March 6, 2000 (San Francisco) -- Laura DeMarco (not her real name) knewshe'd get her period during her honeymoon, so she decided to skip it thatmonth. She's not alone: Many women are deliberately avoiding menstruation bynot taking the seven dummy pills at the end of their birth control packs andstarting a new pack right away.

Although preventing a period is not widely discussed, some gynecologistshave routinely recommended this method to their patients for everything fromtreating anemia to avoiding menstruation while on vacation. But doctors remaindivided over whether to recommend skipping one's period for more than anisolated occasion.

Disagreement Among Doctors

There is a common belief among women that getting their period every monthis "natural," according to Kirtly Jones, M.D., spokesperson for theAssociation of Reproductive Health Professionals and a proponent of thepill-skipping method. A monthly period lets women know they're not pregnant,and it "provided reassurance [when] women weren't convinced the pill wouldwork," she explains. "You don't need a week off. When you take thattime off, it's not required medically."

But not all doctors agree that women using oral contraception should stopmenstruating. "It's a controversial topic that goes back to when the pillwas introduced," says Fred Hawwa, MD, assistant clinical professor ofobstetrics and gynecology at the Brown University School of Medicine inProvidence, R.I. He says that skipping the dummy pills in a birth control packcan be a good idea if your period happens to be on your honeymoon or if you'regoing on vacation, but he wouldn't recommend practicing it permanently.

First, Hawwa says, this method can provoke anxiety because a woman has noway of knowing whether she's pregnant. (He acknowledged, however, that the riskof pregnancy while taking the pill continuously is less than 1%.) Second,skipping your period may mask other health problems, such as an underactivethyroid and cancer of the uterus, that manifest themselves through changes inthe amount of menstrual bleeding. However, Jones focuses on the positive sideof skipping a monthly period: It can help decrease the symptoms ofendometriosis, anemia, cramps, migraines, or seizures during menstruation.

Problems Still Continue

The downside of using this method is that it doesn't always let women avoidbreakthrough bleeding, also known as spotting, and PMS symptoms. "I stillhad the cramping, and the bloatedness, and the emotional craziness,"DeMarco says.

Spotting occurs, according to Shelley Breene, M.D., an OB/GYN at SantaMonica Bay Physicians in California, because the endometrial lining normallybuilds in response to female hormones. When the pill suppresses those hormones,the lining is never built -- so it stays thin. Sometimes it's not thin enough,or it becomes irritated due to bacteria, inflammation, or hormonal imbalance,all of which can cause spotting. Breakthrough bleeding can also be a symptom ofother conditions, such as uterine fibroids.

To deal with spotting while taking the pill continuously, a woman has twochoices, Jones says. She can either continue to take the pill and just ignorethe spotting, or stop taking the pill after she finishes her three-week cycleof pills -- which, of course, will lead to a period again. She recommends thatwomen who try the latter method keep a calendar of when they get their periodin case they need to see their physician.