Periods do not always arrive at a convenient time. A holiday, wedding, sporting event, festival or long-awaited break can become more difficult to plan around when your expected period falls during the dates you will be away. Murrayfield Pharmacy offers a private period delay service to help suitable patients postpone a period following a clinical assessment and prescription.
Period delay treatment is not suitable for everyone, and it is important to plan ahead. The medicine must be started at the right point in your cycle, and there may be occasions when an alternative approach or further medical advice is needed. This guide explains how the service works, when to arrange it and what to discuss with the pharmacist.
What is the period delay service?
The service assesses whether a prescription medicine called norethisterone is appropriate for you. Norethisterone is a progestogen, a medicine that can temporarily delay the lining changes associated with a period. When it is stopped, a withdrawal bleed commonly occurs within a few days, although the timing can vary between individuals.
Norethisterone is not a contraceptive. It does not protect against pregnancy and should not be used as a substitute for contraception. If pregnancy is possible, this should be discussed during your consultation. You should also continue to use appropriate contraception and protection against sexually transmitted infections where relevant.
The service is provided following a confidential clinical assessment. The pharmacist will consider your health, medicines, menstrual pattern and travel or event dates before deciding whether treatment is suitable. If there is any uncertainty or a concern that requires a GP or other healthcare professional, you may be advised to seek further assessment.
When should you book?
It is best to arrange a period delay consultation as early as possible, particularly during busy summer travel periods. Early planning gives time to check your suitability, confirm the expected dates of your period and arrange the prescription before you leave.
Norethisterone is generally started around three days before the expected start of a period. It is therefore important to know, as accurately as possible, when your next period is likely to begin. Your cycle may be less predictable if you have recently stopped or started hormonal contraception, have irregular periods, are breastfeeding, have been unwell or are experiencing significant stress.
A consultation arranged too close to the expected start date may leave insufficient time to assess you or may mean the medicine is less likely to work as intended. Do not wait until you are already bleeding before seeking advice, as starting treatment at that point may not provide the desired result.
Useful information to have ready
- The first day of your last period.
- Your usual cycle length and whether your periods are regular.
- The date your next period is expected.
- The dates of your holiday, event or travel.
- Any contraception or hormone treatment you use.
- A list of medicines, supplements and allergy information.
- Relevant medical conditions and previous problems with hormonal medicines.
How the prescription is planned
During the consultation, the pharmacist will ask questions about your medical history and the dates you wish to cover. If norethisterone is considered suitable, you will be advised when to start and how to take it. Follow the instructions on the prescription and do not change the dose or extend the course without clinical advice.
The medicine is usually taken at regular intervals each day for the period delay required. The exact instructions will be confirmed for you. Once the course ends, a period-like withdrawal bleed usually follows after a short interval, but this is not guaranteed to occur on a precise day. This is worth considering if you are planning onward travel, a special event or a return to work.
If you miss a dose, take it when you remember unless it is nearly time for the next dose. Do not take extra tablets to make up for a missed dose unless a healthcare professional tells you to do so. If you are unsure what to do, contact the pharmacy or follow the advice supplied with your prescription.
Who may not be suitable?
Norethisterone is not appropriate for everybody. The pharmacist will check for conditions and circumstances that could make treatment unsuitable or require medical supervision. These may include current or previous blood clots, certain clotting disorders, serious liver disease, unexplained vaginal bleeding, some hormone-sensitive conditions or a known allergy to the medicine.
You should tell the pharmacist if you have migraines, high blood pressure, diabetes, epilepsy, asthma, kidney or liver problems, depression or any other ongoing condition. You should also mention if you are pregnant, trying to become pregnant, breastfeeding or unsure whether you could be pregnant.
Some medicines can affect how hormonal treatments work or may increase the risk of side effects. Tell the pharmacist about all prescribed medicines, pharmacy medicines, herbal remedies and supplements. This includes medicines used for epilepsy, tuberculosis, HIV or other long-term conditions. Do not assume that a medicine is irrelevant because you only take it occasionally.
Side effects and when to seek help
Some people experience no significant problems, while others may notice symptoms such as nausea, headache, breast tenderness, bloating, mood changes or changes in bleeding. A small amount of spotting can occur, particularly if treatment is started later than advised or if the body does not respond fully.
Seek urgent medical help if you develop possible symptoms of a blood clot, such as sudden chest pain, difficulty breathing, coughing blood, painful swelling in one leg or sudden weakness. Severe headache, visual changes, yellowing of the skin or eyes, or a serious allergic reaction also requires prompt medical attention.
If bleeding is unusually heavy, persistent or concerning, contact a healthcare professional. After taking the treatment, seek advice if you do not have a bleed when expected and there is any possibility of pregnancy.
Planning period delay around a holiday
Period delay can be useful for seasonal travel, but it should form part of a wider health plan. Arrange the consultation before travel, allow time to collect the prescription and pack the medicine in your hand luggage if you are flying. Keep it in its original labelled packaging, particularly when travelling internationally.
Check whether your destination has any requirements for carrying prescription medicines. It is sensible to take enough medication for the prescribed course, but do not extend treatment independently if your travel plans change. If you are crossing time zones, ask how to maintain a regular dosing schedule.
Period delay treatment does not address other travel health needs. Depending on your destination, you may also need vaccinations, malaria prevention or advice about altitude sickness. Murrayfield Pharmacy is a designated yellow fever vaccination centre and provides a broad travel clinic service, so travel health requirements can be discussed when appropriate.
Book your period delay consultation
If you have an upcoming holiday or important event, early assessment can make planning easier. Book the period delay service at Murrayfield Pharmacy for a confidential clinical consultation and personalised advice about prescription timing and suitability.