And then there are worries about more pernicious health problems. Even as many experts tout the safety of menstrual suppression, others -- particularly those suspicious of oral contraceptives to begin with -- voice concerns about the health risks of a placebo-less pill hormone regimen. Since long-term use of estrogen products has been linked to an increased risk of breast cancer, some doctors fear that a daily dosage of the hormone could be particularly harmful. And Rako says that nonstop pill usage could increase the odds of contracting cervical cancer among women who have the human papilloma virus (HPV), a not uncommon sexually transmitted disease. Pointing to studies connecting the traditional birth control pill with higher incidences of cervical cancer among HPV-infected women, Rako worries that Seasonale and other menstrual suppression regimens will increase women's risk of cervical cancer even more.

"The normal menstrual period is a somewhat complicated process," adds Dr. Edward Kleiber, an endocrinologist with the University of Massachusetts Medical Center who is leery of the traditional birth control pill -- and even more suspicious of a pill that eliminates periods altogether. "We've been manipulating it as though we could do it without any serious implications." Pointing to the recently publicized health hazards associated with certain hormone replacement regimens, and to the heightened risk of heart disease that has been linked to Depo-Provera, Kleiber says that tampering with a woman's natural hormonal balance is no small risk.

Difficult as these medical debates may be to resolve, the sociological questions may be even more divisive. For better or worse, the monthly period has become deeply interwoven with many women's identity, a badge of honor connoting health and fertility and communion with nature -- or a curse, depending on whom you ask.

Jordan Rosenfeld, a 29-year-old freelance writer in San Francisco, says she would never voluntarily eliminate her own period. "It's an event that I've known pretty consistently for more than half my life," she says, with a hint of wistfulness in her voice. "There's a certain amount of my feminine identity that's attached to having my period." And although Rosenfeld suffers from moderate cramps, she describes a certain satisfaction in feeling the workings of her uterus on a monthly basis. "Maybe there's a certain kind of pride you get in suffering," she says.

In Rako's view, toying with a woman's emotions and libido -- both of which she says rise and fall throughout the monthly hormonal cycle -- amounts to meddling with her very femaleness. "It is appalling to me to think that some parents with teens might petition their doctor to give their daughters nonstop birth control pills," says Rako. "Girls in their teens need to get to know themselves and their bodies and their rhythms and their sexuality."

Even advocates of menstrual suppression acknowledge that the thought of forgoing monthly periods is hard for a lot of women to swallow. According to Dr. Anita Nelson, a professor at the UCLA medical school and a member of the advisory board of Barr Laboratories, many female patients first regard period stopping with some degree of suspicion. But Nelson says that once women separate the facts about monthly menstruation from the myths, they often experience a "wave of anger" that comes from the realization that they've been enduring monthly cramps for no reason.

Dian Campbell, a 48-year-old craftsperson in Seattle who has been practicing menstrual suppression for two years, counts herself among those who endured needless pain for too long. After struggling with severe cramps and flu-like symptoms every month, Campbell's doctor recommended she take birth control pills with no placebos. "I am so happy to not be spending a couple of days a month in [misery], psychologically, mentally, emotionally -- to say nothing of the physical," Campbell says. "I was certainly not cherishing anything about any of that womanly stuff."

Likewise, Sandra Wooten, a 41-year-old unemployed banker, says she wasted too many years enduring monthly abdominal pain. After taking high doses of over-the-counter drugs, then prescription narcotics, and eventually having two surgical procedures on her uterus, Wooten finally found salvation when her gynecologist suggested menstrual suppression. Two years later, pain free and period free, Wooten wonders how -- and why -- she withstood those years of pain.

Then there's the feminist case to be made for menstrual suppression, and it's one that the backers of Seasonale are promoting. Some studies show that menstruation-related suffering is a leading cause of missing school days and workdays for girls and women. And that even when menstruating women are present, they are less productive during their periods.

"When you're talking about a glass ceiling, I wonder if women walk past the Kotex to get there," says Nelson. Recalling the case of a 12-year-old patient whose severe menstrual cramps caused her to miss several days of school each month and fall behind in her classes, Nelson says there's a fine line between exploring your femininity and needless torture.

"They need to learn pain and suffering? They need to know that women have a different role in life?" Nelson asks indignantly. "What if guys had clumps of blood coming out of the ends of their penises? We would have come out with this a decade ago."

Maybe so. But for women like Angela Fontaine, the advent of Seasonale is better late than never. And as menstrual-suppression regimens make their way into pharmacies around the country, each woman will have to decide for herself: to bleed or not to bleed.

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