Postpone menstruation

There are many reasons why a woman may want to take a pill to delay periods.

Monthly menstruation can be very painful. The hormone fluctuations can completely disrupt the state of mind, as a result of which some women can no longer function normally. In one woman, the loss of blood is not that bad, but in other women, it can be a lot. There may be situations where a sanitary towel or tampon has to be changed every hour.

In addition, cramps, headaches and possible nausea may occur. A link has been established between menstruation and bouts of migraines. This can be a good reason to keep your period to a minimum. Certain medications allow you to choose to have your period once every six weeks, or maybe even not to have it for a year.

Another reason to take a pill to delay periods may be that a medical procedure is planned. Specialist and hospital schedules cannot be adapted indefinitely to your menstrual cycle, and you yourself may not want to have your period while in hospital, both during surgery and during the recovery period. This can also be a good reason to postpone or bring forward your period.

Finally, there are social reasons to take a pill to delay periods. It happens to every woman once in a while; you have planned a great holiday and find out that you will get your period exactly in that week. Or you may need to make a presentation in the middle of the week of your period. In these situations, it is convenient to be able to adjust your cycle.

Fortunately, there are options to postpone, advance or stop periods, even if you are not taking a contraceptive pill.

The menstrual cycle is a monthly cycle around ovulation. In the course of the cycle an egg matures, the uterus prepares for a possible pregnancy, the egg is released after the fertile period and the uterus is cleared for the next cycle. The duration can vary from 24 to 37 days.

1. The beginning of the menstrual cycle is marked by the moment when your period begins. This is day one of a phase that lasts on average five days, with a peak around the third day. Actually, this phase should be seen as the last one. It is the phase in which all preparations for a possible pregnancy occur. In this phase, the uterine wall lets go of the lining, the mucous membrane of the uterus, and discharges it together with the unfertilised egg. This is accompanied by blood loss, and you lose about 50 millilitres of blood. For many women, menstruation is also very painful. You may experience cramps in the muscle tissue of the uterus, and headaches and nausea are also common side effects;
2. The second phase runs from the sixth day up to and including the fourteenth day. This is called the follicular phase. In this phase, under the influence of hormones, the uterus is prepared for a possible pregnancy. Moreover, in one of the ovaries, an egg begins to ripen. It is ripe between the tenth and fourteenth day of the cycle;
3. The third phase is on or around the 14th day. Ovulation now takes place. In this process, the ripe egg cell separates itself from the ovary and ends up in the fallopian tube. Some women may even feel ovulation, often in the form of shooting pain lasting from a few minutes to hours. From this moment on, you are fertile;
4. In the fourth phase, the luteal phase, the egg is on its way to the uterus. During this journey, which takes a few days, the egg can still be fertilised. The egg can still live In the uterus for 24 hours. If the egg is fertilised, it will settle down and the placenta will take over the production of hormones. If the egg is not fertilised, your body will automatically prepare to discard the egg. And that completes the cycle.

When you use hormonal contraceptives, there is no menstrual cycle. In this case, no egg ripens, and the uterus does not prepare itself for possible fertilisation. The bleeding from the first phase is therefore not menstruation, but withdrawal bleeding.

This means that you may be able to use the contraceptives that you already take as a pill to stop periods and control the timing of this withdrawal bleeding. You can use them to make the bleeding occur sooner or later, or even skip it completely.

Research has shown that it is safe to use your hormonal contraception continuously for 1 year. You remain protected against pregnancy and there are no known additional risks. However, the risk of breakthrough bleeding increases, but this is only an inconvenience. You can solve this by incorporating a stop week and then carrying on with continuous use. It has not been investigated whether it is also safe to take a pill to stop periods for more than one year, but there is no reason to assume that this is harmful.

There are no pills to stop menstruation immediately, However, if you are already using the contraceptive pill, postponing your period is usually easy. Please note that you can skip a stop week about 3 times. After that, the risk of breakthrough bleeding increases.

