What medications can be used to stop a woman's menstruation for one month?

Medications to Stop Menstruation for One Month Cycle

Combined hormonal contraceptives are the most effective medications to temporarily stop menstruation for one month by skipping the hormone-free interval. 1, 2

First-Line Options

Combined Hormonal Contraceptives (CHCs)

• Combined oral contraceptives (COCs), contraceptive patch, or vaginal ring can be used continuously without the hormone-free interval to skip menstruation 1
• For women already on CHCs:
  • Skip the hormone-free week (placebo pills) and immediately start a new pack 1
  • For contraceptive ring users: remove the ring after 3 weeks and immediately insert a new ring instead of having a ring-free week 1
• For women not currently on CHCs:
  • Can start CHCs at any time if reasonably certain she is not pregnant 1
  • Will need 7 days of continuous use before menstruation is reliably suppressed 1
  • May experience breakthrough bleeding, especially during first-time extended use 2

Alternative Options

Progestin-Only Methods

• Depot medroxyprogesterone acetate (DMPA) injection can cause amenorrhea but timing is less predictable 1
• Progestin-only pills (POPs) may reduce menstrual flow but are less reliable for complete suppression 1
• Levonorgestrel intrauterine system (LNG-IUS) can reduce bleeding but takes time to achieve amenorrhea 1

Efficacy Considerations

• Extended or continuous use of CHCs is more effective than placebo for reducing menstrual bleeding 3
• Skipping the hormone-free interval increases contraceptive efficacy while providing the benefit of postponing menstruation 2
• Total number of bleeding days requiring sanitary protection is lower with extended regimens compared to conventional 28-day cycles 2

Side Effects and Management

• Breakthrough bleeding is the most common side effect of extended CHC use 1, 2
• If breakthrough bleeding occurs during extended use:
  • Can take a 3-4 day hormone-free break to allow for controlled withdrawal bleeding 1
  • Then resume hormonal contraception 1
• Other potential side effects include:
  • Breast tenderness 1
  • Nausea (more common with COCs than vaginal ring) 3

Important Considerations

• CHCs should not be used in women with certain medical conditions:
  • History of deep venous thrombosis or pulmonary embolism 1
  • Breastfeeding women less than 1 month postpartum 1
• Backup contraception is needed if starting CHCs more than 5 days after the start of menstruation 1
• Emergency contraception should be considered if unprotected intercourse occurs within the first week of starting CHCs 1

Clinical Pearls

• Counseling about expected bleeding patterns improves satisfaction and continuation rates 1
• Extended use of CHCs is a well-established off-label practice 2, 4
• While extended use of CHCs is primarily used for contraception, it can be effectively used to postpone menstruation for special occasions, travel, or other personal preferences 2
• Newer formulations with lower doses of ethinylestradiol or natural estradiol may have fewer side effects 4

Remember that while these medications can effectively stop menstruation for one cycle, they should be used according to their approved indications and contraindications, with appropriate medical supervision.