Several hormonal contraceptives are available that reduce or eliminate monthly uterine bleeding. The safety and efficacy of these methods make them desirable for women who have medical indications for suppression of menstruation, as well as those who simply want the convenience of not having a monthly bleed (whether or not they desire contraception).
Use of hormonal contraceptives for suppression of menstruation is reviewed here. Evaluation and management of women with abnormal uterine bleeding, as well as general principles of use of hormonal contraceptives, are discussed separately. (See "Initial approach to the premenopausal woman with abnormal uterine bleeding" and "Chronic menorrhagia or anovulatory uterine bleeding" and "Overview of the use of estrogen-progestin contraceptives".)
BENEFITS OF MENSTRUAL SUPPRESSION
Menstruation (ovulation followed by withdrawal bleeding) is not physiologically necessary. In fact, most modern women experience many more menstrual cycles in their lifetime than women in prior generations because of earlier menarche, fewer pregnancies, reduced duration of breastfeeding, and later menopause . Moreover, this frequent, regular ovulation may actually increase a woman's risk of some diseases, such as ovarian cancer. The concept that monthly bleeding is healthy has been perpetuated by oral contraceptives (OC) that were initially designed to mimic the average length of a normal menstrual cycle. This "artificial" period had no medical benefits and the initial choice of 21/7 OC formulations that result in withdrawal bleeding each four weeks was entirely arbitrary.
Medical benefits — Suppression of menstruation can be beneficial in prevention or treatment of several medical conditions. The mechanism involves a reduction in the volume and frequency of uterine bleeding or a reduction in normal cyclic hormonal fluctuations.