From the Guidelines
To postpone menstruation using norethindrone (progestin), a patient should start taking it at any time, but for the purpose of postponing menstruation, it is recommended to start 3-5 days before her expected period, however, the exact timing may vary depending on the individual's menstrual cycle and medical history. The typical regimen involves taking norethindrone 5-10 mg daily, continuing until she wants her period to begin, at which point she should stop the medication 1. Menstruation typically starts 2-3 days after discontinuing the medication. This approach works because progestins maintain the endometrial lining, preventing it from shedding. For best results, the patient should take the medication at the same time each day. Some key points to consider when using norethindrone to postpone menstruation include:
- Starting the medication at any time, but ideally 3-5 days before the expected period, to allow for maximum flexibility and effectiveness
- Taking the medication continuously until the desired time of menstruation, at which point it should be discontinued
- Being aware of potential side effects, such as breakthrough bleeding, breast tenderness, nausea, and headaches, which are generally mild and temporary
- Understanding that this method is temporary and does not affect future fertility, making it a convenient option for women who need to postpone their period for a short period
- Considering the patient's medical history, including any history of blood clots, liver disease, breast cancer, or unexplained vaginal bleeding, which may contraindicate the use of norethindrone for this purpose 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Norethindrone Acetate Tablets USP, 5 mg Therapy with norethindrone acetate tablets must be adapted to the specific indications and therapeutic response of the individual patient. Secondary amenorrhea, abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology: 2. 5 mg to 10 mg norethindrone acetate tablets may be given daily for 5 to 10 days to produce secretory transformation of an endometrium that has been adequately primed with either endogenous or exogenous estrogen. The FDA drug label does not answer the question.
From the Research
Norethindrone for Postponing Menstruation
- Norethindrone can be used to postpone menstruation, with studies showing its effectiveness in delaying menses when started on or before cycle day 12 2.
- The ideal time to start taking norethindrone to postpone menstruation is not explicitly stated in all studies, but one study suggests starting on or before cycle day 12 for optimal results 2.
- Norethindrone has been compared to combined oral contraceptives (OCPs) in terms of delaying menstruation, with norethindrone showing superior results in preventing breakthrough bleeding 2.
Dosage and Administration
- The dosage of norethindrone used in studies varies, with one study using 5mg three times daily 2.
- Norethindrone can be started at any time in the menstrual cycle, but starting on or before cycle day 12 is recommended for optimal results 2.
Side Effects and Efficacy
- Norethindrone has been shown to be effective in postponing menstruation, with a significant reduction in breakthrough bleeding compared to OCPs 2.
- Common side effects of norethindrone include weight gain, irregular bleeding, and systemic side effects 2, 3.
- Patient satisfaction with norethindrone is high, with one study showing that 80% of patients were willing to choose this method again 2.