Norethisterone 5mg Dosage to Delay Menstruation
For menstrual delay, norethisterone 5mg should be taken three times daily (15mg total per day), starting 3 days before the expected period and continuing throughout the time you wish to delay menstruation, with bleeding typically occurring 2-3 days after stopping the medication.
Dosing Regimen for Period Delay
The standard approach for menstrual postponement differs significantly from other therapeutic uses of norethisterone:
- Take 5mg three times daily (total 15mg/day) starting 3 days before your expected menstruation 1
- Continue throughout the desired delay period - you can safely delay for up to 2 weeks 1
- Expect withdrawal bleeding 2-3 days after discontinuation in approximately 82-87% of women with regular cycles 2
Important Distinctions from Other Norethisterone Uses
This dosing is substantially higher than norethisterone used for other indications, which is critical to understand:
- For hormone replacement therapy: Only 5mg daily for 12-14 days per month is used 1, 3
- For menorrhagia treatment: 5mg twice daily (10mg total) on days 19-26 of cycle 4
- For contraception: Doses range from 0.5-3mg daily, with 3mg being the minimum effective contraceptive dose 5
The higher dose for menstrual delay (15mg/day) is necessary to maintain adequate progestational effect to prevent endometrial shedding throughout the delay period.
Clinical Considerations and Timing
Timing is critical for effectiveness:
- Must start before menstruation begins - ideally 3 days prior 2
- Starting after bleeding has begun will not be effective
- Women with regular cycles (variation ≤2 days) have 87% success rate versus 82% overall 2
Duration of use:
- Can be continued safely for the entire period you wish to delay menstruation
- Most commonly used for 1-2 weeks
- Longer durations may increase breakthrough bleeding risk
Contraindications and Precautions
Absolute contraindications include:
- Current or history of venous thromboembolism 1
- Active liver disease or hepatic tumors 1
- Undiagnosed vaginal bleeding 1
- Pregnancy 1
- Breast cancer or hormone-sensitive malignancies 1
Relative cautions:
- History of depression - may worsen mood symptoms 1
- Cardiovascular risk factors - though norethisterone has lower thrombotic risk than combined contraceptives 3
- Migraine with aura if over 35 years 1
Common Pitfalls to Avoid
- Don't confuse with contraceptive dosing - the 5mg dose used for period delay refers to 5mg three times daily, not once daily
- Don't start too late - beginning after menstruation has started will not work
- Don't expect immediate return to normal cycles - the next period may be heavier or irregular 6
- Don't use as regular contraception - this regimen is for temporary menstrual delay only and should not be relied upon for pregnancy prevention