Menstrual suppression

Menstrual suppression refers to the practice of using hormonal management to stop or reduce menstrual bleeding. In contrast to surgical options for this purpose, such as hysterectomy or endometrial ablation, hormonal methods to manipulate menstruation are reversible.

There are a number of medical conditions for which fewer menstrual periods and less blood loss may be beneficial.[1][2] In addition, suppression of hormonal cyclicity may benefit menstrual-related mood swings or other conditions which increase in frequency with menses.[3] Management of menstruation may be a challenge for those with developmental delay or intellectual disability, and menstrual suppression can benefit individuals with specific job- or activity-related needs.[1][4] There is increasing attention being given to menstrual suppression for transgender men and non-binary transmasculine people who may experience dysphoria with menstruation.[5] Menstrual suppression is also being used by individuals with a variety of personal reasons to have less frequent or no menses, including honeymoon, vacations, travel, or other specific reasons.

Options for menstrual suppression include hormonal medications like extended cycle combined hormonal contraceptive pills, progestogen-only contraceptives (including progestogen-only pills, progestogen-containing implants, progestogen-containing intrauterine devices, and progestogen-only injectable contraceptives), gonadotropin-releasing hormone modulators, and testosterone, as well as the surgical options of hysterectomy (removal of the uterus) and endometrial ablation (removal of the endometrium).[6][7] Most options for the suppression of menstrual bleeding are not immediately 100% effective, and with many options, unscheduled bleeding (termed "breakthrough bleeding") can occur; for many options for menstrual suppression, breakthrough bleeding becomes less frequent with time.[8]

  1. ^ a b Cite error: The named reference :0 was invoked but never defined (see the help page).
  2. ^ Cite error: The named reference :3 was invoked but never defined (see the help page).
  3. ^ Rapkin, Andrea J; Lewis, Erin I (2013). "Treatment of Premenstrual Dysphoric Disorder". Women's Health. 9 (6): 537–556. doi:10.2217/WHE.13.62. ISSN 1745-5065. PMID 24161307.
  4. ^ "ACOG Committee Opinion No. 448: Menstrual Manipulation for Adolescents With Disabilities". Obstetrics & Gynecology. 114 (6): 1428–1431. 2009. doi:10.1097/AOG.0b013e3181c6f922. ISSN 0029-7844. PMID 20134299.
  5. ^ Schwartz, Amanda R.; Russell, Kristen; Gray, Beverly A. (2019). "Approaches to Vaginal Bleeding and Contraceptive Counseling in Transgender and Gender Nonbinary Patients". Obstetrics & Gynecology. 134 (1): 81–90. doi:10.1097/AOG.0000000000003308. ISSN 0029-7844. PMID 31188325. S2CID 186205682.
  6. ^ Cite error: The named reference pmid30980941 was invoked but never defined (see the help page).
  7. ^ Hillard PA (2014). "Menstrual suppression: current perspectives". Int J Women's Health. 6: 631–7. doi:10.2147/IJWH.S46680. PMC 4075955. PMID 25018654.
  8. ^ Nelson, Anita L. (2007). "Communicating with Patients about Extended-cycle and Continuous Use of Oral Contraceptives". Journal of Women's Health. 16 (4): 463–470. doi:10.1089/jwh.2006.0206. ISSN 1540-9996. PMID 17521249.