NEWS | homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do
Read women's comments about stopping menstruation.
In March and April, 2000, several articles and comments appeared (including in the New Yorker magazine - read that whole article for free - The Lancet medical journal, and the Guardian (U.K.) newspaper, and in many places since then) about the benefits of stopping menstruation. The inspiration is mainly the book Is Menstruation Obsolete? (read some excerpts), by Brazilian Dr. Elsimar Coutinho, with Dr. Sheldon Segal (Oxford University Press, 1999), which argues that the benefits far outweigh any problems. The work of Beverly Strassmann, of the University of Michigan [U.S.A.], who has studied the menstrual customs of the Dogon people of Africa for years - they use menstrual huts - also supports the argument for fewer periods.
Read two opposing opinions: by the Brazilian physician who is the author of Is Menstruation Obsolete? (Oxford University Press, 1999) and by an American physician at Texas A&M University
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation


Uninterrupted use of hormonal contraceptives for menstrual suppression:
why I do not recommend it

Dr. Nelson Soucasaux, Brazilian gynecologist
(personal details and more of his articles at the bottom of this page)

Though the subject is controversial, new and arouses great discussion, personally I am not in favor of the continuous use of hormonal contraceptives for preventing the coming of menstruation. To my way of thinking, this method is valid only in exceptional cases, in the presence of important medical indications - but always as an exception. (The only gynecologic problem that always demands menstrual suppression as an essential condition for the success of the treatment is endometriosis.) I do not mean that the continuous administration of hormonal contraceptives, without the usual seven-day interval between one series and the other, is especially problematic - it is too early for affirming that. I simply cannot see reasons that, in most of the cases, can justify the adoption of such atypical way of taking these medicines.

Nevertheless, some debatable reasons for menstrual suppression have been announced by those who defend the administration of hormonal contraceptives without the usual seven day interval between each series of 21 days of treatment.

The medical conditions more frequently presented for justifying the hormonal suppression of menstruation are premenstrual syndrome and dysmenorrhea. However, we must remark that almost all premenstrual symptoms usually are successfully treated by means of several available therapeutic methods, without any need for abolishing the coming of the menses. In many cases, the dysmenorrhea is considerably reduced or even disappear with the use of the oral contraceptives in their habitual mode of administration. Another highly effective treatment for dysmenorrhea consists of the use, during the menstrual period, of the modern anti-inflammatory drugs that inhibit the synthesis of prostaglandins.

Regardless of all of this, there is a very old non-medical reason that is also being used for reinforcing this new "fashion" of abolishing menstruation through the continuous use of oral contraceptives or the subcutaneous implant of devices that release progestogens continuously: I am talking about the psychological rejection that many women manifest in relation to this cyclical uterine bleeding that is menstruation - even when asymptomatic and entirely normal from the medical point of view. Behind this attitude lies a defective adaptation of these women to one of the most characteristic features of the female physiology, a feature that is the main external manifestation of the typical cyclical pattern of woman's nature. In my point of view, the ideal approach to this feeling of rejection to menstruation is psychotherapy. I perfectly understand that, from the physical point of view, the menstrual bleeding in itself is not pleasant. Even so, I believe this should not constitute a reason for intending to suppress the menses.

Now, some explanations about the functioning of the oral contraceptives become necessary. The oral contraceptives - the best and the safest of all contraceptive methods - work by creating a reversible inhibition of the ovarian function, due to an interference on the physiology of the hypothalamus-hypophysis-ovaries axis. The resulting inhibition of this functional axis is due to the effect of the hormonal association contained in the oral contraceptives. The menses that come after each series of 21 days of taking the hormonal contraceptives are not natural menstruations, since the ovarian cycle is inhibited during their use. They are artificial and due to the habitual interruption in the ingestion of these products at the end of each series of 21 days. This interruption causes a sudden fall in the blood levels of the synthetic estrogens and progestogens contained in the oral contraceptives, imitating what happens with the natural ovarian hormones at the end of each physiologic cycle.

