Is it safe to use norgestrel (a progestin) to delay a period for a trip?

Using Norgestrel to Delay Menstruation for a Trip

Norgestrel is generally safe and effective for delaying menstruation for a trip, with progestin-only methods being preferable to combined hormonal contraceptives for this purpose due to fewer side effects and better effectiveness when started late in the cycle.

How Norgestrel Works to Delay Periods

Norgestrel is a progestogen that can be used to temporarily delay menstruation by:

• Stabilizing the endometrial lining
• Preventing the normal shedding of the uterine lining that occurs during menstruation
• Altering cervical mucus and potentially affecting ovulation

Effectiveness for Period Delay

• Norgestrel is superior to combined oral contraceptives when started late in the cycle for delaying menstruation 1
• Only 8% of women using norethindrone (a similar progestin) experienced breakthrough bleeding compared to 43% using combined oral contraceptives 1
• Patient satisfaction is significantly higher with progestin-only methods for menstrual delay 1

Dosing and Administration

• Typical dose for norgestrel when used for contraception is 75 μg daily 2
• For menstrual delay purposes, higher doses may be used
• Should be started before the expected menstruation (ideally 3-7 days before)
• Continue taking until the end of the trip when menstruation can safely occur
• Withdrawal bleeding typically occurs 2-3 days after stopping the medication

Safety Considerations

Advantages of Norgestrel:

• No increased risk of venous thromboembolism (RR 0.90,95% CI 0.57-1.45) 3
• Suitable for women with certain health conditions where estrogen is contraindicated
• Can be used by women of all ages 3
• Fertility returns quickly after discontinuation 4

Potential Side Effects:

• Menstrual irregularity (most common side effect) 4
• Temporary weight gain that resolves after cessation 1
• Heavier withdrawal bleeding after stopping the medication 1
• Breakthrough bleeding (though less common than with combined hormonal methods) 1

Important Considerations

• Norgestrel does not protect against sexually transmitted infections; condoms should be used if STI protection is needed 3
• If a dose is delayed by 6 hours or missed completely, there appears to be little effect on ovarian activity or cervical mucus 5, though this is more relevant for contraceptive efficacy than period delay
• For women with hereditary angioedema, progestins are generally well-tolerated compared to estrogen-containing contraceptives 6

When to Avoid Norgestrel

• Known or suspected pregnancy
• Current or past history of breast cancer
• Severe liver disease
• Undiagnosed vaginal bleeding

Follow-up After Use

• Expect withdrawal bleeding 2-3 days after stopping the medication
• If no withdrawal bleeding occurs within 3 weeks after stopping, consider taking a pregnancy test 6
• Normal menstrual cycles typically resume within 1-2 months

Norgestrel offers a reliable option for women wanting to delay their period for a special occasion or trip, with fewer side effects than combined hormonal methods and better effectiveness when started later in the cycle.