Can I skip my periods?
October 7, 2011 8:36 PM   Subscribe

Nuvaring and skipping my periods: is it OK? Do I really need to ramp it up?

I am due to replace my first NuvaRing next Thursday, which means I've had it in for over two weeks. I've been menstruating non-stop since I put it in. I would really like to skip my periods until at least the holiday season is over. I'm aware that some breakthrough bleeding is normal, but my main goal is to stop the horrendous PMS that I get during that time of the month.

I am aware that skipping menstruation is a relatively new thing in the medical and science field but that it is common and thought as a safe thing to do. As far as I know, I have no medical conditions that would preclude me from doing this, and my doctor and I have had previous conversations about this (I think her thought was "sure!" but I can't remember exactly). Unfortunately, I got the prescription from Planned Parenthood, and getting an appointment there or with my PCP could take several weeks.

I was set to go ahead to do this (and tell my doctor about it later), but my husband seemed concerned and mentioned that he read it was best to ramp it up. Is this really necessary? I feel like I will just keep getting endless periods for a while, which is pretty much the opposite of what I want. I need stable hormones, no PMS, and fewer periods.

So, to wrap it up:

-Is it OK to skip my periods, ideally to 3-4 times a year?
-Is it necessary to ramp it up?

For those who are on the NuvaRing specifically, can you tell me an additional few things:

-When did your first "breakthrough bleeding" stop? Did it last for the whole first cycle?
-Did you experience some occasional cramping?
-What's your most successful insertion position? I haven't had many problems, although occasionally I do accidentally put it out when I remove my 'pon.
-So far I feel like, if anything, I'm much hungrier and maybe a bit angrier. Did you have similar side effects, and if so, did they subside at all? I'm not sure about the hungrier part being related, as I did recently start a new gym routine.

Thanks in advance!
posted by two lights above the sea to Health & Fitness (18 answers total) 1 user marked this as a favorite
What do you mean by "ramp it up"?

FWIW, I never had breakthrough bleeding, cramps, or mood/appetite symptoms on Nuvaring.
posted by thirteenkiller at 8:45 PM on October 7, 2011

Response by poster: Er, sorry, that probably wasn't clear. My husband suggested (base on something he read) that I ease into skipping my periods. At first, only do one ring, then do two consecutive rings, then three, then four, etc. I'm not saying I want to skip 6+ months, but 3-4 times a year would be great. Thanks again!
posted by two lights above the sea at 8:47 PM on October 7, 2011

Best answer: I did nuvaring continuously, and I currently do pills continuously. I didn't "ramp up". It works for me, not saying it will work for you though but it is possible. I never had breakthrough bleeding or cramping either though.

But yes, on nuvaring (more than on any other form of bc) I was STARVING, like all the time. Like 20 minutes after eating dinner I'd be in the kitchen looking for more food. My roommate felt the same way.
posted by magnetsphere at 8:51 PM on October 7, 2011

I've never done nuvaring, but I have a hormonal IUD and definitely spotted more-on-than-off for what seemed like forever, until suddenly it just went away and I only occasionally have light spotting. I think that's a feature of the constant release of hormones. And honestly, I feel totally fine about skipping periods.

There are some amazing Livejournal groups that discuss IUDs and other birth control in so much detail it will make you wonder why you can't just read the internet and then go buy what you want at the store. There is almost certainly a Nuvaring group that can give you some context for what you're going through, and make sense of what your husband's read.
posted by padraigin at 8:57 PM on October 7, 2011

I was on the Nuvaring for 6 months and I stopped because of the side effects. I didn't have the same side effects on the pill. I also didn't use the pill to skip periods, which I did do with the nuvaring.

I found that it made me slightly depressed, I lost my sex drive, and I was moodier. It helped with my menstrual headaches, but not enough that the rest of the side effects were worth it.

As far as positions, try squatting. That was the easiest for me.

IIRC, I started the first month at the onset of my period, so I just had a normal cycle that month. The next month I had about 2 weeks of bleeding; after that it was less, possibly nonexistant.

I don't recall ever having cramping.

As far as "ramping it up" -- I've never heard of this and not done it, though it might not be a bad idea to give your body one new thing to adjust to at once.
posted by DoubleLune at 9:20 PM on October 7, 2011

Best answer: This "ramping it up" is nonsense. I've used nuvaring continuously in the past or simply an extra week here and there to divert an inconveniently timed period.

