From the Guidelines
No, it is not necessary to check height, weight, or BMI before prescribing norethisterone to delay periods in a 32-year-old woman. According to the U.S. selected practice recommendations for contraceptive use, 2024 1, weight (BMI) measurement is not needed to determine medical eligibility for any methods of contraception, including progestin-only pills like norethisterone.
When prescribing norethisterone for period delay, the focus should be on the patient's medical history, particularly any history of breast cancer, severe liver disease, unexplained vaginal bleeding, or previous thromboembolic events, as these would be contraindications.
- Key points to consider before prescribing norethisterone include:
- Review of relevant medical history
- Blood pressure measurement is required for combined hormonal contraceptives but not explicitly stated for progestin-only pills like norethisterone in the context of period delay
- Informing the patient that norethisterone is not a contraceptive when used for period delay and advising them to continue their regular contraceptive method if pregnancy prevention is desired
- Typical dosing of norethisterone for period delay is 5mg three times daily, starting 3-4 days before the expected period and continuing for up to 14 days, with menstruation typically beginning within 2-3 days after stopping the medication 1.
It's essential to note that while BMI screening is crucial for combined hormonal contraceptives due to the increased risk of thrombosis in women with high BMI, norethisterone, being a progestin-only medication, has a significantly lower thrombosis risk profile 1.
From the Research
Checking Height, Weight, and BMI Before Prescribing Norethisterone
- There is no direct evidence from the provided studies that suggests checking height, weight, and Body Mass Index (BMI) is necessary before prescribing norethisterone for delaying periods 2, 3, 4, 5, 6.
- The studies primarily focus on the effectiveness of norethisterone in reducing menstrual blood loss, its comparison with other medical therapies, and its use in menopausal hormone therapy, without mentioning the requirement of checking height, weight, and BMI before prescription.
- However, it is essential to consider the overall health and medical history of the patient before prescribing any medication, including norethisterone, to ensure safe and effective treatment 6.
Considerations for Prescribing Norethisterone
- Norethisterone is a progestin that can be used to delay periods, and its effectiveness has been studied in various contexts, including heavy menstrual bleeding and menopausal hormone therapy 2, 3, 4, 5.
- The medication can be prescribed in different regimens, including short-cycle and long-cycle therapy, and its effectiveness may vary depending on the specific context and comparison with other medical therapies 5.
- Patient satisfaction and quality of life are also important considerations when prescribing norethisterone, and individualized treatment approaches may be necessary to ensure optimal outcomes 6.