Convenience, not symptoms, motivates menstrual cycle manipulation

University students who use combination hormonal contraceptives to schedule a bleeding cycle do so for convenience rather than relief of symptoms, according to a new study by University of Oregon investigators. And family or friends--not health care professionals--are the source of information on how to manipulate method use for many of these women.

The findings from the research, which was supported by the National Institutes of Health and published in Contraception, are based on a self-administered e-mail survey of scheduled bleeding practices and beliefs that was distributed to 11,900 female students at the University of Oregon.  Of the 1,719 students who responded, 1,374 (79.9%) had used combination hormonal contraceptives, 17% of whom altered scheduled bleeding patterns by deviating from package instructions. 

Convenience or personal choice was the motivation behind delaying or skipping scheduled bleeding for half of the women that manipulated their contraceptive use. Personal preference was cited by 28.9% of the respondents and reducing menstrual symptoms was cited as a motivator for only 16.7% of respondents. Forty-seven percent of women who had altered their own cycles learned about to do so from health care professionals but 30% said they got the information from family or friends.

Likelihood of manipulating contraceptive use to skip a period was lower in women who were Asian, used COCs for bleeding cycle regulation, exercised regularly, or had a personal preference for a monthly cycle. Interestingly, the probability of manipulating contraception to adjust bleeding was 17% higher in women who preferred having one cycle per year than in those who preferred having a menstrual period every 3 months.

“These findings emphasize the need for health care providers to carefully interview combined hormonal contraceptive users on how they are using their method-for example, many women may be skipping pills to extend their cycles,” said researcher Christopher Minson, a coauthor of the study. “With a greater understanding of the issues, health care providers may be able to more effectively engage in conversations with college-aged women and educate them about available options.”