Last updated: Apr 19, 2008
Naturale is just as "natural" as the regular Pill.
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In 2003, extended-use birth control pills were the big news that wasn't news at all, at least not to doctors. Many gynecologists had already been prescribing continuous pill use—without the usual weeklong "break" that creates a period—to women with troublesome cycles.

Seasonale, the "extended cycle" pill approved in 2003, gives you only four periods a year. Lybrel, the continuous-use, "no period" pill, was approved in 2007. They work the same as regular birth control pills by preventing ovulation.

"Isn't it unnatural?" many women worry. Yes and no. Extended-use pills are not any more "unnatural" than other birth control pills—the "period" you get with a regular monthly birth control pill isn't really a period, because you're not ovulating.

The upside
The new continuous pills appear to be a safe, effective, and convenient treatment option for endometriosis and for women who have debilitating periods, with severe cramps, mood swings, and the like.

"The extended-use pill is safe, reliable, and reversible," says Lee Shulman, MD, a professor at Northwestern University who sits on the board of directors of the Association of Reproductive Health Professionals. "When you're pregnant, you don't have a period," he says, and what these pills do is to suppress ovulation and convince your body that it's pregnant—a natural state.

In fact, Dr. Shulman says, women today have more periods in their lifetimes due to smaller families (thanks to birth control) and longer life expectancy. "Two hundred years ago, most women were either pregnant or breast-feeding most of their lives." The extended-use pill mimics that process. Medication that suppresses ovulation has been shown to lower the risk of ovarian cancer.

The downside
Since you won't be expecting your period, you won't know if the method failed and you happen to be pregnant. (This risk is minuscule: less than 1% when used properly.)

Also, you may focus on the "no period" convenience and fail to consider the risks of taking medication—although small statistically for hormonal birth control, the risks are real. "You can get blood clots, pulmonary embolism; you can die," says Dr. Hilda Hutcherson, an ob-gyn professor at Columbia University.

Dr. Hutcherson also says she does not like the message she feels the continuous pill could give to young women: that their bodies are "abnormal" because they bleed, and that menstruation is an unpleasant condition to be medicated away.

"There are young women starting the pill as if it's a vitamin or something, just because they don't want to have a period," reports Dr. Hutcherson. "It makes me crazy!"