Blog of the Society for Menstrual Cycle Research

The pill, reduced period pain and the ongoing delusion

January 20th, 2012 by Laura Wershler

Is there a woman over the age of 18 anywhere who doesn’t know that taking the birth control pill can make her periods lighter and less painful? Most women know this, but not many know why. The news stories swirling around a new study about the pill and period pain will not enlighten them.

Photo credit: Ceridwen, Creative Commons 2.0

A 30-year longitudinal Swedish study has finally proved the worth of what is accepted practice in North America and Europe: the prescribing of combined oral contraceptives (COCs), or birth control pills with synthetic estrogen and progestin, to treat painful periods known clinically as dysmenorrhea.

Of course, pharmaceutical companies that manufacture COCs are probably eager for this research, as prescribing the pill for dysmenorrhea is still an off-label use in the U.S. (unlicensed use in the U.K.). Pill manufacturers may be able to use this finding to lobby the FDA (or equivalent agencies in other nations) to approve the pill as treatment for menstrual pain, leading to increased sales and insurance coverage. Perhaps that’s why news media have been treating this discovery as breaking news.

Take this headline: Yes, the Pill CAN ease the agony of period pain: Scientists confirm what millions of women already know, or this one: The pill ‘does ease period pain’, or this one: Combination oral contraception pills cut menstruation pain, or, really, any of these.

You can read the abstract of the study by Swedish researchers Ingela Lindh, Agneta Andersson Ellström and Ian Milsom, published this week in the journal Human Reproduction, here: The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. The conclusions are simple: “COC use and increasing age, independent of each other, reduced the severity of dysmenorrhoea. COC use reduced the severity of dysmenorrhea more than increasing age and childbirth.”

Forget the age factor for the purposes of this discussion. The fact that COC use reduces the severity of dysmenorrhea is not astounding. This is old news. So says Dr. Steven Goldstein, an obstetrician/gynecologist at NYU Langone Medical Center in New York City, quoted in a USA Today story:

“The study results are not surprising. It’s gratifying to see researchers documenting scientifically what practitioners have been seeing for a very long time. The amount of discomfort from a woman’s period with a combination birth control pill is a fraction of what it is without the Pill. There is a diminution of pain from the Pill.”

What is astounding is what Dr. Goldstein, and other OBGYNs, didn’t say in responding to the study. That the reason the pill reduces menstrual pain is because the synthetic hormones in the pill shut down a woman’s own menstrual cycle. The “period” women experience when on the pill is technically known as a “withdrawal bleed,” brought on by seven days of placebo pills. While it feels like a period to menstruators, it is not the same physiologically as the period they experience when NOT on the pill. That’s why it doesn’t hurt as much.

The point is, the pill is too often credited with regulating the menstrual cycle. It does no such thing. The pill does not regulate any woman’s menstrual cycle; it supercedes it. This research, and the many news stories that reported it, once again ascribe power to the pill – this time the power to cut menstrual pain. This is an incomplete truth.

7 responses to “The pill, reduced period pain and the ongoing delusion”

  1. Great article Laura…. I posted it to my Facebook page and within minutes had this comment:

    I’m so glad you posted this now — one of my daughters asked me what I thought about her taking the pill to regulate her periods. I thought it was a terrible idea, but wanted to do a little research to explain why. This info is exactly what I needed. Thank you.

  2. Laura Wershler says:

    Thanks for letting me know, Leslie. Be sure to pass on to this mother the link to the Centre for Menstrual Cycle Research where she can find lots of information on how to help her daughter regulate her cycle without having to take the pill.

  3. Lauren says:

    Great article. I wish more women knew how the pill really worked – why can’t we simply be told when it is prescribed to us? I remember when I found this out after you (Laura) directed me to the CEMCOR site when I was briefly volunteering for SHAA and I went off the pill immediately after.

    Going off the pill changed my life completely. I feel so much healthier. It still frustrates me to no end that doctors feel it’s ok to not inform their patients about exactly how the pill works.

