Period Delay

There are many reasons why a woman would want to delay her period. These include going on holiday, a special time such as a wedding, a sporting event, an important meeting, a job interview, driving test or a time of stress such as a bereavement or difficult situation.

Periods can be difficult to manage. Women have to deal with the physical side of changing sanitary products, such as the regular need to change tampons or sanitary towels. This is not always convenient particularly on holiday when you don't know the availability of a bathroom or where to get supplies.

Sanitary wear must be refreshed to avoid toxic shock syndrome which can develop without regular changes. Toxic shock is caused by a build-up of bacteria that releases toxins and damages tissue or stop organs working. It's associated with tampon use and can be fatal.

Alongside the physical aspects, periods bring a change in hormones. This can mean PMS for a lot of women. These symptoms include anxiety, stress, upset and emotional troubles. These aspects are not welcome during stressful times or periods of enjoyment.

No matter the reason it is possible to delay your period until a more convenient time. Many women do so and it is not harmful.

There are two ways women can delay a period. Using the combined contraceptive pill, patch or ring or with a medication.

The combined contraceptive pill

Women already taking the combined contraceptive pill can skip their period by taking up to three packets of pill without the seven-day break.

• Monophasic pill - Usually you'll take a pill for three weeks followed by a seven-day pill-free break. To delay your period start your second packet of pills without the break.
• Everyday Pills (ED pill) - ED pills contain 21 active pills and seven dummy pills. To delay your period take all 21 active pills but leave the dummy pills. Instead, start taking a new packet of pills.
• Phasic 21-day pills - These pills contain a mixture of hormones so it's harder to manage a period delay. Speak to your GP or pharmacist for advice.

Taking you contraceptive pill without a break is not harmful and it will still provide you will full contraceptive cover. If you use the patch or ring you can use the next month's supply without a break.

If you are not currently taking the pill but would like to your doctor will need to carry out a consultation to make sure it suits you. Combined contraception contains oestrogen, which certain women cannot take. This includes:

• If think you are pregnant
• If you smoke and are over 35
• If you stopped smoking over a year ago and are over 35
• If you are overweight
• If your current medications cause a contraindication
• If you have or have had a blood clot
• If you have heart disease including high blood pressure
• If you experience migraines with visual disturbances
• If you've had breast cancer
• If you have gallbladder or liver disease
• If you have been diabetic for over 20 years or have diabetes with complications

The mini progesterone only pill cannot delay a period, but brands containing desogestrel may prevent ovulation and therefore periods if you take it long term.

There is a prescription medicine that can be used to delay your period for up to 17 days and this is its primary objective.

• Period delay tablets are different from the combined pill. It contains no oestrogen, so it's suitable for a wider range of women.
• It's important to understand that period delay tablets are not a contraceptive. You will need to use contraception during the time you are taking period delay tablets.
• it should be started three to four days before your period is due, so you will need to have an understanding of your menstrual cycle. Three tablets containing 5mg of progesterone a day are required to stop your period. In order to successfully delay your period, you will need to take the tablets regularly and on time throughout the day.

When you stop taking period delay tablets, your hormones levels will return to normal and your period will arrive several days later. On occasion it takes longer than a few days. If you do not have a period you should take pregnancy test.

It is suitable for a variety of women but there are some who should not take it.

• If you are pregnant or think you might be pregnant
• If you are breastfeeding
• If you have unexplained vaginal bleeding
• If you have liver disease or complications
• If you have or have had breast, womb, and/or ovarian cancers
• If you've had blood clots
• If you have migraines with aura

Your doctor will consider your suitability for period delay tablets if you smoke, have diabetes, high blood pressure, liver or kidney problems or lupus.

The combined pill is the longest lasting period delay. You can take up to three packets without a break on your doctor's advice. You may experience some bloating, breakthrough bleeding and other side effects during this time. Don't take more than three packets in a row unless under supervision from your doctor.

Period delay tablets will delay your period for up to 17 days. It's not recommended that you take it for longer than this or use it regularly.

The combined pill works by making long-term changes to your hormones. It contains the sex hormones oestrogen and progesterone which are taken at a low dose each day. This manages your level of hormones and prevents ovulation.

Without ovulation you will not have a period. The bleeding experienced on the seven-day break is a withdrawal bleed from the hormones, rather than a period.

In contrast, period delay tablets only contains the hormone progesterone. Progesterone tablets keep your natural levels of progesterone high. When levels drop your body sheds it blood lining. The progesterone simply stops your womb from shedding for a time.

The combined contraceptive pill can cause side effects in some women. Not all women experience them and others find the benefits of the combined pill, including an over 99% effectiveness rate and the ability to control their menstrual cycle, is worth the more common mild side effects.

Common side effects, which should dissipate after three months include:

• Nausea
• Diarrhoea
• Breast tenderness
• Headaches
• Mood changes

There are other more serious side effects associated with the combined pill but these are rare. Rare side effects include a raised risk of blood clots and certain cancers. These risks are very small affecting a tiny majority of women on the pill.

Period delay tablets are used successfully by many women, including those sensitive to oestrogen such as smokers and overweight women, but there can be some side effects. The most common are:

• Stomach ache
• Breast tenderness
• Skin rashes
• Headache
• Disturbances in mood and sex drive
• Nausea

There are a number of rare but serious side effects that should be treated by a doctor as soon as possible. Few women experience a rise in blood pressure, jaundice, migraine/bad headache, dark brown urine, abdominal pain, sudden severe changes in your senses, blood clots. Very rarely an allergic reaction may occur. Symptoms are a tight chest, wheezing, a swollen mouth and/or hives.

Using the combined pill you can delay your period for up to three packets which makes nine weeks. Speak to your doctor if you need to do this regularly. Some women take the combined pill without a break frequently if they are experiencing a medical condition such as endometriosis or anaemia.

With period delay tablets, it is not recommended for frequent use. If you need to delay your period regularly it's worth speaking to your doctor about a more permanent method. Some birth control can prevent periods including the intrauterine system, the patch, injection and the newer mini pills containing desogestrel.

Will I experience any spotting?

It is possible that you will experience spotting using both the methods of period delay discussed. Starting period delay tablets less than three days before you period increases the possibility, as does taking the pills late or missing them. Usually spotting is light on the combined pill. Spotting is not anything to worry about and is quite common.