How can I stop my menstruation for the next cycle?

How to Stop Your Period for the Next Cycle

The most effective method to stop menstruation for your next cycle is to use combined hormonal contraceptives (pills, patch, or vaginal ring) in an extended or continuous regimen by skipping the hormone-free interval and immediately starting the next cycle of active hormones. 1

Primary Recommended Method: Extended Combined Hormonal Contraceptives

If you are already taking combined oral contraceptive pills, simply skip the 7-day hormone-free interval (placebo pills) and start a new pack of active pills immediately to delay menstruation for as long as desired, without needing additional contraceptive protection. 1

Starting Combined Hormonal Contraceptives for Menstrual Delay

If you are not currently using hormonal contraceptives:

• Combined hormonal contraceptives can be started at any time if it is reasonably certain you are not pregnant. 2
• If started within the first 5 days of menstrual bleeding, no backup contraception is needed. 2
• If started more than 5 days after menstrual bleeding began, use backup contraception (condoms) or abstain from intercourse for 7 days. 2, 1

Available Formulations

Combined hormonal contraceptives are available as: 1

• Oral contraceptive pills (most common)
• Transdermal patch
• Vaginal ring

All formulations can be used in extended regimens to delay menstruation. 1

Expected Bleeding Patterns and Management

Unscheduled spotting or bleeding is common during the first 3-6 months of extended use, occurring in approximately 43% of users, but generally decreases with continued use and is not harmful. 2, 1, 3

Managing Breakthrough Bleeding

• Breakthrough bleeding is not a sign of method failure and usually improves with persistent use. 2, 1
• If persistent breakthrough bleeding occurs, taking a 3-4 day hormone-free interval can help reset the cycle, followed by resuming active hormones. 2, 1
• If breakthrough bleeding persists beyond 3-6 months, evaluation for pregnancy, medication interactions, or uterine pathology is warranted. 1

Important Clinical Considerations

Contraindications to Combined Hormonal Contraceptives

Do not use combined hormonal contraceptives if you have: 1, 4

• Severe uncontrolled hypertension
• Active liver disease or impairment
• Complicated valvular heart disease
• History of blood clots, stroke, or heart attack
• Known or suspected breast cancer
• Current pregnancy or breastfeeding

Postpartum women should not use combined hormonal contraceptives during the first 3 weeks after delivery due to increased risk of venous thromboembolism. 2

Thromboembolism Risk

The baseline risk of venous thromboembolism increases 3-4 fold with combined hormonal contraceptives, though this remains lower than pregnancy-associated risk. 1, 4 Call your healthcare provider immediately if you experience sudden vision changes, chest pain, severe leg pain, or severe headaches. 4

Alternative Option: Norethindrone Acetate (Progestin-Only)

For women with contraindications to estrogen-containing contraceptives, norethindrone acetate 5-10 mg daily can be used to delay menstruation, though it has a higher breakthrough bleeding rate (43%) compared to combined hormonal contraceptives. 3, 4

• Norethindrone acetate should be started 5-10 days before the expected period. 4
• Menstrual bleeding typically occurs within 3-7 days after discontinuing the medication. 4
• Do not confuse this with low-dose progestin-only pills (0.35 mg norethindrone) used for contraception, which provide inadequate ovulation suppression for reliable menstrual postponement. 3

Clinical Pearls and Pitfalls

• Monophasic formulations (same hormone dose throughout) are preferred over multiphasic regimens for extended use. 1
• Lower-dose estrogen pills (20 mcg) may show more follicular activity when missed, potentially increasing breakthrough bleeding risk. 2, 1
• Before prescribing any hormonal method, rule out current pregnancy, underlying gynecological pathology, and sexually transmitted infections. 3
• Consider medication interactions, particularly with enzyme-inducing drugs (certain antibiotics, anticonvulsants) that may reduce contraceptive efficacy. 3

Who May Particularly Benefit

Women with the following conditions may particularly benefit from extended hormonal contraceptive regimens: 1, 5

• Heavy menstrual bleeding (menorrhagia)
• Severe menstrual cramps (dysmenorrhea)
• Premenstrual syndrome or premenstrual dysphoric disorder
• Menstrual migraines
• Endometriosis
• Epilepsy exacerbated by menstruation