  4. In my personal experience and in my work with women as a physician, cramps are effectively treated with ibuprofen. Ibuprofen just must be taken before cramps are fullblown and again as soon as the cramps start to come back.
    Given that such a cheap and easy over-the-counter medicine works for cramps, why would any woman want to take the Pill? The Pill suppresses her whole reproductive system, decreases her normal sexual response and may prevent the gain in bone that is important in late adolescence as well as causing a three-times increased risk for blood clots or pulmonary emboli. That is like using a sledge hammer to kill a flea.

  5. This is propaganda for the Pill. Considering its extreme one-sided slant I don’t see how it can be labeled as anything else. It’s certainly not ‘news’ and is founded on dangerous and manipulative half-truths. It’s almost as a ridiculous as that crazy piece of research about how women who take the Pill are less likely to die of any cause. Less likely to die. Bizarre. Considering what’s been happening with Yaz – the FDA appraisal, the independent watchdog revealing industry ties – this seems like lucky timing. A nice distraction from the fact that Yaz has a 50 to 75% higher chance of causing you to have a blood clot than other pills and this information was not just unknown, but covered up and it is still on the market. Just two media outlets reported fully on that. Just two. Every single newspaper, blog and magazine went after this piece of new research on the Pill’s impact on period pain.

    I find it interesting that for propaganda it is always ‘The Pill’ – no brands mentioned – just this overall title like it isn’t a real drug, or a product being sold to consumers but some other entity entirely and outside of the rules that govern these areas. Just an aside thought.

    Not sure how many people saw that it was revealed also that Bayer paid Allure magazine to feature and advocate Yaz. Now, I don’t think I’m a conspiracy theorist to suggest they likely paid other magazines too. I distinctly remember reading about Yaz in UK magazines, wherein drugs are not advertised directly.

    As a journalist myself I know the ‘media’ is just a bunch of people experiencing the same world as everyone else and as such a bunch of people with the same lack of knowledge about the Pill as everyone else – but these scientific research stories – well, they have to get their information from somewhere, and most journalists won’t be confident enough to want to make their own statements from their own understandings. Which means this information is coming via some kind of press release. They’re all so similar it even reads that way. People who do KNOW that the Pill does not prevent period pain but prevents periods is choosing not to pass this along in order to get a bigger impact for the story and therefore more funding…from who? Pharmaceutical companies who profit from these stories.

    I don’t think understanding how capitalism works makes me a conspiracy theorist. I get called that a lot I’ve noticed. The thing is I know that people don’t want to accept how capitalism works – it’s too horrible and too hopeless – why would you? That’s why we say that the recession is caused by a few greedy men instead of a system based on rewarding greed. That’s why even the Occupy Movement says that. The pharmaceutical industry is the most profitable industry for the US. The MOST profitable. There is a massive vested interest in creating and keeping big markets of people on drugs for long periods of time with as little effort in advertising etc needed as possible. A news story like this one goes a long, long way.

    Anyway, I’m going to end up writing the blog post I’m readying for this week, so I’ll end there.

  6. Amy Sedgwick says:

    Thanks for this article, Laura. As someone who was put on the pill at an early age to “regulate” my periods and help me “manage” menstrual pain, I very much relate to this article. What my doctors didn’t tell me was the long term health and fertility implications of being on the pill and how my menstrual pains were (and are) my body’s way of speaking to me – asking me to increase my intake of certain nutrients, asking me to take more time to rest, asking me to exercise, meditate, reduce sugar consumption, etc. There is nothing positive to be gained by shutting down the body’s ability to speak it’s wisdom to us.

  7. Sofia says:

    Still considered a period in my book. What the hell is “breakthrough bleeding” supposed to be? If it empties the lining in my uterus, it is still a period.

Readers should note that statements published in Menstruation Matters are those of individual authors and do not necessarily reflect the positions of the Society as a whole.