Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Contraception that will minimize periods

6 June, 2018

Question:

I have a very difficult time being in niddah and was looking for a birth control method that would minimize my periods in order to minimize my need to be in niddah. The Dr. suggested Mirena with the hopes that it would stop my period. I had Mirena inserted, but I am still having regular cycles. Do you know of anything I can combine with Mirena to help minimize or manipulate cycles? The doctor was unsure. I am seriously considering having the Dr. remove the Mirena. What is the best method of birth control that will minimize periods and niddah status?


Answer:

We are sorry to hear that niddah has been so difficult for you. Sometimes, a conversation with a yoetzet halachah can help a woman find ways to improve her experience of niddah. Please don't hesitate to contact us if you'd like to share more about your difficulty or would like a referral to a local yoetzet.

As for Mirena, it generally takes about six months before it stops or minimizes menstruation. If you have had it for less time, we suggest you wait longer to see if it will have the desired effect.

Another option is to use combined hormonal contraception, and extend time spent on active hormones before taking the placebo. In this way, you will be niddah less often. You can use a standard combined hormonal method (pill, patch, or ring) and gradually extend the time you are using the active hormones to the maximum time (up to three months) that your body can go without breakthrough bleeding. (There are pill formulations meant to be used this way, such as Seasonale and Seasonique, but they have a high incidence of breakthrough bleeding.)

Combination hormonal contraception can also be taken in conjunction with Mirena. After a few cycles, you can stop to check what happens with the Mirena alone. It is also possible to use progesterone alone while on Mirena to push off the next cycle. This may make the actual bleeding heavier than usual.

All these medical options should be discussed further with your physician. If your current physician is not familiar with these options, you could consider seeking a second opinion.

No matter what you choose, it is important to review the laws of stains (as by reading our site's articles "Stains" and "Toilet Paper") so that you do not become niddah unnecessarily.

Please write back with any further questions.


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