It seems intuitive that women would be attached to their monthly menstrual cycle. They are taught from their early days in sex education that menstruation is a natural part of womanhood; something to be accepted and embraced as the monthly reminder of fertility. However, results from a recent study on attitudes toward menstruation and menstrual suppression suggest that the proverbial “Aunt Flo” is neither a beloved member of the family nor a welcome visitor. Most women have to deal with cramps, moodiness, and bloating, and hence maintain little affection toward their period. If given an option, a majority would prefer less frequent menstrual cycles. Many women express interest in suppressing their monthly periods and are curious to learn more about it.
Education is paramount, because many women have misunderstandings about their period, such as what is “natural.” Many women do not realize that because women menstruate earlier, give birth later, have fewer pregnancies, spend less time breastfeeding, and enter menopause later, they can expect far more periods in their lifetime than women in prehistoric times; a woman in an industrialized country can expect 450 periods in her life versus prehistoric woman’s 160 periods. Furthermore, many women are misinformed or unsure about the effects of hormonal contraceptives on the body, which leads to concerns about menstrual suppression. Above all, women want assurance that suppression is safe and that it will not affect their fertility. They want to ensure they will be able to fully control when and if they do have a period. Finally, they want it to be affordable.
- Women view their periods as a nuisance. Women are not ashamed of their period – they do not feel any need to hide the fact that they get their period or have to purchase pads and tampons – they just see it as an inconvenience. Strong majorities view their period as something they just have to put up with (77 percent agree).
- Women view their periods as an annoying visitor, but one that actually puts them at a disadvantage in today’s society. A strong majority of women feel that men have a real advantage because they do not have a period (74 percent agree).
- Women are irked by the inconvenience their periods have on their lives. Nearly all women report having experienced cramps (81 percent), moodiness (84 percent), and bloating (84 percent). And an overwhelming majority mention times when their period has gotten in the way of their daily lives; (74 percent) of women say that their menstrual symptoms have caused them to miss sex, and nearly half of women say that their symptoms have gotten in the way of taking part in an athletic event (46 percent), a party (44 percent), or time with friends and family (40 percent.)
- Roughly half (49 percent) of women would be interested in learning more about stopping or delaying their period.
- When asked what their ideal menstrual interval would be, most would choose to have a period less frequently than once a month (78 percent). Nearly half, 40 percent would prefer never to have it at all.
- Interest in menstrual suppression, which offers an alternative to the monthly period, is high. Over half (55 percent) of women say they would be interested in stopping or delaying their period.
- Nearly three-quarters (73 percent) of women have used birth control pills at some point in their life. However, usage does not seem to increase knowledge of the effect of hormonal contraceptives on a woman’s reproductive system. Only 16 percent of women who had used birth control pills agreed that taking the pill continuously stops women from having their period. In contrast, 76 percent of women who had used birth control pills agreed that it is natural for women to get her period, even if she is on the pill.
- Women do not believe that menstrual suppression does not affect fertility. Only one-quarter of women correctly believed that suppression would not affect fertility.
- Most women are familiar with the regular birth control pill, and thus were extremely likely to agree (67 percent) that it is natural for women to have their period when they are on the pill. Indeed, most women (56 percent) did not believe that taking the pill continuously would affect their menstrual cycle.
The biggest concerns about suppression relate to safety, although many women also express concerns with affordability. Women are overwhelmingly concerned that there might be side effects (88 percent worried) or long term health effects (89 percent). More than half of women worry about the costs (57 percent).
The following memo is based on two rounds of research. We conducted a web survey of 1,021 women 18-40 who had not had hysterectomies and were not trying to get pregnant. Respondents were selected randomly from a panel of Knowledge Networks research participants. The Knowledge Networks panel is based on random-digit-dial sampling of the full United States population and represents people with and without their own Internet access. The survey was conducted July 8-13, 2005 and has a margin of error of +/- 3.1 percentage points. We also conducted in-depth interviews of 25 OB/GYNs, primary care physicians, nurse practitioners, and physician assistants who have patient contact and prescribe contraceptives.
Thomas, Sarah L. and Charlotte Ellbertson, “Nuisance or Natural and Healthy: Should Monthly Menstruation Be Optional for Women?,” The Lancet, 355, March 11, 2000, 922-24.
About Audrey Kelly, PharmD