Chapter 7 – Abnormal Uterine Bleeding and Other Disorders of the Menstrual Cycle

Menstrual suppression

Requests to delay a menstrual period

Requests to delay or skip a menstrual period because of an important event are common. Ideally there is sufficient time to be able to advise at least 3 weeks of a combined hormonal contraceptive method (a pill or vaginal ring) for those who are medically eligible following which the hormone-free break can be skipped in order to avert a withdrawal bleed. Alternatively, 1 tablet norethisterone 5mg (Primolut N) 2 to 3 times daily for up to 10 -14 days, beginning about 3 days before the expected menstruation can be used.  Bleeding will occur 2 – 3 days after having stopped medication. Note that due to the partial conversion of norethisterone to ethinyloestradiol, administration of Primolut N is expected to result in similar pharmacological effects as seen with COCs including an elevated risk of venous thromboembolism and should therefore not be used in women with pre-existing VTE risk factors.

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Women living with disability

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Menstrual Suppression in trans men and gender diverse individuals

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