Menstrual Suppression in Teens
Menstrual suppression refers to using medication to stop someone from having a period or make it lighter or more regular. The questions I often hear next are why someone would want to do this and if it’s safe.
There are many reasons why you might be interested in menstrual suppression. Some families who ask about reducing periods are those who have children with physical or developmental disabilities. They sometimes opt for menstrual suppression for reasons related to hygiene, sensitivity or sensory issues. Other reasons for controlling a menstrual cycle with medication include:
- Premenstrual syndrome (PMS) symptoms that include pain or discomfort before or during periods
- Migraines or seizures that occur with periods
- Gender dysphoria (when a person does not identify with their biological sex)
- Postural orthostatic tachycardia syndrome (POTS) (a condition of the nervous system that affects blood flow)
- Chronic pain
- Participation in competitive sports
- Personal preference
Regardless of the reason for choosing it, menstrual suppression can be managed safely and effectively. Here are some of the questions I am asked most often about this topic.
Q: Isn’t a monthly period a sign of good health?
A: During puberty, the first period is a good sign that everything is working. Once we know a period has started, we can then look at suppression options. Yet with menstrual suppression, periods do not have to fully disappear. Depending on the type of medication, less frequent or just lighter periods are also an option. Studies have also shown that people using menstrual suppression medications have a decreased risk of ovarian cancer.
Q: Is this new or experimental?
A: No. People have been safely using hormonal medications to suppress periods since the 1960s.
Q: Will menstrual suppression stop periods forever?
A: No. For as long as the medication is taken, periods will be stopped. As soon as the medications are stopped, the period should start back up again within a couple of weeks to a couple of months.
Q: Does menstrual suppression create problems with having children in the future?
A: No, menstrual suppression does not have an impact on a person’s ability to have kids in the future. Once off the medication, periods will start up again like normal.
Some, but not all, menstrual suppression medications prevent pregnancy while taking them. It is a good idea to talk to your provider and know whether the chosen medication prevents pregnancy. None of the medications prevents sexually transmitted infections.
Q: What types of medications are used for suppressing periods?
A: You may have heard of someone taking more than one month of birth control pills in a row without the placebo (sugar) pills to delay their period. This is one form of menstrual suppression. Other options include certain intrauterine devices, birth control shots, contraceptive patches, vaginal ring and arm implants. Some of these options are better at completely stopping periods, while others will make them lighter.
Testing and pelvic exams typically are not needed to be able to start medication.
Q: What should I expect after starting menstrual suppression medication?
A: Menstrual suppression can last for as long as you want. Most people experience few side effects. The most common side effect is breakthrough bleeding or spotting. This might happen in the first couple of months as the body gets used to the new routine. It is not uncommon for the spotting to be a bit different than your usual period (lighter or darker than what you’re used to).
Q: When taking menstrual suppression medication, when would we need to call the doctor?
A: Although rare, if abdominal pain, chest pain, heavy bleeding, vision changes or severe leg pain occurs while on this medication, call your child’s doctor.
Menstrual suppression can be a good option for a variety of people and for many different reasons. Talk to your child’s healthcare provider to learn more if you think it could be the right fit for you or your daughter.
WANT TO LEARN MORE?
I recommend the videos below if you’re interested in hearing more about menstrual suppression. In them, one of our nurse practitioners Lisa Y. Reebals, MSN, APRN, CPNP, and I go further in-depth about menstrual management for kids with special needs and their caregivers. Part 2 deals specifically with menstrual suppression.