging out over--is not itself likely to cause more clotting than Seasonale/Seasonique.

On the other hand, low-dose oral contraceptives have lower efficacy in heavy women than they do in smaller women, so that's one good solid strike against it for most of us Dimmers.

persimmon

still a mouthy pharmacy student


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## GWARrior (May 22, 2007)

To me, not having a period just freaks me out. As gross and annoying as that visit it, id be creeped out by not having it.


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## Sandie_Zitkus (May 23, 2007)

I have done some reading about menstruation through the ages and from what I have read, a woman having a period is a fairly recent thing. It is not necessary to have monthly periods.


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## wistful (May 23, 2007)

Sandie_Zitkus said:


> I have done some reading about menstruation through the ages and from what I have read, a woman having a period is a fairly recent thing. It is not necessary to have monthly periods.




What?? Now you have caught my attention.Can you please share more about this?


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## Sandie_Zitkus (May 23, 2007)

wistful said:


> What?? Now you have caught my attention.Can you please share more about this?



Well, ask a gynecologist - if they are honest they will tell you it is only necessary to have your period once every 4 - 6 months. That's what a few have told me as I have never been regular.

On the internet there is info about the number of periods women - say in the middle ages or old west - would have. They started later (early 20's) and ended earlier. Because of poor diet and harsh living conditions and hard lives they would usually have their periods a couple times a year.Not to mention having children and breast feeding would stop menstruation for a year or more.

This site: www.mum.org is great.


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## BeaBea (May 23, 2007)

wistful said:


> What?? Now you have caught my attention.Can you please share more about this?



Further to what Sandie said - my understanding is that evolution has actually designed animals to be either pregnant or nursing throughout their fertile years. 

Human societal pressures tell us that its not ideal for teenagers to have babies and that not everyone wants or can cope with twelve children - but evolution says our best chance of passing on our DNA is really to have as many babies as possible. 

It must also be quite a burden on a womans health to create that warm, safe womb lining every month just to eject it unused. I guess in evolutionary sense every menstrual bleed is a wasted opportunity (whereas for me it just means a sigh of relief )

Tracey xx


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## Waxwing (May 23, 2007)

From what I understand, since, as Bea said, we're designed to be pregnant more often than we are, the monthly cycle of bleeding and building up again is actually very hard on the body. 

I'll chime in with my usual Mirena championing and say that I haven't had a real period in 3 years. It doesn't stop the cycle, but it diminishes the bleeding. Best of both worlds.


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## persimmon (May 23, 2007)

Mirena! Mirena! I <3 my Mirena, too. I just wish our FDA would approve the frameless IUDs that are available in Europe and the UK--then it would be super-fantastic awesome, instead of just awesome.

And unlike super-low-dose pills, progestin-releasing IUDs have almost entirely local effect, meaning they are equally effective for the heavy womens, as well as having all the same advantages they do for the skinny chicks (unforgettability, lighter periods, blah blah blah).

persimmon


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## love dubh (May 23, 2007)

Once I get the funds, I will join the Mirena gang!

Like Persimmon said, since the hormone is right at the source (so to speak), they are equally effective for all women. No silly blood to travel through.


<3 <3


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