It's definitely possible.

I'd still double check with the prescribing doctor (GYN, Family doctor, clinic, whatever) just to make sure they approve. They know you and your reproductive organs better than I do.
posted by sunshinesky at 9:31 PM on October 7, 2011

FWIW, I also stopped using nuvaring because I was an angry, mood-swingy bitch on it, often without cause. This has happened to me on other hormonal birth controls as well, but not all. It could subside after the first few months, as your body adjusts.

I never had to wear it through my period, since I only bled on my off week, so no advice on the tampon issue... but for insertion, I found it easiest to do the one leg up on the toilet position, as often shown in tampon instructions.
posted by sunshinesky at 9:35 PM on October 7, 2011

Best answer: Skipping is fine. You might be fine just keeping the ring in an extra week, so put a new one in every 28 days; I've been told to do that, but it seems to increase my risk of breakthrough bleeding (as opposed to putting a new one in after 21 days).

I also find if I skip a bunch in a row that I will end up with breakthrough bleeding, so I basically try not to skip unless I have a pretty strong reason. I do find that allowing a normal period and then starting with a new ring after it's been out 7 days seems to reset things and put me back on track.

My sister, however, says that she does best just dealing with the breakthrough bleeding at that eventually it goes away and she can just stay on the ring permanently. I've never managed to get that far, myself.

For me it's been by far the least side effect-y form of hormonal birth control I've tried. You may or may not have the same result!
posted by nat at 9:42 PM on October 7, 2011

Twice I've messed up my pills in such a way that caused non-stop bleeding for weeks. The only way to get it to stop was by stopping for a few days and starting a new pack. It was the only way to signal the system to stop what it was doing.
posted by bleep at 9:51 PM on October 7, 2011

Best answer: Is it OK to skip my periods, ideally to 3-4 times a year?

It's safe to skip your period indefinitely. There's a case on Managing Contraception where someone did it for something like thirty years, taking the pill continuously with no placebos. As long as you're not contraindicated for hormonal contraception, you could theoretically skip your period straight from menarche to menopause. There's really no way to know if you'll spot or not, though. The conventional wisdom is that if you bleed, you can try upping the hormone level a bit--for nuvaring, if you were spotting switching the ring every four weeks, you could try putting in a new ring after three--but that still might not work.
posted by Violet Hour at 10:32 PM on October 7, 2011

Best answer: Is it OK to skip my periods, ideally to 3-4 times a year?

Yes. They even sell pills specially packaged to do this (example). My partner has found that if she tries to go more than three months she'll start getting spotting; obviously, as with all things hormonal, your mileage (and bleeding) may vary. I've never heard of "ramping it up" as a strategy, and I've sat in on many hours of discussions of this with various OBGYNs, but perhaps that works well for some people.
posted by Forktine at 6:11 AM on October 8, 2011

Best answer: I did this. Then I realized that I'd go through more rings in a year than I was prescribed. And more than the hassle of getting a new prescription early, I really didn't want to pay for more refills (insurance still left me paying $50/each).

Eventually, after years on the ring, I figured out that I could leave the ring in a little longer (I put it in on, I think, a Thursday and took it out four Sundays later) and that if I didn't have a full seven days without it, I wouldn't have a period. Or maybe it was that the period would start around the fifth day without it, so I only went without for four days. Your milage will surely vary, but I was able to keep to a 4-week cycle by leaving the ring in for a few extra days. Looking back, this technique may eventually risk ovulation, but I thought I'd have a period if the ring "wore out." I never got pregnant doing this, but again, YMMV.

Regardless of your strategy, ramping it up is unnecessary and may, as your body tries to figure out what you're doing, result in more overall breakthrough bleeding. Just go for it.
posted by katieinshoes at 6:47 AM on October 8, 2011

Best answer: Skipping menstruation is NOT a new thing. It's just that before hormonal birth control, it was usually done by being pregnant. I saw a study a few years ago that today's women have more periods than has been historically true due to lower birth rates and longer life spans. (on mobile, or I'd find and link)

The bad thing abouot breakthrough bleeding is that no one can predict if you'll have it or how long it will last. I had it for a full year with Depo provera but never with any form of oral contraceptive, whether I was on a monthly or seasonal pack. You don't need to "ramp up" to skipping periods, and you might find that being continuous with the hormones helps the breakthrough bleeding go away a little sooner.
posted by peanut_mcgillicuty at 7:00 AM on October 8, 2011 [1 favorite]

Best answer: I loved the Nuvaring for this! Had to get off it because it was making me more paranoid than usual, but loved it otherwise. I never had breakthrough bleeding with it at all, though I didn't always skip my periods. I also used it with a DivaCup rather than tampons, which I highly recommend because a DivaCup makes periods SO much nicer. (Put the ring in first, then the cup.)

