"As more companies bought into the idea, the week of placebo pills was here to stay. Doctors liked that they made explaining the instructions to women easy. Women liked having one fewer thing to remember about their birth control. Few questioned why women on the pill should be having a “period” at all. Today there are a small handful of options that reduce or eliminate monthly bleeding: Seasonale, a form of the pill sold in packets of 84 active pills and seven placebos that make it so bleeding happens just four times a year, became available in 2003. In 2007, the F.D.A. approved Lybrel, the first oral contraceptive to provide continuous active pills, with no breaks for withdrawal bleeding. Doctors agree that a menstrual cycle can be a useful indicator of overall health, and yet it still isn’t necessary. When Dr. Lori Picco’s patients ask if they can skip the inactive pills, she says she tells them to go right ahead. “It’s completely fine — there’s no medical concerns,” says Dr. Picco, a gynecologist at Capital Women’s Care in Washington and a fellow of the American College of Obstetrics and Gynecology. “Honestly, I would think people would want to do it all the time.”"