In contrast to surgical options for this purpose, such as hysterectomy or endometrial ablation, hormonal methods to manipulate menstruation are reversible.
[1][2] In addition, suppression of hormonal cyclicity may benefit menstrual-related mood swings or other conditions which increase in frequency with menses.
[3] Management of menstruation may be a challenge for those with developmental delay or intellectual disability, and menstrual suppression can benefit individuals with specific job- or activity-related needs.
[1][4] There is increasing attention being given to menstrual suppression for transgender men and non-binary transmasculine people who may experience dysphoria with menstruation.
[1] There is also a growing recognition that transgender men and non-binary transmasculine people may experience dysphoria with menses, and thus may request medical therapy for menstrual suppression.
These methods have traditionally been used in a cyclic fashion, with three weeks (21 days) of hormones, followed by a 7-day hormone-free interval (with combined oral contraceptives, often with a week of placebo pills) during which time withdrawal bleeding or a hormonally-induced menstrual period occurs, mimicking an idealized spontaneous menstrual cycle.
The rate of amenorrhea (no bleeding) is in the range of 60% for users who are continuing to use combined hormonal contraceptive pills at the end of a year.
Estrogen negative feedback on the anterior pituitary greatly decreases the release of FSH, which makes combined hormonal contraceptives more effective at inhibiting follicular development and preventing ovulation.
Low-dose progestogen-only contraceptives, including traditional progestogen-only pills (e.g., norethisterone (Micronor, Nor-QD, Noriday)), levonorgestrel-releasing implants (Norplant, Jadelle), and hormonal intrauterine devices (IUDs) (e.g., levonorgestrel (Mirena)), inhibit ovulation in about 50% of cycles and rely mainly on other effects, such as thickening of cervical mucus, for their contraceptive effectiveness.
High-dose progestogen-only contraceptives—the injectables DMPA (Depo-Provera) and norethisterone enanthate (Noristerat)—completely inhibit follicular development and ovulation.
Among oncologists caring for adolescents with cancer, GnRH modulators were the most commonly recommended treatment for menstrual suppression to prevent or treat heavy bleeding during therapy.
[12] The hormonal agent danazol (Danocrine) was once used for the treatment of endometriosis, and was associated with amenorrhea, but its use was limited by androgenic side effects such as the potential for permanent lowering of the voice or hair growth.
As these side effects may be desired in transgender men and non-binary transmasculine people, there has been some consideration of this option for menstrual population in this group of individuals.
The intention behind this decision was the hope of the inventor, John Rock, to win approval for his invention from the Roman Catholic Church.