Cover Story

Should your patient be on extended-use OCs?

By Patricia J. Sulak, MD

Women treated with OCs for menstrual disorders like dysmenorrhea and irregular bleeding may not want to put up with the withdrawal symptoms linked with the standard regimen's 7-day hormone-free interval. Extending active therapy and reducing hormone-free days can improve their quality of life.

Women had far fewer periods before they gained widespread access to contraception-and fewer gynecologic disorders, too. In fact, the number of menstrual periods a modern woman experiences over a lifetime has risen dramatically-nearly threefold since the pre-Pill era. Women used to have an estimated 40 to 160 menstrual periods over a lifetime compared to a modern woman's average of 450. There are many reasons for the greater number of lifetime menstrual cycles. For one thing, the average age of onset of menarche has been drifting downward, reaching 12.6 years in 1995. And then there's the later onset of menopause, delayed childbearing, fewer pregnancies, and decreased incidence and duration of breastfeeding.^1,2 While having consecutive years of monthly menstruation may appear "normal" to the modern woman, is it truly "natural"?