From the Guidelines
Medications that can induce a period include hormonal options like medroxyprogesterone acetate (Provera) or norethindrone acetate (Aygestin), and combined hormonal contraceptives containing estrogen and progestin. To induce a period, the most effective treatment option is to use hormonal medications, such as progestin-only contraception or combined hormonal contraception, as recommended by the American College of Obstetricians and Gynecologists 1. The following are key points to consider:
- Medroxyprogesterone acetate (Provera) is typically prescribed as 10mg daily for 5-10 days, or norethindrone acetate (Aygestin) usually 5mg daily for 5-10 days, to induce a period.
- After stopping these medications, a withdrawal bleed typically occurs within 3-7 days.
- Combined hormonal contraceptives containing estrogen and progestin can also be used to regulate periods.
- For emergency situations, emergency contraceptive pills like levonorgestrel (Plan B) may trigger bleeding.
- These medications work by mimicking or altering hormone levels in the body, specifically progesterone, which controls the uterine lining.
- When progesterone levels drop after stopping the medication, the uterine lining sheds, causing a period. It's essential to consult with a healthcare provider before taking any medication to induce a period, as irregular periods may indicate underlying health issues that require proper diagnosis and treatment, as noted in the U.S. Selected Practice Recommendations for Contraceptive Use, 2013 1. Additionally, a recent review on functional hypothalamic amenorrhoea and polycystic ovarian morphology highlights the importance of careful consideration in the use of oral ovulation inducers, such as clomiphene citrate, for inducing a period 1. Self-medication without medical guidance is not recommended as it may mask important symptoms or cause complications.
From the FDA Drug Label
Progesterone capsules are used for the treatment of secondary amenorrhea (absence of menstrual periods in women who have previously had a menstrual period) due to a decrease in progesterone When you do not produce enough progesterone, menstrual irregularities can occur. If your healthcare provider has determined your body does not produce enough progesterone on its own, progesterone capsules may be prescribed to provide the progesterone you need Progesterone capsules may be given as a single daily dose of 400 mg at bedtime for 10 days.
Medication to induce menstruation:
- Progesterone capsules can be used to treat secondary amenorrhea due to a decrease in progesterone.
- The recommended dose is 400 mg at bedtime for 10 days 2.
- Clomiphene citrate is also used to induce ovulation, but it is not directly used to induce menstruation 3.
From the Research
Medications to Induce Periods
Medications can be used to induce periods in women with polycystic ovary syndrome (PCOS) or other conditions that cause irregular menstrual cycles. Some of the medications used for this purpose include:
Clomiphene Citrate
Clomiphene citrate is a commonly used medication for ovulation induction in women with PCOS. It works by stimulating the release of hormones that trigger ovulation. Studies have shown that CC can be effective in inducing ovulation and improving menstrual regularity in women with PCOS 4, 6. However, some women may be resistant to CC, and alternative treatments may be needed 4.
Alternative Treatments
Alternative treatments to CC include raloxifene and tamoxifen. Raloxifene has been shown to be as effective as CC in inducing ovulation in women with PCOS 5. Tamoxifen has also been used as an alternative to CC, but its effectiveness is still being studied 7.
Other Approaches
Other approaches to inducing periods in women with PCOS include weight loss, insulin-sensitizing drugs, aromatase inhibitors, minimal stimulation protocol, gonadotrophins, and surgery (laparoscopic ovarian drilling) 8. These approaches may be used alone or in combination with medications like CC.
Efficacy of Treatments
The efficacy of these treatments varies, and more research is needed to determine the best approach for each individual woman. Studies have shown that CC can improve menstrual regularity and ovulation in women with PCOS, but the quality of the evidence is often low or very low 7. More research is needed to confirm the effectiveness of alternative treatments and to determine the best course of treatment for each woman.