Against The Flow

Why getting rid of PMS for good might not be such a great idea

Valerie Phillips

My biggest problem with menstruation is probably the words used to describe it. First: menstruation. It's just a horrible word. (If you're interested, my other hated words: panties, slacks, moist. The worst sentence in the world: "Her menstrual flow moistened her panties and slacks.") Period is no good either. And most of the euphemisms are even worse—"Aunt Flo," "on the rag," "riding the crimson wave," "the curse." It's like a cabal of sexless nuns and sex-crazed 12-year-old boys got together and came up with every word or phrase to describe a woman's cycle. There's a damp reek of mothballs and Cheez-Its hanging over them all.

On the other hand, I've always viewed the thing itself, the, er...time of the month, as inevitable and nothing $10 and a trip to the drugstore can't resolve. But when it stopped for a year or so while I gestated and lactated, I found that I did enjoy the absence of mood swings, of cramps, of blood. I lapsed into denial that I'd ever had a period, that it would ever come back.

Then one day I found myself screeching obscenities at a parking garage attendant before storming out, in tears, yelling, "I'm never using this garage again!" (I'm sure he was heart-broken.) While the situation was frustrating−he wouldn't give me my car−I was rattled that I was so rattled. And the feeling persisted for days. I felt nauseated and filled with neck-throttling rage. I wasn't sleeping, my skin broke out, I was bloated...and then, of course, I got my period. Ah, you again.

Distance had not made me any fonder of menstruation (the word or the bodily function). Suddenly it seemed ridiculous that for more than 20 years I had accepted the fact that I'd feel lousy once a month. By my calculations, I'd already spent nearly five years of my life bleeding. So I was intrigued when Lybrel, the first continuous oral contraceptive (OC), was approved by the Food and Drug Administration this spring. Unlike most birth control pills, where you take "blanks" for a week to induce a period, on Lybrel you take a low dose of estrogen and progestin 365 days a year so that, in theory, you never bleed. (In practice, after a year, 59 percent of women experienced complete amenorrhea—i.e., no period; 20 percent had light spotting; and 21 percent experienced breakthrough bleeding heavy enough to require protection.)

This isn't a new idea—doctors have been advising women with very painful or heavy menses to skip the placebos in their pill packs for decades. Still, Lybrel will make this protocol more accessible. And though Lybrel is not FDA-approved to treat premenstrual syndrome or premenstrual dysphoric disorder (PMS's angrier, uglier cousin), scientists say it could reduce or even eliminate the pre-period blues for many women. And like all OCs, it's 98 percent effective in preventing pregnancy, will reduce your risk of ovarian and endometrial cancer by 30 to 50 percent if you take it for three years or more, and is completely reversible (women who went off Lybrel usually began ovulating and menstruating again within a month and showed no decrease in fertility).

This Is A Developing Story

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