7.3.6 Delaying Menstruation During Holidays

Delaying menstruation during holidays

Patients already taking COCs can delay menstruation by taking two packets back-to-back (for monophasic 21-day pills). Advice differs for other pill types. See NHS choices for further details.

For patients not taking hormonal contraception, norethisterone 5mg three times daily, started 3 days before the expected menses can be prescribed. Menstruation will occur 2-3 days after stopping taking the norethisterone.

Norethisterone is partially metabolised to ethinylestradiol and a daily dose of 10-20mg of norethisterone is estimated to be equivalent to taking a 20-30microgram COC pill. It should be avoided in women at increased risk of VTE. There is some limited evidence to suggest medroxyprogesterone acetate 10mg three times a day may offer a safer alternative for high risk women (off label prescribing).