For those seeking to delay or skip a menstrual cycle, the key pharmacological principle involves maintaining a consistent level of hormones, typically estrogen and progestin, to prevent the uterine lining from shedding. The most common approach involves manipulating the standard cyclic use of hormonal birth control, though dedicated extended-cycle pills and other prescription medications also offer viable solutions. Always consult a healthcare provider before changing your regimen to ensure it is safe and appropriate for your health needs.
How to delay your period using contraceptive pills
Monophasic combined oral contraceptive pills
This is the most common method for those already using a standard combined oral contraceptive (COC) pill, where every active pill contains the same dose of hormones. A typical pack has 21 active pills, followed by seven inactive (placebo or sugar) pills. To delay your period, you simply skip the inactive pills at the end of a pack and immediately start the active pills of a new pack. Some well-known monophasic brands include Microgynon, Yasmin, and Rigevidon.
This continuous consumption of active hormones prevents the drop in hormone levels that normally triggers withdrawal bleeding. For many, taking two to three packs back-to-back is safe and effective. However, it's common to experience breakthrough bleeding, or spotting, especially in the first few months, which is not a health risk but can be inconvenient.
Extended-cycle oral contraceptive pills
For those who wish to have fewer periods on a regular basis, extended-cycle or continuous-use pills are a designed option. These regimens typically involve taking active hormone pills for 84 days, followed by a week of either inactive pills or low-dose estrogen pills, resulting in a period only four times a year. Some brands, like Seasonique, are specifically designed for this purpose. Continuous-use pills, such as Amethyst, involve taking active pills indefinitely to potentially eliminate periods entirely, though breakthrough bleeding may still occur.
Period delay pills: Norethindrone
For individuals who are not on hormonal birth control, or are on a progestin-only method (which cannot be used to delay periods), a doctor may prescribe a progestogen medication like norethindrone (also known as norethisterone).
Key facts about norethindrone:
- How it works: It's a synthetic form of progesterone that prevents the uterine lining from shedding as long as it's being taken.
- Timing: You start taking it a few days before your period is expected to begin and continue for up to 17 days.
- After stopping: Your period will typically begin two to three days after you stop the medication.
- Contraception: It is crucial to remember that norethindrone, when used for temporary period delay, is not a contraceptive. You must use a separate method, like condoms, to prevent pregnancy.
Comparison of period delay methods
| Feature | Monophasic Combined Pills | Extended-Cycle Pills | Norethindrone (Period Delay Pill) |
|---|---|---|---|
| Best for | Occasional delay, already on the pill | Scheduled, long-term fewer periods | Short-term delay for those not on COC |
| Mechanism | Skipping placebo pills for continuous hormones | Packaged for continuous use with few breaks | High dose of progestogen for temporary effect |
| Usage | Take active pills back-to-back | Follow specific 91-day or continuous regimen | Taken for a limited time just before period |
| Contraception | Yes, if taken correctly | Yes, if taken correctly | No, must use alternative contraception |
| Side effects | Breakthrough bleeding, bloating | Breakthrough bleeding, especially early on | Nausea, headaches, mood changes |
| Prescription needed | Yes, for the initial pill | Yes, specific prescription | Yes, temporary prescription |
Other hormonal options for menstrual suppression
Besides oral tablets, other hormonal contraceptive methods can also be used to delay or eliminate periods.
- Vaginal Ring (e.g., NuvaRing): Typically used for three weeks, a new ring can be inserted immediately after removing the old one, skipping the hormone-free week to delay the period.
- Contraceptive Patch (e.g., Xulane): Similarly, applying a new patch every week without a patch-free week can suppress bleeding.
- Hormonal IUD (e.g., Mirena): The long-term use of a hormonal intrauterine device often leads to lighter or no periods over time, though this varies by individual.
- Birth Control Injection (e.g., Depo-Provera): This injection provides a high dose of progestin every three months and can lead to a reduction or cessation of periods.
Considerations for delaying your period
It is important to discuss these options with a healthcare provider to determine the safest and most suitable method. While delaying your period with hormonal birth control is generally safe for most individuals, there are some factors to consider.
- Breakthrough bleeding: As noted, unscheduled bleeding or spotting is a common side effect when first starting continuous hormonal use. This usually decreases over time as your body adjusts.
- Pregnancy detection: Skipping your period can make it harder to tell if you are pregnant. If you experience symptoms like morning sickness, it's wise to take a pregnancy test.
- Fertility: Suppressing your period with hormonal contraceptives does not affect your long-term fertility. After you stop, your cycles will typically return to normal.
- Individual health: For certain medical conditions, such as migraines with aura, a history of blood clots, or certain types of cancer, combining estrogen and progestin might be contraindicated. A doctor can evaluate your specific health profile.
Conclusion
Several pharmacological options exist for those who want to delay their period, from manipulating standard monophasic birth control to using extended-cycle pills or temporary prescription medications like norethindrone. It is a safe and effective practice for most people and can improve quality of life for those with painful or heavy menstruation. However, the choice of method and regimen requires medical guidance to ensure safety and account for potential side effects. Always consult your doctor to find the best option for you, whether for a specific event or for continuous menstrual suppression.
For more information on the safety of suppressing menstruation, refer to the guidance from the American College of Obstetricians and Gynecologists.
