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FDA Approves Period Suppression
Pill
Andrew Bridges
AP
Wednesday May 23, 2007
The first birth-control pill meant to put a stop to women's monthly
periods indefinitely won federal approval Tuesday. Called Lybrel,
it's the first such pill to receive Food and Drug Administration
approval for continuous use. When taken daily, the pill can halt
women's menstrual periods indefinitely and prevent pregnancies.
Lybrel is the latest approved oral contraceptive to depart from
the 21-days-on, seven-days-off regimen that had been standard since
birth-control pill sales began in the 1960s. The pill, manufactured
by Wyeth, is the first designed to put off periods altogether when
taken without break.
The pill isn't for everyone, an FDA official said. About half the
women enrolled in studies of Lybrel dropped out, said Dr. Daniel
Shames, a deputy director in the FDA's drugs office. Many did so
because of the irregular and unscheduled bleeding and spotting that
can replace scheduled menstruation.
"If you think you don't want to go down this road, this is
not for you," Shames told reporters.
Wyeth plans to start Lybrel sales in July. The Madison, N.J., company
said it hasn't yet determined a price for the 28-pill packs. The
pill contains a low dose of two hormones already widely used in
birth-control pills, ethinyl estradiol and levonorgestrel.
A study showed Lybrel was just as effective in preventing pregnancy
as a traditional pill, Alesse, also made by Wyeth. However, since
Lybrel users will eliminate their regular periods, it may be difficult
for them to recognize if they have become pregnant, Shames said.
Most of the roughly 12 million American women who take birth-control
pills do so to prevent pregnancy. Others rely on hormonal contraceptives
to curb acne or regulate their monthly periods.
Some nontraditional pills such as Yaz and Loestrin 24 shorten monthly
periods to three days or less. Seasonique, an updated version of
Seasonale, reduces them to four times a year. With Lybrel, in one
test, 59 percent of the women who took Lybrel for a year had no
bleeding or spotting during the last month of the study. However,
because of dropouts, that translates into only about one-third of
all the women originally enrolled in the study, Shames said.
"Women who use Lybrel would not have a scheduled menstrual
period, but will most likely have unplanned, breakthrough, unscheduled
bleeding or spotting," Shames said. The bleeding can last four
to five days and may persist for a year, he later added. Women who
take other low-dose pills have reported similar issues.
Still, a women's health expert said Lybrel would be a welcome addition
for the woman who seeks relief from the headaches, tender breasts,
cramps and nausea that can accompany monthly periods. Whether Lybrel
relieves those symptoms was not directly studied.
"Over time she will experience markedly less bleeding episodes
or no bleeding episodes," said Dr. Vanessa Cullins, vice president
for medical affairs at Planned Parenthood Federation of America
Inc. "That is very beneficial for some women -- and is wanted
by some women."
University of New Hampshire sociologist Jean Elson pointed to advantages
for what she characterized as a small number of women who suffer
extraordinarily during menstruation, but overall she said the pill
left her with mixed feelings.
"For women in that situation, I certainly can understand the
benefits of taking these kinds of medications, but for most women
menstruation is a normal life event -- not a medical condition,"
said Elson, who researches the sociology of gender and medical sociology.
"Why medicate away a normal life event if we're not sure of
the long-term effects?"
In recent years, as the hormone content of birth-control pills
has dipped, failure rates have climbed. The FDA is considering whether
to establish an acceptable failure rate for the pills. In January,
a panel of agency advisers said less-effective birth-control pills
should still merit federal approval if they promise other benefits,
including improved safety.
Generally, lower-dose birth-control pills can reduce the risk of
serious and sometimes deadly side effects, including blood clots
and stroke, associated with their use.
The injectable hormonal contraceptive Depo-Provera also can eliminate
monthly periods.
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