It is one of the safest and most used contraceptive methods by women, but there are still many false myths to eradicate and doubts that a good part of women have.
The perplexities concern both the possible effects (positive or negative) on health, and its functioning and its relationship with the menstrual cycle.
To shed light in particular on this last aspect, the Italian Society of Contraception (Sic) has drawn up a simple and clear decalogue that can be of great help to many women.
The meaning of menstruation
During childbearing age, the ovary produces estrogen and progesterone, female hormones that induce ovulation and promote the formation on the inner wall of the uterus of the endometrium, an extremely vascularized mucosa that will accommodate the embryo in case of conception.
If this does not happen, estrogen and progesterone levels will tend to drop as the end of the 28-day ovarian cycle approaches, causing menstruation, or the flaking and detachment of the endometrium that will be expelled through the vagina.
This process is renewed every month, in order to offer the egg, in case it is fertilized, an always optimal “soil” on which to grow.
Blood loss is very often associated with painful symptoms, the intensity of which varies from woman to woman. These disorders are due to inflammation of the uterus and surrounding organs and tissues that is favored by molecules, such as cytokines and prostaglandins, whose synthesis is induced by hormonal changes that precede menstruation.
Hormones that “block” other hormones
The birth control pill is a drug that usually contains two hormones, an estrogen and a progestin, capable of inhibiting the synthesis by the pituitary gland of two other hormones, the gonadotropins LH (luteinizing hormone) and FSH (follicle-stimulating hormone), which normally stimulate the ovary to produce the egg cell.
Regular intake of the pill is therefore able to temporarily “put the ovary to sleep” and thus make pregnancy impossible.
Over the years, different types of this drug have been developed, which differ in the hormones contained, their dosage and the mode of intake.
10 things to know about the pill and menstruation
1) Physiological menstruation is a sign that you are not expecting a baby and occurs on average every 28 days.
The purpose of the menstrual cycle is to create a favorable environment for the implantation of the fertilized embryo.
Menstruation is a loss of blood that occurs when the uterus expels the surface layer of its mucous membrane and when the level of two hormones, estrogen and progestin, is lowered. Obviously, this process only takes place if the egg has not been fertilized by the sperm.
2) Menstruation that occurs when taking hormonal contraceptives is not entirely similar to physiological menstruation.
The bleeding that occurs while taking a hormonal contraceptive is a false menstruation. The contraceptive pill in fact puts the ovaries at rest and, thanks to the estrogen hormones and progestogens contained in the pill, the uterine mucosa continues to grow and, upon monthly suspension of the oral contraceptive, flakes off.
3) Menstruation is avoidable if you take the pill.
When John Rock started working on what we now familiarly call “the pill” in the 50s, he was convinced that he was in the process of creating a “natural” system.
Since at the time it was believed that both the doctor and the woman psychologically associated the concept of reproductive well-being with bleeding, Rock also “invented” a fake menstruation, caused by the suspension of the hormones contained in the pill.
4) The “false cycle” caused by the pill has no impact on the reproductive health of the woman.
And that’s not all. Cycle-related disorders are, if not absent, much milder and the intensity of the losses can be modulated thanks to the variation in the type of contraceptive and the administration regimen.
5) It is not true that the more menstruation you have, the healthier you are.
From ancient times to today the number of pregnancies for each woman has reduced enormously (160 menstruations over the average life of yesterday against about 400 menstruations today).
This is because compared to our grandmothers we have fewer children. Since women’s bodies have not yet adapted to the change, having fewer cycles means having fewer problems related to the cycle, such as, just to name a few, migraines and endometriosis.
6) Not all women want to menstruate every month.
60%-70% of women would either not have a period at all or have it at more distant intervals.
This is also because menstruation, even in women who do not suffer from particular diseases related to bleeding, has an important impact on sexual activity, sports, work or recreational activity, vacation and even clothing.
Studies that have compared the administration of the pill for 21, 22, 23 days or more modern 24 days have shown neither a presence of hormones different from woman to woman, nor side effects or metabolic alterations.
7) The longer the pill is taken continuously, the more pain and other symptoms related to menstruation are under control.
The cycle causes important changes in the endometrium. The consequences can be in some cases abdominal cramps, very abundant menstrual flows that can cause anemia, fatigue, irritability, difficulty concentrating; increase in diseases such as endometriosis and ovarian cancers; headache, epilepsy, exacerbation of autoimmune diseases.
8) Not all Italian women want to menstruate even when they take the pill.
To want the monthly cycle is 25%-40% of Italian women (the figure varies with age). 30% would never want it, the rest would like less frequent menstruation.
9) Hormonal contraception treats dysmenorrhea.
Over 80% of women suffer from uterine cramps when they have their period. In 25% of these cases, intense pain (dysmenorrhea) also occurs. Women with this syndrome take painkillers and are sometimes forced to suspend or limit work, study and social activities.
The use of the pill without interruption decreases the number of menstruation and is very indicated.
10) Continuous hormonal contraception may be helpful for women with heavy menstrual flows (menorrhagia).
Menorrhagia creates discomfort for the woman because it not only limits her in clothing and freedom to have an active lifestyle, but also forces her to spend more money on sanitary pads.
Menorrhagia can also cause anemia resulting in fatigue, irritability and difficulty concentrating.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.