Last month we launched Period Support Group: a space where women can talk openly and fearlessly about periods — and all of the weird stuff that happens to our bodies. The response so far has been tremendous. We’ve heard thousands of women across the country share their thoughts and feelings about everything from managing their menstrual cycle to how their period affects their mental health. We’ve also heard a lot of questions, and an unanimous desire for expert advice on the topics that concern our community.
You asked, we answered. Introducing LOLA’s “Ask an Expert” blog series. Each month we’ll send questions from our community to our panel of resident reproductive health experts, and post their responses here. When it comes to your reproductive health, you shouldn’t have to go it alone. So join the conversation, by submitting your questions and subscribing to our monthly community newsletter.
Without further ado, here are this month’s period-related questions, with responses from Dr. Navya Mysore, a primary care provider who works collaboratively with her patients, providing guidance to help them achieve their health goals, and Dr. Corina Dunlap, a board certified naturopathic doctor who specializes in women’s health.
Using birth control pills to intentionally skip your period
“Are there any medical concerns with using birth control pills to purposely skip periods for more than a certain number of months in a row? Is there a limit to the number of months that is okay to skip? Is there any health benefit to letting my body have a period some months? Is the ‘period’ phase at the end of the pill pack the same as the period you get when you don’t use birth control pills?” — Cristina
From what we know there are no medical concerns to skipping your period with the combined birth control pill. That being said, we don’t have enough data on the subject — there haven’t been enough studies, performed over a long enough period of time — to say skipping your period is 100% safe.
There is no limit to the number of months that is okay to skip. When you stop purposefully skipping your period, your natural cycle will typically kick in within one month. Skipping your period with the combined birth control pill can simply be a personal preference. But it can also be helpful when dealing with unpleasant symptoms associated with your period: headaches, heavy bleeding, mood swings, etc. When you skip your period you can potentially reduce or eliminate those symptoms. On the flip side, there can be drawbacks and side effects to using birth control to skip your period. A major one is that you can experience breakthrough bleeding in between cycles.
Traditional hormonal birth control is designed to mimic your body’s natural cycle. But the bleed that occurs while using this type of contraception, known as a withdrawal bleed, is basically just the body’s response to stopping the hormones for that week. This is technically not the same as a period. Many birth control types are designed for extended use, which can be helpful for some medical conditions. Some prescribers will recommend allowing for a withdrawal bleed at 3 month or 6 month intervals to give the body a break from the hormonal therapy. But this is more a matter of preference, rather than medical necessity.
Our takeaway? There may be downsides to using birth control to skip your period, but there aren’t any known risks. Thanks for asking the question so many of us have had, Christina!
Knowing when your period blood flow is too heavy
“In terms of bleeding during a period, how heavy is too heavy? I’ve had heavy periods literally since my first period, but I’m concerned that I have clinically HEAVY period bleeding. How do I know the difference? If it turns out that I DO have periods that are too heavy, what can be done about it? I’m 28 and considering a hysterectomy to escape the painful and bloody hell I live in.” — Bex
Very heavy flow (or menorrhagia) is defined as a flow heavier than 80ml of blood per cycle. In terms of what that much blood actually looks like: if you need to change your fully soaked pad or tampon every 1 to 2 hours you likely have a clinically heavy flow. Menorrhagia can be defined not only but the amount of blood you lose day to day, but also by the length of your period. If you menstruate for more than 7 days then you likely have menorrhagia as well.
Combined birth control can be very helpful in reducing the heaviness of one’s period. If you are already on birth control and your period is heavy, you can consider skipping your “period” by continuing on to your next pack. That way you can avoid a withdrawal bleed completely. This approach can also be helpful if you have anemia as a result of your heavy period. An IUD is another great option to help heavy periods. There are a lot of choices when it comes to IUDs, so I recommend talking to your primary care physician or gynecologist to find the right fit for your needs.
Signs and symptoms of a very heavy flow include:
• bleeding through one or more pads or tampons every hour for several consecutive hours
• needing to use double protection
• waking up at night needing to change your pad or tampon
• bleeding in between periods
• bleeding after menopause
There can be both structural and hormonal reasons why heavy bleeding occurs. It’s important to get a complete work-up by a trusted gynecologist or women’s healthcare provider if you have concerns about heavy bleeding.
Bex, that sounds rough. But you’re definitely not alone. We hear a lot of similar experiences from our community at Period Support Groups and on periodsupportgroup.com. But now, thanks to your question, we all have better information to bring to our doctors.
Postpartum periods: what’s normal, what’s not
“I delivered my first baby in July. I bled for about 4-5 weeks after. Since, I have had two periods within a 30 day cycle twice now (so, 4 periods total). Is this normal?” — Ashley
I hear you! I just delivered my first baby in August. Typically, heavy postpartum bleeding lasts for about 10 days, followed by lighter bleeding and spotting that can go on for 4-6 weeks. After that, when your period returns it can totally vary. If you are breastfeeding exclusively it might not return until you start to wean off. Or it could come back when your baby does a longer stretch without feeding at night. If you are doing a mix of breastfeeding and formula, or just formula, your period could return around 6 to 8 weeks postpartum.
It’s normal for the first few periods in postpartum to be irregular. You could have two periods in a month. Or have your period, skip a month or two, then get your period again. Your first few periods may also be heavier and more painful than your previous periods pre-pregnancy, since your thicker-than-normal uterine lining needs to shed. That said, I would check in with your primary care provider or OBGYN to make sure that what you’re experiencing is a normal change for you.
Postpartum periods can be variable at first because the body is still trying to get back into a natural rhythm. Your body can experience inconsistent ovulation that then leads to inconsistent cycles after having a baby, especially if you are breastfeeding. If you have irregular periods — meaning either too frequent or too prolonged, occurring less than every 25 days or more than every 35 days — for more than three menstrual cycles, you might want to talk to your healthcare provider.
Thank you to all the community members that submitted questions! Your reproductive health journey can be scary, but we’re all in it together.
Have a question of your own? Ask an Expert on periodsupportgroup.com and our panel of doctors may answer yours.
Ask an Expert is meant to reflect individual women’s experiences and expert advice, and do not necessarily reflect LOLA’s point of view. LOLA in no way encourages illegal activity or harmful behavior.