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Block Your Period for Vacation? Ob/Gyns Say It's Safe

— Doctors frequently counsel patients on menstrual suppression

MedpageToday
 A photo of a worried looking woman holding up calendar with a red X on five days in a row

It's summer vacation season, and one question will inevitably be popping up on social media channels: can I delay my period?

On first glance, it may not sound like the best idea, but ob/gyns say it's perfectly fine to do so, and many are happy to help their patients -- though they caution that advance planning is critical.

Pamela Berens, MD, an ob/gyn at the McGovern ľֱ School at UTHealth Houston, said asking your ob/gyn for help moving your period is a "very common question," and completely fair game. She's helped patients move their periods for sporting events, weddings, travel, and even religious ceremonies or funerals that historically don't allow people who are menstruating to attend.

The two most common methods are altering birth control schedules or taking a form of progesterone called norethindrone. For both of these methods, timing is critical, and the further you plan ahead, the more likely you are to be successful, ob/gyns said.

Charis Chambers, MD, who specializes in pediatric and adolescent gynecology and is known as "" on social media, told ľֱ that periods "are triggered by a drop in progesterone. So if you just give it consistently to your body ... that withdrawal doesn't occur, so you don't have the bleed."

It's relatively easy for people already on birth control pills to skip their period, Berens said. The longer you've been on them, the lower your chances of breakthrough menstrual bleeding, she added.

She often counsels patients to skip the week of placebos because, although most birth control packages are designed to include them, they're not actually necessary. The same goes for vaginal rings, which often recommend a week off in between products, though there isn't any medical reason to do so.

Berens said doctors can prescribe an adequate amount of birth control to take active pills the whole time, rather than using the week of fakes standard in a pack of birth control pills.

She added that starting birth control for menstrual suppression is safe, but results might not happen right away because the uterine lining has already had a chance to grow.

"So when you're having natural cycles with no hormonal manipulation like birth control pills, then if you skip your cycle, the lining of the uterus can get overly thickened," Berens said. "That is completely different [from] when you're skipping periods on birth control pills because the estrogen and the progesterone in the pills are balanced, so very little uterine lining ever grows."

Using norethindrone can be a bit more challenging, ob/gyns said. You need to start norethindrone before you ovulate, otherwise your body will still have a period that month, Chambers noted.

It must also be taken within a small window of time each day -- and if you stop taking it, you mimic a withdrawal of progesterone, thus triggering menstruation, although it might take up to a week, she said.

There's no shortage of advice online about how to stop your period, such as using apple cider vinegar, vitamin C packets, ibuprofen, or lemon juice. But these methods aren't hormonal so they won't have an impact, Chambers said.

Ob/gyns also caution against buying norethindrone or birth control pills online.

"The issue with doing this without guidance from a healthcare provider would be that you could actually get bleeding irregularities from the hormone itself and then the potential side effects from progesterone," Berens said. "The side effects would be the same, but just maybe not expected if they weren't discussed with you."

Beyond vacation, suppressing menstruation is beneficial for other reasons. Chambers said hormonal intrauterine devices (IUDs) are commonly used for eliminating periods in young disabled patients who are uncomfortable bleeding or whose caregivers struggle to manage their cycle. Not having a period can help maintain personal hygiene.

The official stance of the American College of Obstetricians and Gynecologists (ACOG) is that for menstrual suppression. ACOG outlines other populations, including transgender patients and incarcerated patients, who could benefit from lighter or nonexistent periods.

Kathryn Stambough, MD, one of the authors of the , said that "for some transgender and gender-diverse individuals, ongoing menstruation can lead to serious gender dysphoria, which can be damaging to mental health. Menstruation suppression is a safe way -- supported by science -- for clinicians to alleviate that distress and to improve patients' lives."

Conversely, Chambers noted that norethindrone can also be used to trigger periods in people who don't have them regularly but might need to, such as patients with polycystic ovary syndrome.

"I believe and support that women and people with periods should be able to manage their periods in a way that supports their life, their goals, and their happiness, and that there shouldn't be judgment associated with that," Chambers said, noting that she thinks fellow providers should help prescribe medications that allows menstruation to fit seamlessly into people's lives.

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    Rachael Robertson is a writer on the ľֱ enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.