Lybrel: No More Periods with this Birth Control Pill?

Lybrel is a new birth control pill manufactured by Wyeth. What is unique about Lybrel is that it is the first birth control pill designed to suppress menstruation altogether. The birth control pill itself is made up of two hormones: ethinyl estradiol and levonorgestrel. Both of these hormones are already used in most birth control pills.

The traditional pack of birth control pills has a week of placebo pills, designed to create a regular monthly menstruation period. Lybrel is designed to be taken every day, keeping the level of hormones high enough in a woman's body that she will not menstruate.

The premise isn't entirely new. In 2003, Barr Laboratories released a pill called Seasonale. As its name suggests, it was designed to reduce the menstruation cycle to four times per year. And while Seasonale was the first birth control pill designed to suppress menstruation to be approved by the Food and Drug Administration, numerous other manufacturers followed suit.

This ability to suppress or banish menstruation isn't as new or scary as it seems at first glance. The week of placebo pills designed to create a menstrual cycle in the traditional birth control pills was more for cultural reasons than medical ones. From the very beginning, the birth control pill had the power to suppress menstruation. In fact, the week of placebo or so-called "sugar pills" merely stops the flow of hormones to create a phenomenon called "break-through" bleeding. The monthly symptoms and bleeding that a woman on birth control pills experiences isn't technically menstruation anyway.

A fertile woman's body releases an egg from an ovary every 28 days or so. This egg travels toward the uterus via the fallopian tubes. If the egg is fertilized, it will be implanted into the nice, thick nest awaiting it in the uterus. If the egg arrives unfertilized, both the egg and its nest will be washed out of the uterus via the monthly bleeding from the vagina. That is menstruation.

One problem with Lybrel, though, is that no one knows if suppressing periods indefinitely really helps with any of the associated symptoms of menstruation: headache, bloating, irritability, cramping and any of the other symptoms lumped under PMS or pre-menstrual syndrome. For women who have periods so heavy that they are largely immobilized on a monthly basis, Lybrel may offer them some freedom they haven't previously enjoyed.

Another potential problem that women are reporting after taking Lybrel is unscheduled breakthrough bleeding. As described before, traditional birth control pills provide a week for a scheduled breakthrough bleeding period. But Lybrel's continuous low dosage of hormones is causing at least half of women who take it to have unscheduled bleeding.

This bleeding can last for four or five days or about the length of a normal period. This leaves the woman vulnerable to the dreaded dark stain on her panties or even worse, the back of her skirt. One of the benefits of birth control pill that I found was having a completely predictable menstrual period. I usually knew the hour, let alone the day that bleeding was going to start and was almost equally adept at knowing when the bleeding would end.

Lybrel is as effective at preventing pregnancy as any other birth control pill, including Wyeth's traditional pill called Alesse. That means that there is a slight chance that you may become pregnant even while taking Lybrel. But because of the lack of scheduled periods, you may not know that you are pregnant. The effect on the fetus of continuing to take Lybrel after pregnancy is unknown.

Pros? If you are one of the lucky 50% of women who have no bleeding, then you get to be without a period.

Cons? You may just be trading a scheduled period for unscheduled and random bleeding.

I think I'll wait.