As the hormonal contraceptives inhibit the ovarian function, it is advisable that, at least once a year, their users stay one or two cycles without taking the "Pill," in order to avoid a prolonged inhibition of the already mentioned hypothalamus-hypophysis-ovaries axis. The usual seven day interval between each series of 21 days taking the oral contraceptives is intended to make women menstruate, simulating the menstrual cyclical pattern of the natural cycles. At the same time, these intervals may also function for allowing a seven day interruption in the inhibition of the hypothalamus-hypophysis-ovaries axis. Though this pause of seven days in the active inhibition of the system that controls the ovarian function is too short, even so I believe we should not deny its importance. We must remember that the hormonal contraceptives were always administered in this way, and that a seven day interval between each series of 21 days of taking these products is better than the absence of any interval.

The uninterrupted, continuous use of the hormonal contraceptives intending to suppress the menses eliminates this short but possibly important period of rest between each 21 days using these products. This results in keeping a continuous inhibition of the intricate system that controls the ovarian function. Moreover, the continuous administration of the hormonal contraceptives impedes the monthly cyclical fall of the hormonal levels which the female organism is used to. One of my main objections to the continuous use of hormonal contraceptives, without the usual pause of seven days between the series, is based mostly on this fact. My other objection is that the endometrium (the tissue that covers the interior of the cavity of the uterine corpus) was designed by nature to being constantly renewed, by means of its periodic menstrual desquamation and reconstruction along the next cycle. This is a fundamental feature of the endometrial physiology.

The artificial menstruations ("fake" menstruations) that purposefully occur during the seven days interval between each series of 21 days taking the hormonal oral contraceptives are the most practical way women usually have to know that the contraceptive is working - that is, that they did not get pregnant during the use of the "Pill" (though, of course, there are rare exceptions). Taking this into consideration, if these "fake" menstruations are abolished by the uninterrupted use of the contraceptives, a crucial question arises: what will provide women the usual and most practical control they have regarding the efficacy of the method? If there are no menstruations, which early "information" will women have indicating that the contraceptive may have failed?

Finally, I also would like to emphasize that the present attempts of stimulating women to artificially suppressing menstruation for reasons of minor importance do not seem to reveal a healthy attitude with regard to this typical aspect of woman's nature. From the point of view of psychosomatic gynecology, I believe that this new and debatable idea that menstruation is "useless" and "superfluous" will certainly contribute to reinforcing the old-fashioned female negative attitudes in relation to menstruation, and now hidden under the name of science. I think this is not good for women's psycho-physical health.

© Nelson Soucasaux 2001


Nelson Soucasaux is a gynecologist dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Brazil, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Ed., 1990, 1993.

Website (Portuguese-English): www.nelsonginecologia.med.br

E-mail: nelsons@nelsonginecologia.med.br


Read two opposing opinions: by the Brazilian physician who is the author of Is Menstruation Obsolete? (Oxford University Press, 1999) and by an American physician at Texas A&M University


Read women's comments about stopping menstruation.
In March and April, 2000, several articles and comments appeared (including in the New Yorker magazine - read that whole article for free - The Lancet medical journal, and the Guardian (U.K.) newspaper, and in many places since then) about the benefits of stopping menstruation. The inspiration is mainly the book Is Menstruation Obsolete? (read some excerpts), by Brazilian Dr. Elsimar Coutinho, with Dr. Sheldon Segal (Oxford University Press, 1999), which argues that the benefits far outweigh any problems. The work of Beverly Strassmann, of the University of Michigan [U.S.A.], who has studied the menstrual customs of the Dogon people of Africa for years - they use menstrual huts - also supports the argument for fewer periods.

NEWS | homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation

©2001 Harry Finley. It is illegal to reproduce or distribute work on this Web site in any manner or medium without written permission of the author. Please report suspected violations to hfinley@mum.org