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2.
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Norethisterone Tablets from £20
Advice for Period Delay
There are many circumstances in a woman’s life when she may wish to postpone her period due to the inconvenience caused by pain and discomfort. Going on a holiday, performing a religious pilgrimage, preparing for a wedding or sporting event, are some of the most common reasons for wanting to delay one’s period. But women who have very heavy or painful periods may also want to delay their monthly bleeding if they’re facing a big day at work or they have an event to attend. Whatever the reason, delaying your period is actually a perfectly safe thing to do, provided you use the correct methods.
At Pharmacinta, our period delay treatment Norethisterone is a synthetic version of the female hormone progesterone. Progesterone contributes to the regulation of the monthly menstrual cycle, and thickens the uterus lining every month in preparation of receiving a fertilised egg. If you don’t get pregnant, your progesterone levels fall, causing the womb lining to shed and your period to begin.
Norethisterone works by mimicking your natural progesterone levels, keeping them raised which stops your womb lining from shedding and delays your period. This needs to be started 3 days before your expected period, and can be used to delay your period for up to 17 days. It is taken three times a day, and upon completing the course of treatment the period usually starts two to three days later.
The main symptom of primary dysmenorrhoea is cramping pain in your tummy (lower abdomen). The pain can also spread to your lower back and your thighs. You may feel this a few days before and/or during your period, and it usually gets better at the end of your period. As well as pain, you might have some other symptoms before or during your period, such as:
- Tiredness
- Feeling sick or being sick
- Diarrhoea
- A headache or feeling light-headed
- Bloating
- Emotional symptoms such as mood swings
The duration of pain is completely individual and may start one to two days before you begin bleeding. It will last (on average) for around three days.
If you have secondary dysmenorrhoea, besides cramping pain you might also have a feeling of heaviness in your tummy, and back pain. You may also have other secondary dysmenorrhoea symptoms, such as:
- heavy or irregular periods
- bleeding in-between periods
- an unusual discharge from your vagina
- pain during sex, and you may bleed afterwards
Period pain is caused by muscular contractions of the womb’s wall. During menstruation, these contractions become more intense, in order to encourage the wall to shed its lining. These stronger contractions cause the wall of the womb to press against the surrounding blood vessels, briefly cutting off the womb’s blood supply. Without blood, the womb becomes temporarily deprived of oxygen, which causes the affected tissues to release a pain-triggering chemical. This, in turn, causes the body to produce another chemical called prostaglandins. Prostaglandins will cause the muscles in the womb to contract further, which will increase the intensity of the period pain even more.
Period pain can be caused by an underlying medical condition. This kind of period pain is called secondary dysmenorrhoea. Some of the conditions that can cause secondary dysmenorrhoea include:
- Endometriosis: Where the cells that line the womb begin to develop elsewhere in the body, usually the ovaries and fallopian tubes. As these cells start to shed, they can cause intense pain.
- Pelvic inflammatory disease: A bacterial infection that affects the womb, causing it to become inflamed and irritated.
- Intrauterine devices: Also known as IUDs, these contraceptive devices are made from plastic and copper. Fitting inside the womb, they can sometimes cause period pain.
- Fibroids: is a condition caused by non-cancerous growths inside the womb. These benign tumours can make periods heavier and more painful.
- The intrauterine device (IUD) may also make period pain worse. This is a contraceptive device that is inserted into your uterus - it is usually made of plastic or copper.
While any woman can develop dysmenorrhea, the following women may be at an increased risk for the condition:
- Women who smoke
- Women who drink alcohol during their period (alcohol tends to prolong menstrual pain)
- Women who are overweight
- Women who started their periods before the age of 11
- Women who have never been pregnant
Period delay medication is a tablet taken specifically to delay your period. It contains the active ingredient Norethisterone, although it can be branded under different names including Utovlan. It can be suitable for occasional use, but should not be taken regularly.
To delay your period using Norethisterone, you will need to take one tablet three times a day and start the course three days before your period is expected. After the course has finished, your period should start within three days of stopping the pill. You can take the tablets for a maximum of 20 days, which will delay your period by a maximum of 17 days.
Most women find that Norethisterone prevents their period from starting until they choose to stop taking the tablets. However, some women find that they have spotting or breakthrough bleeding while they are taking Norethisterone. Starting to take Norethisterone less than three days before your period is due to start greatly increases the chance of spotting.
Norethisterone is a synthetic progesterone. During the menstrual cycle, a woman’s oestrogen and progesterone levels vary. A drop-in progesterone is what triggers a period to start. Norethisterone works by keeping your progesterone levels artificially high, which prevents the triggering of a period.
