Period delay

Period delay means using a short course of medicine to move your period back for a few days, for example for a holiday, a wedding, an exam or a sporting event. It is a temporary change for a specific date, not a long-term treatment. If you already take a combined contraceptive pill, you may be able to delay your period with your pill instead, so check with a pharmacist or GP.

Wanting to delay a period for an important event is a very common reason people speak to a pharmacist or GP. It is worth planning ahead, as the medicine needs to be started a few days before your period is due. Medicines used to delay a period are not a form of contraception, so you will still need to use contraception, such as condoms, if you could get pregnant.

Yes, for many people it can, but it is not suitable for everyone, for example if you have had blood clots, or could be pregnant. A UK-registered clinician reviews your health history and decides whether it is safe for you. How well it works varies from person to person. If you have unusually heavy, painful or irregular periods, or bleeding between periods, speak to a GP rather than delaying.

Each month, your levels of the hormone progesterone fall, and this drop triggers your period. Period delay tablets contain a man-made version of progesterone. Taking them keeps your progesterone level up, so your womb lining is not shed and your period is held back.

When you stop taking the tablets, your hormone level falls and your period usually starts within 2 to 3 days.

How well they work varies from person to person, and they do not always stop all bleeding. Some people have spotting.

Start taking tablets 3 days before your period is due.

Example: if your period is due on a Saturday, start taking the tablets on the Wednesday before.

• If your cycle is irregular, start on the earliest day your period could begin. A period tracking app can help you work this out.
• If you start later than 3 days before, or your period has already started, the tablets may not work. Your hormone level may already have started to drop.
• Plan ahead. Your consultation needs to be completed and the tablets supplied before your start date, so allow time for this. [HEALTHERA: typical lead time, stated factually with no promise of approval]

• Dose: usually 1 tablet, 3 times a day. Space the doses through the day, for example morning, afternoon and bedtime. [AYAZ: confirm against the product information supplied]
• Duration: carry on taking them for as long as you need to delay your period, up to the maximum your prescriber tells you.
• After you stop: your period will usually start within 2 to 3 days.
• Missed dose: take it as soon as you remember, then carry on at the normal times. Do not take a double dose to make up for a forgotten tablet.
• No period after stopping: if you do not have a period after finishing the course, speak to your prescriber or GP, and take a pregnancy test.
• Reminders: three doses a day is easy to forget, especially when you are travelling, so setting phone reminders helps.
• Storage: keep the tablets below 25 C in the original pack, out of the sight and reach of children.

Your prescriber will tell you how many days you can take the tablets for, based on how long you need and your health.

You may see different numbers on different websites, from about 2 weeks to 4 weeks. That is because the product information for different brands, and the NHS guidance written for prescribers, give different limits. We follow [AYAZ: the source and maximum we state - for example the product information for the tablet supplied]. If you need a longer delay, or need to delay periods often, speak to your GP.

Period delay tablets are for occasional use, not for regular, month-after-month use. [AYAZ: confirm the wording on how often they can be used]

For most people, taking period delay tablets for a short time is low risk. But they are not suitable for everyone, which is why a prescriber checks your health first.

The most important risk is a blood clot. The chance is very small, but it is slightly higher while you take a hormone medicine like this. It is higher still if you:

• have had a blood clot before, or a close relative has
• are very overweight
• cannot move for long periods, for example after an operation
• have a serious injury or major surgery.

Long flights: sitting still for a long time also raises the risk of a blood clot. On long journeys, get up and move around when you can, flex your ankles and drink plenty of water. Tell your prescriber if you are planning a long-haul flight. [AYAZ: confirm the travel wording]

Call 999 or go to A&E for:

• sudden, severe or sharp chest pain
• sudden shortness of breath, a fast heartbeat, or coughing up blood
• signs of a severe allergic reaction: wheezing, difficulty breathing, feeling faint, swelling of the face, tongue, hands or feet, or an intense itchy rash
• signs of a stroke: weakness or numbness in any part of your body, difficulty speaking, changes to your sight, or collapsing.

Get medical help straight away for:

• pain, tenderness or swelling in your calf, ankle or foot, or skin on your leg that turns purple, red or warm (signs of a clot in the leg)
• an unusually severe or long headache, or a migraine for the first time
• yellowing of your skin or the whites of your eyes.

If you are not sure, call NHS 111.

Many people take period delay tablets with no side effects. Those that are reported include:

• spotting or bleeding between periods
• breast pain or tenderness
• feeling sick, bloating or stomach upset
• headache, dizziness or tiredness
• mood changes or low mood
• changes in sex drive
• acne or skin changes.

While taking them, some people say it feels like the day before their period, with mild cramps or bloating, even though the period does not come.

Your next period may be a little heavier or more uncomfortable than usual. This usually settles over the following cycles.

Mood: some people taking hormone medicines like this have reported depression. If your mood changes or you feel low, contact your prescriber or GP as soon as possible. If you have thoughts of harming yourself, call 999 or go to A&E.

The patient leaflet gives the full list of side effects. You can report any suspected side effect to the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Do not take period delay tablets if you:

• are pregnant or might be pregnant
• have ever had a blood clot, such as a deep vein thrombosis (DVT) or a clot in the lungs, or a close family member has had one
• have had a heart attack or angina
• have liver problems, or had jaundice or an itchy blistering rash (pemphigoid gestationis) in a past pregnancy
• have vaginal bleeding (not a period) that has not been explained
• have severe itching all over your body
• have porphyria
• are allergic to the medicine or similar hormone medicines.

Your prescriber needs to know if you have:

• epilepsy, migraines or asthma
• heart or kidney problems, or diabetes
• systemic lupus erythematosus (lupus)
• a history of depression
• a history of repeated miscarriage
• an operation planned while you would be taking the tablets.

Also tell them if you are breastfeeding.

[AYAZ / HEALTHERA: the minimum age and any BMI or migraine criteria the service applies]

Tell your prescriber about every medicine you take, including ones you buy and herbal remedies. Some can change how period delay tablets work, including:

• some epilepsy medicines
• some antibiotics
• some HIV medicines
• St John's wort
• ciclosporin
• anti-inflammatory painkillers such as ibuprofen
• medicines for high blood pressure.

The tablets can also affect some blood tests, so tell your doctor if you are having tests.

• Not a contraceptive. Period delay tablets do not stop you getting pregnant. Use condoms, or carry on with your usual contraception, while you take them.
• Pregnancy: do not take them if you are pregnant. If you do not get a period after stopping, take a pregnancy test.
• Fertility: there is no evidence that short-term use affects your fertility in the long term. Your cycle usually returns to its normal pattern after your next period. [AYAZ: confirm this wording]

• Over the counter: no. Period delay tablets are prescription-only in the UK, so you need a prescription from a GP, a pharmacist prescriber or another prescriber.
• NHS: many GP practices no longer prescribe period delay tablets on the NHS for holidays or events, because this is not a medical need. Check with your practice. If you need to delay periods for a medical reason, speak to your GP.
• Privately: you can get a private prescription after a consultation with a pharmacy or online prescribing service. The prescriber decides whether it is suitable for you.