You don’t need a monthly period. Tips to safely skip your menstrual cycle
September 5, 2024
It never fails – you’re planning a big event, and the week before, you start feeling the signs that your menstrual cycle is coming. Or you’re looking ahead on the calendar and realize that your period is expected to start the day before you leave for vacation.
That inconvenience was familiar to pro runner Elle Purrier St. Pierre, who got her first post-childbirth period the week of the Olympic trials (where she qualified to compete in the 1,500-meter race at the Paris games).
Whatever you have planned, your period probably wasn’t on the itinerary. Wouldn’t it be great if you could just skip all that hassle and make life a little easier for travel, work commitments, and other activities?
I’m here to tell you that you can! Take it from me as a board-certified gynecologist: It’s safe to medically suppress your period with help from your health care provider.
Many women think they need a monthly period to be healthy. Despite what birth control product packaging and marketing campaigns have led us to believe, your reproductive system doesn’t have to menstruate to “cleanse” or “reset” every month.
Several hormonal birth control options allow you to safely skip your monthly period. Let’s talk through what happens during your menstrual cycle, how to suppress it safely, and when a skipped period could be a sign of something serious.
What happens during your period
Menstruation happens because we ovulate. The lining of the uterus thickens and softens to give a fertilized egg a place to land. If fertilization doesn’t happen, we shed that unneeded blood and tissue through the menstrual cycle (your period).
The menstrual cycle is managed by hormones, such as estrogen and progesterone. Hormonal birth control options like the pill interrupt that process, shutting off the signals that tell your ovaries to ovulate. No ovulation means no menstruation, which is a state called amenorrhea.
So, why do many women on birth control still deal with monthly periods? Because contraceptives are packaged to mimic the menstrual cycle.
Birth control pills come with a week of inactive (placebo) pills. Extended-release methods like vaginal rings and skin patches have instructions to remove the product after three weeks and then wait a week to insert or apply the next dose. The bleeding after stopping the hormones is called a “withdrawal bleed,” and your body doesn’t require this. The bleeding happens because you have stopped the medications.
These contraceptives were designed to mimic the typical 28-day cycle, a decision that was influenced by cultural and societal expectations rather than medical necessity. The historical stigma surrounding menstruation means many women deal with the monthly disruption of a period they don’t really need. But that doesn’t have to happen.
“There is no health benefit or medical need to bleed. Whether it's to avoid having monthly painful, heavy periods, or because you're planning a beach vacation, people should be informed about their choices to manage their periods.”
How to safely stop (or reduce) your period
The No. 1 rule is to talk with your women’s health care provider first. They’ll discuss details and steps with you so you can make an informed decision. In general, you can safely delay, diminish, or stop your period if you’re on a prescription for hormonal birth control such as:
- Most forms of the birth control pill
- Injections (e.g., Depo-Provera)
- Vaginal rings (e.g., NuvaRing)
- Skin patches (e.g., Xulane, Twirla)
- Implants (e.g., Nexaplanon)
- Intrauterine device (Mirena) – with a hormonal IUD, you can go for years without a period
If medically induced amenorrhea is safe for you, the next step is to decide whether you want to delay your period or suppress it long-term:
- To delay your period, you’ll skip the week of placebo pills or insert/apply a new device as soon as you remove the old one. There’s no need to adjust your prescription – but keep in mind that your supply will run out faster.
- To stop your period indefinitely, your provider can adjust your prescription to "skip placebo pills and restart with new pack.” This tells your pharmacist to dispense the packs so there are enough to last a full 3 months. While many insurance companies cover a change like this without interruption, some do not, and you can talk with your provider about other options, such as pills designed for use 3 months at a time.
- You should be aware that becoming completely amenorrheic, or having no periods or spotting at all, is less common early on in this process. You should expect some unscheduled or light breakthrough bleeding, but studies have shown that the longer you use the method, the more likely you’ll achieve amenorrhea.
- Also, some people prefer to know when they’re going to bleed and to schedule it. You can do this with 3-4 months of continuous use of the contraceptive, followed by a scheduled withdrawal bleed when it works for your life and schedule.
- If you want to restart your natural period, you should expect it to take up to 2 to 3 months for your body to resume a regular cycle. But do realize, once you stop the pills/patch/ring, you will not have reliable contraception on board, even if your periods haven’t come back to normal.
Whatever you decide, it’s important to give your body time to adjust. If you’re near the end of your cycle, your first time skipping the placebo might lessen your flow rather than suppress it, and you can have breakthrough bleeding/spotting when starting this process.
When a missed period could signal something more
If you have irregular periods that come less frequently or amenorrhea but you are not intentionally suppressing menstruation with some type of hormonal birth control, it could be a sign of a medical condition such as:
- Pregnancy
- Hormonal abnormalities with the thyroid, prolactin (a hormone associated with lactation), or changes due to significant weight changes
- Obesity, due to increased estrogen levels
- Polycystic ovarian syndrome (PCOS), a condition that disrupts ovulation and hormone levels
- Endometrial hyperplasia or cancer
- Scarring of the lining of the uterus from infection or prior surgery
- Congenital abnormalities if you have never had a normal period
Talk with a health care provider if you have abnormal symptoms, such as postmenopausal bleeding, suddenly heavier or irregular periods, or bleeding after sex or between periods (breakthrough bleeding).
There are several other situations when natural body changes disrupt ovulation, but these typically aren’t red flags:
- Breastfeeding can fully suppress your period or make it irregular, though it is possible to become pregnant while breastfeeding. Nearly all hormonal birth control methods have been proven safe to take while breastfeeding.
- Very low body fat can alter your body’s ability to ovulate. You’ll hear elite athletes talk about their periods slowing or stopping as their bodies adapt to high-intensity training. Competitive athletes should work with their doctors to keep an eye on body changes. Low body fat can also stem from an eating disorder, which requires specialized treatment.
- Menopause doesn’t happen overnight (unfortunately). It can take years for your ovaries to retire. If you’re sexually active, it’s safe to continue with your birth control. If the menopausal changes are wreaking havoc, your doctor can prescribe a personalized treatment plan to manage symptoms.
Most women hate getting their periods. It’s natural, but it isn’t necessary. If you don’t want to deal with your monthly menstrual cycle, talk with your health care provider about safe ways to show your period the door.
To talk with a gynecologist about managing your period, call 214-645-8300 or request an appointment online.
