Hormonal implants: what are they and what are their impact

HORMONAL IMPLANTS: HOW SAFE ARE THEY AND WHAT ARE THE IMPACTS?

Written by Mark Godwin

Can periods be made optional?  Hormone implants suppress your periods, essentially making them optional. So, how safe are the menstrual suppression strategies out there?  Also, what might the impact of using hormonal implants be?

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Regardless of how predictable one’s period is, there are times when it is simply unwanted, is really inconvenient, or perhaps a more medical reason why simply not having them is a relief.

This might be during a long travel, having a crucial exam or being involved in an athletic competition.

Similarly, periods may be unwanted for other health reasons: heavy bleeding, endometriosis, bleeding disorders or anemia, severe menstrual pains or associated headaches.

Still, others want menstruation by choice just for the sheer desire of being in control of their menstrual and reproductive health.

Hormonal implants

Many techniques abound for stopping menstruation, short term (weeks, months) or long term (years). Hormonal implants are among the most effective at 99% success rate. The implant is typically, about the size of a toothpick, made of flexible plastic filled with a progestin hormone called etonogestrel. The implant is effective for at least 3 years. Nonetheless, hormonal implants aren’t the right option for every woman.

Hormonal implant

When should Hormones NOT be used to prevent period.

There are circumstances where they should NOT be used, for example in: pregnant women, women with unexplained vaginal bleeding, women with serious liver disease or women who have had breast cancer. And please note, they do not protect against sexually transmitted infections (STIs).

The side effects of hormonal implants are also different for every woman. The commonly reported one ironically being irregular menstrual bleeding.

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Bleeds are usually light, resolve shortly and are not serious medical concern. If you experience irregular menstrual bleeding and it’s bothersome, call your GP.   Other symptoms may be: headaches, scalp hair loss, weight gain, acne, breast pain and mood changes. All should be reported back to your GP.

What are the long-term impacts?

Many women continue to query what the longer-term or overall impacts might be, based on prevailing social norms and narratives.

Two schools of thought come to mind, here.   

The first, argues that having fewer periods is more natural than incessant bleeding.  Dr. Sophia Yen, who doubles as a pediatrics associate professor at Stanford University and the CEO of Pandia Health, a birth-control-delivery organization is a popular proponent of this view. Advocates of this view justify it based on research findings demonstrating that the risk of certain cancers (ovarian especially) and other physical and mental stresses are lower in women who on average have lower period counts during their entire reproductive years. 

Furthermore, Dr, Paula Hillard, a professor of Obstetrics and Gynaecology notes that, some teens are at that stage when they question their gender identities. And even those who aren’t questioning but feel that they’re in the wrong body can experience dysphoria or distresses associated with their menstrual cycle. For this reason among others, Dr Paula agrees with the fewer menses advocates.

Detractors however, make their arguments from a more social and normative standpoint. This second school of thought argues that, menstruating is natural and doesn’t need to be permanently “turned off” as doing so may come with unintended consequences.  For example, if amenorrhea lasts a long time, menopause-related disorders may develop. These include, hot flashes, vaginal dryness, decreased bone mass (osteoporosis), and an increased risk of heart and blood vessel.

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Detractors however, make their arguments from a more social and normative standpoint. This second school of thought argues that, menstruating is natural and doesn’t need to be permanently “turned off” as doing so may come with unintended consequences.  For example, if amenorrhoea lasts a long time, menopause-related disorders may develop. These include, hot flashes, vaginal dryness, decreased bone mass (osteoporosis), and an increased risk of heart and blood vessel disorders.  For these reasons, some experts continue to express safety concerns. The Society of Menstrual Cycle Research, a charitable interdisciplinary research group, has stated that “menstruation is not a disease” and that further research on the potential health risks and long-term safety of period-stopping remains, to conclusively resolve the debates.

Jessica Barnack-Tavlaris, professor of psychology at the College of New Jersey, contends that, movements like #PeriodsOptional stigmatizes menstruation and oversells the point that certain circumstances other than family planning warrant making elective amenorrhoea the norm.

More periods, more problems?

Hormonal implants

There are schools of thoughts linking some evidence that menstruation may increase the risks of certain cancers (ovarian, endometrial, breasts), endometriosis and anemia in some women.

Period suppression can sometimes alleviate some medical conditions like endometriosis, ovarian cysts and uterine fibroids.

Preindustrial women menstruated fewer times (approx. 100 times/life time) due to extended pregnancy and breastfeeding periods. Contemporary women on the other hand, menstruate nearly 400 times per life time and have been demonstrated to suffer more from the factors aforementioned.

Importantly, there is good evidence that implants do not cause infertility. You will be able to get pregnant after the implant is removed.

In conclusion, hormonal implants are both safe and effective options for suppressing menstruation. Whilst less frequent menstruation is important to some women, and research currently shows that on the whole it is safe not only to pause, or stop periods for chunks of time, the jury is still out of whether there is a definite benefit to stopping periods.