Postponing menstruation: choices and concerns

Abstract

Since writing an editorial for this journal in 20141 I have been repeatedly asked about my views on postponing menstruation. Women in the 21st century want to avoid periods when on holiday yet have difficulty accepting highly effective, reversible forms of contraception which provide infrequent bleeding. Authors of a BMJ article published 16 years ago suggested that prescribing progestogens to delay periods was a lifestyle choice and should not be funded by the National Health Service.2 I am not sure I feel that strongly but I do think women need to know all options and any potential risks or side effects associated with each treatment – they may think twice. Only one drug is licensed to postpone menstruation in the UK and that is norethisterone. The Summary of Product Characteristics (SPC) state that at low dose’ (5 mg three times a day) norethisterone may be used to treat “metropathia haemorrhagica, premenstrual syndrome, postponement of menstruation, dysmenorrhoea, endometriosis and menorrhagia”.3 There is limited evidence to support these indications1 but it does delay the onset of …