Back-to-back combined pill (monophasic pills)
Typically when on the combined contraceptive pill you would allow a break in the active pills each month for menstruation. If you take the active pills back-to-back, you may prevent or delay your period. To do this, you would take the 21 days-worth of active contraceptive pills, immediately followed by starting the next pack of active pills, skipping the 7 days without taking the pills. Doing this will not change how the contraceptives work in terms of preventing pregnancy.
It’s safe to take packs back-to-back. Some women take 3 packets in a row, and then have a 4 or 7 day break. Some women take the combined pill continuously with no break. You might find that you get breakthrough bleeding or spotting if you take the pill constantly.
Most brands of the combined contraceptive pill can be used in this way, including Microgynon, Rigevidon and Yasmin.
Back-to-back combined pill (phasic pills)
Phasic combined contraceptive pills contain different quantities of hormones in each pill. You can delay your period when using this pill, but it’s not as simple as taking 2 packs back-to-back. It’s best to speak to your clinician about the best way to go about this.
Progestogen-only pill
For some women taking the mini pill, their periods will become lighter and stop. For others, they will continue to have regular bleeding, and the last group will experience irregular bleeding. It is difficult to know how a woman would respond to the mini pill until they start taking it, and therefore it is not usually a reliable way to stop one’s period.
Other contraceptive methods
- Hormonal coils – can stop periods, but it takes a few months before they stop.
- Injections – about half of people who use the injection will stop having periods.
- Implants – about a third of people with the implant stop having periods, but this only applies from one year after getting the implant.
Frequently Asked Questions
Warming the uterus for example by sitting in a hot bath or using a warm compress on the lower abdomen, can cause local dilation of blood vessels and increased blood supply, which increases the menstrual blood flow.
Anything that increases the levels of female hormones, especially oestrogen, can cause an increase in the risk of developing blood clots. This includes pregnancy, taking hormonal contraception, as well as using hormones to delay the period. The risk of blood clots when using hormones to delay periods is very small as they are used for a very short time compared to contraceptive use, although in stronger doses.
Taking tablets to delay periods is for occasional use only. If you need more control over the timing of periods, discuss with your own GP. Several methods of contraception also have the effect of stopping or significantly reducing periods.
There is evidence that a sudden starting of a high volume of physical training can disrupt the menstrual cycle, but how much is directly due to the exercise and how much to weight loss is not clearly established.
Yes, a natural response to severe stress is not to ovulate but it is not desirable to use stress in this way.
No. Coffee has been shown to affect female hormone levels but the effects are not significant enough to be used to delay a period.
You normally get your period when the lining of your womb sheds. The hormones in the combined contraceptive pill help to sustain the womb lining, and so taking back-to-back packets sustains it for longer.
It is safe to delay your period if you have no risk factors to taking the hormone medication. It is not however recommended to take period delay medications on a regular basis for long periods of time.
While some women experience light or no periods with some forms of contraception, there isn't a treatment that will stop periods completely. Most women will experience a monthly period until they reach menopause.
Yep – if you want to go through your GP to get period delay tablets you can. .
No, period delay tablets are prescription-only. There are some serious health risks for certain people if they were going to take progesterone medications like period delay pills.
If you delay your period by taking period delay medication, you will not be protected against pregnancy. If you have unprotected sex whilst taking Norethisterone, you could become pregnant.
After your course of Norethisterone has finished, your period should come within three days. If your period does not arrive then this could be a sign of pregnancy. You should take a pregnancy test or check with a doctor to make sure that you are not pregnant.
Some women may not observe their period a few days after they stop treatment with Norethisterone, but it may be slightly delayed whilst your body takes time to re-adjust to the hormone changes. However, its recommended to take a pregnancy test if you do not get your period within a week of ceasing treatment, to rule out the possibility of pregnancy.
No, you cannot take norethisterone if you are pregnant or trying for a baby.
Talk to your doctor about alternative ways of delaying your period or feeding your baby if you did decide to take norethisterone.
You can drink alcohol when taking norethisterone. If you drink too much and vomit (be sick) within 2 hours of taking a tablet, it will not have been absorbed into your system.
Yes, you can take painkillers such as paracetamol and ibuprofen while taking norethisterone.
You should tell your doctor that you are taking norethisterone if you are prescribed antibiotics. This is because some antibiotics interact with norethisterone.
Norethisterone has been used by women for many years to delay periods. It has recently been shown that there is a slightly higher risk of developing blood clots. For this reason many doctors prefer to prescribe Provera which has less risk of blood clots. There is no medical research as to which is most effective. Norethisterone is provided under the manufacturers licence for period delay, but using Provera in this way is 'off-label' which means that the doctors take responsibility for the prescribing.