Regarding insertion, it doesn't really matter where the NuvaRing sits. The reason they tell you to keep it in the fridge is because it's heat-activated, so as long as it's in your vagina, it's activated. It's also okay if you take it out for sex or if it comes out when you remove a tampon. The ring can be out for up to 3 hours before the hormones level dip enough to cause problems.

I've had a Mirena IUD for 4 years and haven't bled in 3. The first year featured a lot of breakthrough bleeding, gradually lessening and lessening until it stopped completely. I still ovulate, so I get the snackiness, the mood swings, and the breast tenderness... but I don't bleed or cramp! It's totally fine.
posted by heatherann at 8:58 AM on October 8, 2011

Just as a data point: I use NuvaRing in the "normal way" (3 weeks in, 1 week out), and I used it to skip my period during my wedding by leaving it in. It caused 3 weeks of continuous breakthrough bleeding and terrible cramps afterwards. I bet it would have gotten better if I'd stuck with it, but it was too unpleasant for me to hang in there and find out.
posted by Cygnet at 11:15 AM on October 8, 2011

Best answer: I've never heard of ramping up either.

Modern women have way more periods than our ancestors, who had shorter lifespans, started their reproductive lives earlier, and spent much of that either pregnant or nursing. From an evolutionary perspective, fewer periods == more normal.

Continuous use of NuvaRing has been well-studied. It's safe, though as you alluded to: for some women there's several months of breakthrough bleeding while the body adjusts.

A study by the manufacturer found that for those who do get breakthrough bleeding, skipping 4 days when you change rings is highly effective for reducing overall breakthrough bleeding and spotting.

Check with your provider, but my bet is that they'll say you're fine doing continuous indefinitely. If/when you get 5 successive days of spotting/breakthrough, just give yourself a 4 days break after that ring.
posted by nakedcodemonkey at 12:35 PM on October 8, 2011

Best answer: I used Nuvaring for several years, changing rings every 4 weeks. Some people on the LiveJournal Nuvaring group were even changing it every 5 weeks if they were just using it for period regulation and not so worried about birth control. The nice thing about doing it this way is that every 4 months, you get a 'free' Nuvaring out of your prescription that you could save for emergencies like if you forgot to fill your script on time or accidentally lost the ring after temporarily taking it out, or something.

I found that I could skip my period with it for several months, but then my uterus would fight back and bleed right through the ring. If I could see this was happening I would just take that ring out and wait a week to put it back in, having a much heavier and more uncomfortable period than I would have otherwise. For whatever reason my uterus seemed to like to do some spring cleaning every once in a while.

As other posters have noted, in pregnancy you don't get the option to "ramp up" the hormones - so why would you do it with contraceptives? There is no natural situation in which your body would have the hormones fluctuating in that way unless you were continually getting pregnant and then miscarrying every few months.
posted by treehorn+bunny at 1:47 PM on October 8, 2011

Best answer: I skip bleeding all together - which also means that I skip the wacky hormone crap that comes with fluctuations in hormone levels. I use Seasonale/Jolessa/Quasense to do it; I skip the placebos and go straight to a new pack of pills.

I've had no breakthrough bleeding, no cramps, no nothing. It's pretty awesome and, I think, is as close to being 'male' as a woman can get. Guys don't get the whole random changes in hormone levels with the resultant irritability, acne, crying, etc. Now I don't, either.

Prior to skipping my periods, I researched the medical evidence out there and found that most doctors and scientists see no harm in skipping menstruation. Most see a benefit in it (reduced incidences of endometriosis, anemia, etc.).

I've had one doctor tell me I was doing something wrong. Her basis for her statement was: "God designed women to bleed every month; by not allowing your body to follow its natural cycle, you're causing harm." To say I was floored that a woman of science would espouse such a view is an understatement. I've since found another doctor and sent the 'god-based' one a slew of articles regarding the skipping practice.
posted by LOLAttorney2009 at 4:01 PM on October 8, 2011 [1 favorite]

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