Few are as passionate as Yen about the possibility of a world with far less cyclical bleeding. “It’s my crusade,” said Yen, who also co-founded and runs Pandia Health, a birth-control-delivery company. “This is my moonshot.” People who have periods spend an average of 2,300 days of their lives menstruating. If more people chose to silence their period—or even just dial down the volume—that would mean a decrease in iron deficiency (which women experience at far higher rates than men), and fewer plastic tampon applicators littering landfills.
Yen envisions the period of periods soon coming to an end. But even though menstruation is often messy, painful, and expensive, it’s a meaningful fixture of adulthood for some, and one that can be hard to let go of.
Gabrielle, a 24-year-old who lives in St. Petersburg, Florida, got her first period in fourth grade. (The Atlantic allowed her and others in this story to use their first name only, to protect their privacy.)
“It felt incredibly, incredibly unfair,” she told me, to have been the first among her friends to menstruate. “There were all these little moments where it was embarrassing and bad and painful and weird”—sneaking off to the bathroom with bulky pads stuffed in her shirt, swimming while on her period, learning how to use tampons. Then, at 20, Gabrielle got a hormonal IUD (intrauterine device) for birth control and, as a side effect, stopped getting regular periods. “It feels really good to not worry” about keeping the bathroom well stocked or missing a day of work, she said. “I will keep getting an IUD until I’m ready to get pregnant.”
Read: The tampon: a history
Today, any doctor will tell you there is no medical necessity for periods unless you’re trying to conceive. The body preps for pregnancy by thickening the uterus’s lining, like a bird building a nest for her eggs; hormonal birth control prevents pregnancy, in part, by keeping the uterine lining from ever building up. Many of the roughly 19 million Americans who rely on the pill, the shot, IUDs, implants, patches, or rings see a change in their period—often it’s lighter, but it can also disappear altogether. In clinical trials, more than 40 percent of the Liletta IUD’s users no longer menstruated by the end of the product’s six-year life. More than half of people who get the Depo-Provera shot every three months will become amenorrhoeic within a year, and almost 70 percent in the second year. And anyone using the pill, patch, or ring can safely skip scheduled withdrawal bleeding.
But getting a lighter flow as a side effect of birth control is different from choosing a contraceptive method in the hopes of turning off a period completely, and there are all sorts of reasons someone would want to do so. The cost of so-called feminine products can add up to thousands of dollars over a person’s lifetime: A recent study found that nearly two-thirds of low-income women surveyed in St. Louis couldn’t afford menstrual-hygiene products during the previous year. (This study, and others cited in this story, did not specify whether participants included trans men or nonbinary people who get periods). Amenorrhea can be a medical necessity for people with certain health conditions—such as those born without an intact uterus and vagina. It’s also a treatment option for heavy bleeding or otherwise painful periods, which afflict about one in five women, and can help relieve symptoms of polycystic ovary syndrome (PCOS), which affects 6 to 12 percent of U.S. women of reproductive age. Or a period simply may be one burden too many, especially during a pandemic: A tweet in March proclaiming that “menstrual cycles also need to be suspended until this ordeal is over” started racking up hundreds of thousands of likes.