The different kinds of contraceptives for women are:

• Single-phase pill:
  The single-phase pill is an easy way to stop your period. If your strip has 21 or 22 pills, you can easily skip the stop week and immediately continue with the new strip. If your strip has 28 pills, the last six are placebos. Skip these and start immediately with the new strip. If you want to plan your period to take place earlier, it is possible to do so by starting the stop-week earlier. Make sure that you take at least 7 pills from a strip in order to do this.
• Multi-phase pill:
  In two-, three- or multi-phase pills the composition of the tablets differs in a strip. You can postpone your period by continuing with the pills of the last phase of a new strip after swallowing the last pill from a strip. As this is more complicated, you can also choose to temporarily switch to a single-phase pill.
• Mini pill:
  The mini pill is continually taken without stop weeks. With this pill you cannot adjust the length of your menstrual cycle. Again, you can choose to temporarily switch to a single-phase period pill to delay periods.
• A vaginal ring or contraceptive patch:
  The same conditions apply. This contraceptive does not allow you to adjust your menstrual cycle, but it does allow you to switch temporarily to the single-phase pill.
• Hormone coil:
  This is the only form of contraception where you cannot affect the timing of your periods. The coil is not suitable for adjusting the menstrual cycle, and the procedure to remove it temporarily is too inconvenient just for this purpose.

If you don’t use contraceptives but still want to change your cycle, you can ask your doctor to prescribe a hormone-related pill to delay your period. This allows you to postpone your period for a maximum of two weeks.

Some of the common hormone pills available are:

• Norethisterone:
  To postpone your period, start taking the pills two to three times a day for a maximum of 10-14 days 3 days before your expected period. As soon as you stop, the withdrawal bleeding will start two to three days later. This method is only intended for those cases where pregnancy in the relevant cycle is not possible. A progestogen/oestrogen combination is preferred for early menstruation. Please note - pills with progestogen only do not protect against pregnancy.
• Lynestrenol:
  These pills should be taken two weeks before your expected menstrual period. Keep taking them as long as you do not want your period. As soon as you stop, menstruation will start after two or three days. This allows you to postpone your period for a maximum of two weeks, but if you have started taking the pills later, you can postpone your period for a maximum of one week.
• Primolut N:
  This pill contains Norethisterone and you take it 2-3 days before your period is due. You take it for as long as you want to delay your period, but for no longer than 14 days.
• Utovlan:
  This pill also contains Norethisterone and you take one 5mg pill 3 times a day 3 days before your period is due. You take it for as long as you want to delay your period, but for no longer than 14 days. Bleeding will start approximately 3 days after you stop taking Utovlan.
• Other pills to stop periods are Yasmin, Orgametri, Ovestin and Microgynon.
  
  You should always take the advice of your doctor before taking period pills.

There are alternative medicines to delay periods or bring them forward, but this is a matter of choice and there is no guarantee they will work.

• Ginger:
  Ginger is a herb. Some people believe that drinking strong ginger tea speeds up the beginning of the menstrual cycle as this causes menstrual cramps and starts the menstrual period. This has not been scientifically proven. To make the tea even stronger, you can boil thin slices of ginger root in water for 10 minutes. This method of preparation is called a decoct; the water can absorb more of the contents of the ginger than with an infusion (tea). Season the drink with lemon juice and honey and you have a delicious drink.
• Parsley:
  This herb is also said to induce menstruation. You can make tea from crushed parsley leaves, or use extra parsley often as a garnish.
• Carrots, pumpkin, pomegranate, papaya and pineapple :
  These are other vegetables and fruits that could accelerate your menstrual cycle. Without exception, they are also very healthy products, so this is definitely worth a try!
  
  All these products raise your body temperature. If you supplement your diet with these products from about two weeks before your expected menstrual period, there is a good chance that you will have had your period before you go on holiday, or before you have to give that important presentation. However, this has not been scientifically proven.

Intensive exercise, whether through sport or hard physical work can result in your period being delayed. In order to achieve this, you need to exercise intensively, so it is not the most obvious or reliable method.

Conticonceptie.nl (s.j.), Hormone spiral, consulted on 2 May 2019, at https://www.anticonceptie.nl/product/spiraaltje/hormoonspiraal/

Hendriks, R.J. (2017), Postpone your period, or bring it forward? 2 x 6 home remedies, consulted on 2 May 2019, at https://www.optimalegezondheid.com/menstruatie-uitstellen-vervroegen/

Nederlands Huisartsen Genootschap (2016), NHG Treatment Directive for Menstrual Delay, consulted on 2 May 2019, at https://www.nhg.org/themas/publicaties/nhg-behandelrichtlijn-menstruatie-uitstel

Niemantsverdriet, J (2017), Postponing Menstruation, how do you do that?, consulted on 2 May 2019, at https://www.gezondheidsnet.nl/menstruatie/menstruatie-uitstellen-hoe-doe-je-dat

Thuisarts.nl (2017), I want to postpone my period, consulted on 2 May 2019, athttps://www.thuisarts.nl/menstruatie- uitstellen/ik-wil-mijn-menstruatie-uitstellen