AHRP: Women Find Menstrual Suppression Attractive Idea but Question Safety

MINNEAPOLIS, Oct. 5 -- Patients seem more skeptical than their doctors do on the safety of menstrual suppression with continuous-use oral contraceptives, but the women like the idea, survey results suggested

Asked whether they were interested in suppressing their menstrual periods, about two-thirds of women said they were "extremely" or "somewhat" interested, but also said they were not sure that the practice was safe, reported Kurt Barnhart M.D., M.S.C.E., of the University of Pennsylvania.

Yet 97% of physicians surveyed said that the use of continuous oral contraceptives for menstrual suppression is "medically safe and acceptable," said Dr. Barnhart, at a meeting of the Association of Reproductive Health Professionals' here.

"The gap between physician and patient understanding concerning the necessity of monthly periods is obvious," said Dr. Barnhart. "It is our hope that based on these findings physicians will begin to more readily initiate a dialog with their female patients about continuous therapy, helping to eliminate the misconception that periods are a medical necessity and to emphasize the safety and viability of menstrual suppression."

Dr. Barnhart presented results of two nationwide surveys of practitioner and patient attitudes about menstrual suppression.

Dr. Barnhart and colleagues conducted an online survey of women from the ages of 18 to 49 (of those older than 35 only non-smokers were included). The women had to have intact uteruses and regular menstrual periods.

They also surveyed healthcare professionals, including obstetrician/gynecologists, primary care physicians, and nurse practitioners.

The practitioners had to have full-time office-based practices of at least 30 hours per week for at least two years, with a minimum of 75 female patients per week. The physicians also had to have prescribed or plan to prescribe oral contraceptives to patients 60 and under.

The online patient questionnaire included 59 questions related to demographics, oral contraceptive use and awareness, and attitudes and beliefs regarding menstruation.

Practitioners were asked 141 questions about demographics, practice information, patterns of prescribing of oral contraceptives, experiences with oral contraceptives and attitudes and beliefs about menstruation.

The participants included 500 women in the patient study, and 299 (44.8% female) professionals in the practitioner survey.

The authors found that 32% of women were extremely interested and 31% were somewhat interested in not having their periods. But the practitioners reported that only 16.8% of patients actually asked about the possibility.

Only 12% of patients, however, said that they had talked to their doctors in the past year about eliminating or reducing the number of periods they had annually, and 71% of these women said they brought the topic up first.

Asked whether having a period was medically necessary, 20.2% of women said no, whereas 45.4% agreed with the statement "my period is necessary because it cleanses my body."

Among those practitioners whose patients were on continuous oral contraceptives, 97% agreed that "skipping your menstrual cycle is medically acceptable," but reported that only 38% of their patients feel that it is medically acceptable.

In contrast, four out of five physicians reported discussing continuous use oral contraceptive use with their patients, and 77% reported that they raised the topic.

"We've found that physicians and their patients discuss this topic differently, with doctors using the medical term menstrual suppression, while their patients simply talk about not having a period," he said. "Breaking down this language barrier by speaking in simpler, more patient-friendly terms could have a significant positive impact on understanding."

Dr. Barnhart did not discuss whether questions about patient or physician perceptions of the safety of oral contraceptives were included in the survey.