Some women may wish to delay a period. This may be if a period is due at a time that would be inconvenient - for example, on a special holiday, during an exam, etc. Delaying a period cannot be guaranteed but the following usually works.
Women taking the combined oral contraceptive pill
If you are taking a fixed-dose combined oral contraceptive (COC) pill (often just called 'the pill') then simply start the next pack without the usual seven-day break. Taking two packs back-to-back in this way is safe if it is done occasionally. You still only need to have a seven-day break at the end of these two packets.
If you are taking a triphasic or biphasic type of pill then you will need to take the last phase of the pills from the second pack immediately after finishing the first pack. Alternatively, you can change to a fixed-dose pill.
You should see your doctor, nurse or pharmacist if you are not sure which pill you are taking. The pills most commonly used are fixed-dose. If it is triphasic or biphasic usually the colour of the pill or the packet will not be the same throughout the month.
How does this work?
Women taking 'the pill' do not have normal periods. Rather, they are withdrawal bleeds which occur when the oestrogen in the pill is not taken. The hormones in the pill help to sustain the lining of the womb (uterus). The withdrawal bleed will not normally occur until the pill is stopped and the level of hormone in the body falls (usually once a month in the seven-day break between pill packs).
If you are not already taking 'the pill' then you may consider starting it if it is likely to be a suitable contraceptive for you in the future. You will have to start it a few weeks before your holiday though to ensure you do not have a period when you are away.
Women not taking the combined oral contraceptive pill
If you are not taking the COCP ('the pill') then a hormone tablet called norethisterone can be prescribed. The dose is one tablet (5 mg) three times a day. You start three days before a period is due. It can be continued until you want to have a period. Your period will then normally begin 2-3 days after stopping it. It can be taken for up to 3-4 weeks if necessary. This is only for use on an occasional basis for special events, rather than something to be taken regularly.
Norethisterone is normally safe to take. However, if you have an increased risk of having a deep vein thrombosis (DVT) this method may not be suitable for you. Your doctor will be able to discuss this with you. Some women have side-effects such as bloating, stomach upset, breast discomfort and reduced sex drive (libido).
How does this work?
Norethisterone is a progestogen hormone. Progestogens are hormones that sustain the lining of the womb (uterus). Normally at the time before a period there is a fall in the level of progestogen hormone in the body. When it falls below a certain level, the lining of the womb is shed as menstrual period. By taking norethisterone tablets (progestogen) the lining of the uterus is sustained until the tablet is stopped. Note: norethisterone taken in this way is not a contraceptive.
Further reading and references
Heavy menstrual bleeding - assessment and management; NICE Clinical Guideline (August 2016)
Management of Premenstrual Syndrome; Royal College of Obstetricians and Gynaecologists (2016)
Nevatte T, O'Brien PM, Backstrom T, et al; ISPMD consensus on the management of premenstrual disorders. Arch Womens Ment Health. 2013 Aug16(4):279-91. doi: 10.1007/s00737-013-0346-y. Epub 2013 Apr 27.
Amenorrhoea; NICE CKS, July 2014 (UK access only)
Dysmenorrhoea; NICE CKS, May 2014 (UK access only)
Menorrhagia; NICE CKS, June 2017 (UK access only)
Fibroids; NICE CKS, June 2017 (UK access only)
Singh SS, Belland L; Contemporary management of uterine fibroids: focus on emerging medical treatments. Curr Med Res Opin. 2015 Jan31(1):1-12. doi: 10.1185/03007995.2014.982246. Epub 2014 Nov 12.
Orozco LJ, Tristan M, Vreugdenhil MM, et al; Hysterectomy versus hysterectomy plus oophorectomy for premenopausal women. Cochrane Database Syst Rev. 2014 Jul 28(7):CD005638.
Brito LG, Pouwels NS, Einarsson JI; Sexual function after hysterectomy and myomectomy. Surg Technol Int. 2014 Nov25:191-3.
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