Most women learn about their bodies and menstrual cycles from
moms, friends or a sixth-grade health teacher. Students were taught
that women get a period once a month, except during pregnancy. But
what if she didn’t have to? What was once considered fact is
now an option, due to the newly Food and Drug
Administration-approved drug Seasonale.
Traditional oral contraception, commonly called “the
pill,” requires users to take active pills for 21 days and
placebos for seven. Recently, women have sought an alternative to
daily contraception and turned to the patch, which requires
application once a week. Seasonale, an active oral contraceptive
taken 84 days straight, might seem as burdensome as the pill.
To date, clinical studies have shown no increased health risks
with Seasonale compared to a 28-day pill, but long-term effects of
Seasonale are still unknown. Consumers are warned that Seasonale
requires the same guidelines as the pill; users must take active
pills at the same time daily to increase effectiveness. When used
correctly, Seasonale provides the 99 percent effectiveness of the
pill and the patch.
This idea of limiting a period is not new. “We’ve
actually been doing this for quite some time, sort of
“off-label,” said Susan Ernst, director of gynecology
at University Health Services.
Though there are benefits to this birth control option, there
are drawbacks, too. Traci Jarrett, a sexual health educator at UHS
notes, “Some women … like to have their period monthly
as a visual cue that they are not pregnant and may feel
disconcerted by not menstruating monthly.”
“Users may experience spotting or bleeding before they
begin the placebos that may make some women uncomfortable,”
added Jarrett. Side effects of other hormonal contraceptives are
also associated with Seasonale.
Other new alternatives are now available. A hormone-based
contraceptive like the others, NuvaRing, a flexible ring, is
inserted into the vagina once a month. Hormones in NuvaRing are
heat-activated and also have a 99 percent effectiveness rate.
Unlike the patch, NuvaRing is inconspicuous; most women and their
sexual partners do not even notice its presence. It also has a
lower dose of estrogen compared to other contraceptive forms, so
the side effects are fewer and less intense.
Not all birth control is preventative, however. Sometimes
intended birth control methods go haywire, or are forgotten
altogether. Plan B, commonly referred to as “the
morning-after pill,” is an emergency oral contraceptive and
is 89 percent effective against pregnancy when taken up to 120
hours after unprotected intercourse. Plan B, the first FDA-approved
emergency contraceptive, is most effective within the first 72.
“It’s important to remember that Plan B is just
hormonal; it prevents ovulation and possibly implantation,”
said Ernst. “It is not an abortive pill, as many people
wrongly assume. If implantation has already occurred, Plan B is
completely ineffective and has no harmful effects on the
Currently, Plan B is available only by prescription, requiring a
trip to the clinic in the morning for most users. In December, the
FDA approved Plan B for over-the-counter availability, though the
product has yet to be picked up and produced by any drug
manufacturers. Both the American Medical Association and the
American College of Obstetrics and Gynecologists have endorsed the
over-the-counter status for emergency contraception.
“I hope that if Plan B does go over-the-counter, it comes
with complete and understandable information and
instructions,” Ernst said.
Over-the-counter availability has raised debate among students.
“It’s a big step, but it could really get abused. It
might decrease the seriousness of the whole situation,” said
LSA freshman Elisa Jorgenson.
“It would be nice, especially considering the situations
that college kids get into now, to not have to explain the
situation and yourself, not be looked down on by a doctor. Plus,
UHS isn’t even open on Sunday, which is when some people need
it,” LSA freshman Katie Cwayna said.
Jarrett notes, “Plan B as an over-the-counter medication
would remove a perceived barrier to receiving the medication and
the cost of a medical appointment.” At UHS, an on-call
clinician is always available to answer questions after hours if a
student needs consultation about contraceptives. On-call clinicians
can also phone in a prescription at any time, if necessary.
“If Plan B goes over-the-counter, that may allay a lot of
anxieties about availability and time constraints,” Jarrett
Until Plan B is approved in Michigan for over-the-counter
availability, there are other ways to acquire it. Gynecological
patients can get a prescription for Plan B at any routine exam, to
have on-hand. Exams can also be made for first-time patients who
wish to obtain a prescription.
Women interested in any form of birth control should consult
with a gynecologist to choose the best option. UHS offers doctors
and pamphlets to help potential users make informed decisions.