Delaying menstruation

This usually refers to delaying menstruation through hormonal manipulation rather than trying to prevent premature menarche in precocious puberty. This is usually requested to avoid periods during awkward times: honeymoon, holiday, travel, exams, etc.

Some medical practitioners have hesitations about prescribing in what is essentially a non-medical/lifestyle situation, but others are more sympathetic and take a more pragmatic view that the side-effects are minimal in comparison to the benefit to the patients.

This can be achieved by

  • Norethisterone (“NET”)
  • Extending the duration of the combined oral contraceptive pill, i.e. using more than one pack without a pill-free interval. Warn that break-through bleeding may occur.
  • Medroxyprogesterone acetate 10mgs bd or tds, which may be preferred over norethisterone, particularly in women who are overweight, smokers aged over 35 and any other woman at risk of venous thromboembolysm.

Whatever approach is taken it may be more sensible to delay the period before the one which would be troublesome, rather than complicating whatever the event is with treatment.

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