How to Take Norethindrone for Delaying Your Menstrual Cycle
For menstrual delay, take norethindrone 5 mg three times daily (total 15 mg/day), starting ideally on or before cycle day 12, and continue until you want your period to begin. 1
Dosing Regimen
- Standard dose: 5 mg three times daily (every 8 hours) 1
- Timing of initiation: Start on or before day 12 of your menstrual cycle for optimal effectiveness 1
- Duration: Continue taking the medication until you want menstruation to occur 1
- Withdrawal bleeding: Expect menstruation to begin 2-3 days after stopping norethindrone 2
Key Advantages Over Combined Oral Contraceptives
- Superior breakthrough bleeding prevention: Only 8% of women experience spotting with norethindrone compared to 43% with combined oral contraceptives when started late in the cycle 1
- Can be started later: Effective even when initiated late in the menstrual cycle, whereas combined oral contraceptives are less reliable in this scenario 1
- Higher patient satisfaction: 80% of women would choose this method again 1
Important Considerations and Side Effects
Expected Side Effects
- Weight gain: Significant temporary weight gain may occur during treatment, which resolves after stopping the medication 1
- Heavier withdrawal bleeding: The menstrual period following norethindrone cessation may be heavier than usual 1
Contraindications (Do Not Use If)
- Pregnancy: This is an absolute contraindication (Category X) 3, 4
- Active or history of blood clots: Deep vein thrombosis, pulmonary embolism, or stroke 3
- Breast cancer or other hormone-sensitive cancers 3, 4
- Active liver disease or liver tumors 3
- Undiagnosed vaginal bleeding 3
Required Monitoring
- Before starting: Confirm you are not pregnant and check blood pressure 3, 4
- During use: Monitor for any unusual symptoms, particularly if using for extended periods 4
Clinical Pearls
- Fertility preservation: Time to conception after norethindrone use is actually shorter compared to combined oral contraceptives, making it ideal for women concerned about future fertility 1
- Ideal for special circumstances: This method is particularly useful when even minimal breakthrough bleeding cannot be tolerated (e.g., religious ceremonies, athletic competitions, honeymoons) 1
- Take consistently: For maximum effectiveness, take at the same time each day 5
- No water needed with some formulations: Some norethindrone formulations can be chewed without water, which is convenient if you're traveling 6
Common Pitfall to Avoid
Do not confuse norethindrone with norethindrone acetate - they are different medications with different potencies and dosing requirements 7. The 5 mg three times daily regimen specifically refers to norethindrone, not norethindrone acetate.