How can I delay menstruation for a trip?

Delaying Menstruation for a Trip

To delay menstruation for a trip, skip the hormone-free interval of your combined hormonal contraceptive (pill, patch, or ring) and continue with the active hormones without a break. 1, 2

Options Based on Your Current Contraceptive Method

If You Currently Use Combined Oral Contraceptives (COCs)

• Skip the placebo/inactive pills (usually the last 7 pills in a 28-day pack)
• Start a new pack of active pills immediately after finishing the active pills in your current pack
• Continue taking active pills until your trip is over
• After your trip, you can resume your regular schedule with the hormone-free interval

If You Currently Use the Vaginal Ring

• Instead of removing the ring after 3 weeks, leave it in place for up to 4 weeks (35 days) 1
• Insert a new ring immediately after removing the old one
• Continue this pattern until your trip is over

If You Currently Use the Contraceptive Patch

• Apply a new patch immediately after removing the old one at the end of week 3
• Skip the patch-free week
• Continue this pattern until your trip is over

If You Don't Currently Use Hormonal Contraception

• You'll need to start a combined hormonal contraceptive at least 7 days before you want to delay your period 1
• Continue taking the active hormones without breaks until after your trip

Important Considerations

Effectiveness

• This approach is highly effective for delaying menstruation when used correctly 3, 4
• By 10-12 months of continuous use, 80-100% of women achieve amenorrhea (absence of bleeding) 4

Side Effects and Management

• Breakthrough bleeding or spotting is common, especially during the first few months of extended use 5
• If breakthrough bleeding occurs and is bothersome:
  • You can take a 3-4 day hormone-free break (but not during the first 21 days of continuous use) 1
  • Resume taking active hormones after the break
  • Do not take more than one hormone-free break per month as this may reduce contraceptive effectiveness 1

Safety

• Extended or continuous use of combined hormonal contraceptives is safe and well-tolerated 6
• This approach has been used for decades to manage menstrual disorders 4

Contraindications

• Do not use this method if you have contraindications to combined hormonal contraceptives:
  • Age ≥35 years who smoke ≥15 cigarettes daily
  • History of venous thromboembolism, stroke, or cardiovascular disease
  • Uncontrolled hypertension (BP ≥160/100 mmHg)
  • Multiple risk factors for atherosclerosis 2

After Your Trip

• You can return to your regular contraceptive schedule by taking a 7-day hormone-free interval
• Expect withdrawal bleeding during this hormone-free interval
• If you wish to continue delaying periods, you can continue the extended regimen

This approach not only helps avoid menstruation during special occasions like trips but can also reduce menstrual-related symptoms such as headaches, bloating, and cramping that often occur during the hormone-free interval 4, 6.