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Contraceptive myths busted. Facts and misconceptions about contraception and menstruation

Fact or myth? The 7-day hormone-free interval is important for women’s health

From the beginning, developers of combined oral contraception products (the “Pill”) knew there was no scientific rationale for women on the pill to have a mandatory monthly bleed.1 However they thought the Pill would be socially more accepted if it closely mimicked the natural course of the menstrual cycle by using natural oestrogen and progesterone for 21 days, and by having a 7-day bleed per month (using the placebo pills). This thinking has endured for 60 years, and has become the standard, despite the lack of scientific evidence supporting this 21/7 combined oral contraception regimen.

Fact or myth? I won’t get pregnant having sex during my period.

Not so true ladies. A sperm can live in a woman’s uterus for 2-5 days and ovulation can occur earlier than anticipated, so it’s always wise to be using some form of contraception to prevent unwanted pregnancy.3

Fact or myth? Condoms are too expensive!

Well did you know you could actually be getting your condoms for free*? Family Planning NSW has introduced a Condom Credit Card! The Condom Credit Card, or CCC is a confidential way for people under the age of 25 to access unlimited free condoms.

To access the CCC program, drop into your nearest Family Planning NSW clinic or partnered organisation and ask to register! Upon registering you will be given instructions on how to use a condom as well as some useful sexual health information and tips.

Visit Condom Credit Card Project | Family Planning NSW (fpnsw.org.au) for more information2

*available in NSW only

Fact or myth? The Pill increases venous thromboembolism (VTE) risk

Another risk factor often mentioned with COC use is VTE. VTE risk does go up slightly with using the Pill.1 Interestingly, the greatest risk of VTE is actually during pregnancy and even more in the early weeks postpartum. and can be up to 40-fold higher than the risk of VTE while on the Pill.

Fact or myth? Women need to have a regular monthly bleed

The average woman in contemporary western society has about 450 periods in a lifetime.1 This is a lot more than women had before the pill was introduced as they were either pregnant or breastfeeding.

Fact or myth? The Pill increases the chance of cancer

Although the risk of breast cancer for women on the Pill results in one additional breast cancer over and above the existing rate in the female population (or 1 extra breast cancer per 7690 women using COC), the risk of uterine and ovarian cancer is reduced by 50% with the Pill use. The risks of using the Pill must be balanced against the beneficial effects of combined oral contraception especially with extended use of the Pill as it provides effective contraception, protection against ovarian and endometrial cancers that are diagnosed later than breast cancer and can help women with menstrual cramps or menorrhagia.1

References: 1. Combined oral contraception: managing menstrual myths by Professor Anne MacGregor, July 2019. 2. Family Planning NSW Condom Credit Card Project | Family Planning NSW (fpnsw.org.au) 3. Better Health Victoria – Myths and facts about contraception and long-acting reversible contraception (LARC) – Better Health Channel

Did you know!

When you first learn about periods and get your first one, there’s a lot to take in, and get used to; tracking your cycle, managing the flow, and regularly changing your pads or tampons.

Often shushed by society, period talk – even into adulthood – can seem like whispered ‘women’s-only’ business, a taboo topic rather than a crucial and celebrated part of women’s reproductive health.

So in case you missed a menstrual memo, or just want to learn more, here are four things you may not know about the menstrual cycle.

  1. Menstrual fluid: not what you think

If you had to guess how much menstrual fluid you lose during a period, what would you estimate? 100ml? 150ml? Research shows that women often overestimate the amount of menstrual fluid lost during a period. Despite our best guesses, the average total volume of fluid lost over one period is only 35-50ml – that’s around 2-3 tablespoons.

Losing more than 80ml in a period, or having to change your pad or tampon hourly or more often, or overnight, are signs of heavy menstrual bleeding. If heavy bleeding is disrupting your quality of life, it’s important to speak to your doctor and get support to help you manage it.

As a side note: although it’s commonly referred to as ‘menstrual blood’, blood only makes up part of the fluid. The rest consists of vaginal secretions and cells from the lining of the uterus – and the proportions of each can vary between women.

  1. Knowing your ‘fertile window’

A Monash University study of women seeking treatment for infertility showed a big gap between what the women actually knew and what they believed they knew about their fertile window, with 68% of the women believing they accurately timed intercourse on their fertile days to achieve natural conception.

In fact, just 13% of the women in the study correctly identified the most fertile days of their menstrual cycle.

For the record, the fertile window is considered to be five days prior to and the day of ovulation (the release of the egg), with a woman’s best chance of conceiving being the two days prior to and the day of ovulation. In a typical 28-day cycle, ovulation occurs on day 14, so the fertile window is considered to be days 9-14, but pregnancy has the greatest opportunity of occurring through sex on days 12-14.

  1. Syncing cycles is an urban myth

It’s widely believed that women who live together or spend lots of time together synchronise their menstrual cycles – that is, they begin to get their periods at the same or similar times, and the cycles end up following a similar pattern.

However, a 2005 research study that tracked the cycles of 186 women living in the same dormitory for more than a year found that the women’s periods didn’t align with each other after all.

What’s more, results from another small study, conducted by the fertility app Clue and researchers from the University of Oxford, found that the cycles of 273 pairs of women living together did not align either and were actually more likely to become more different over time.

The urban myth of syncing cycles can be traced back to a 1971 study that documented the findings after studying American college students. It was thought that women release pheromones (chemicals similar to hormones) that influence each other’s cycles, but the 1971 study has since drawn criticism for using flawed statistical methods and its results have yet to be replicated.

Still, the idea of sharing cycles and connections with the women around you seems to be a powerful one and the urban myth lives on.

  1. Your periods take up years of your life

On average, Western women have more than 450 periods in her lifetime. This might not seem like a lot of time when it’s spread out over a lifetime, but if the bleed typically last 4-5 days, this means women spend the equivalent of 5-6 years menstruating – and that is a long time!

And while these stats are interesting (and maybe surprising), there is also an important lesson to learn; when you add up the total time you spend menstruating, you can see it’s a big proportion of your life, so if you have problems with your period – such as severe pain, heavy bleeding or other issues – you do not have to suffer through it in silence. Speak up and get the right advice and support from a trusted health professional.

The above 4 points have been published with the permission of Jean Hailes for Women’s Health.

For more women’s health information head to jeanhailes.org.au or call their toll-free number 1800 JEAN HAILES (532 642).