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Delaying your period through oral contraceptives

Why isn't the ability to delay your periods promoted more widely?

Not all doctors think it's a good idea to delay menstrual periods. Even those who support the option may not mention it to their patients. If you want to try it, you may have to take the lead. Also, some women prefer to keep their natural cycle and like the reassurance that they aren't pregnant.

Will delaying your period cause side effects?

Limited studies have shown that for a small number of women, extended oral contraceptives have the same side effects as conventional oral contraceptives, such as breast tenderness, nausea, headache, mood changes, leg cramps, acne, bloating, weight changes and dark spots on the face.

Bleeding or spotting between periods (breakthrough bleeding) is common during the first three to four months after you start taking any oral contraceptive — particularly when you extend the number of days between periods. As your body adjusts to the hormones, though, this unpredictable bleeding should decrease. If it persists and becomes heavy or bothersome, call your doctor.

The likelihood of breakthrough bleeding increases whenever there's a fluctuation in the level of contraceptive hormones in your system. That can happen if you miss a pill, start a new medication that may interfere with the pill, or develop an illness with vomiting or diarrhea. The same circumstances may reduce the pill's contraceptive effect, so be sure to use a backup method of contraception for seven days afterward.

When on an extended schedule, it may be more difficult for you to tell if you're pregnant. Take a home pregnancy test or visit your doctor if you have morning sickness, breast tenderness or unusual fatigue.

Does delaying your period increase risk of blood clots?

If you take oral contraceptives, whether on a traditional schedule or an extended schedule, you're at increased risk of blood clots.

Know the warning signs of blood clots:

  • Severe abdominal pain
  • Chest pain
  • Coughing up blood
  • Shortness of breath
  • Sudden and severe headache
  • Eye blurring or loss of vision
  • Severe leg pain

At what age can you begin delaying your period?

You can manipulate the timing of menstruation at any age, as long as you can take oral contraceptives. Reducing the frequency of periods is certainly an option for adolescents who miss school and sports because of frequent, irregular and painful periods.

Is it safe for all women to delay menstruation?

If you can take oral contraceptives and want to reduce the frequency of your periods, it's probably safe — especially if you have problems associated with menstruation.

Your doctor can screen you for conditions in which oral contraceptives may be risky. These include:

  • High blood pressure
  • A personal history of stroke, heart attack, blood clot or liver disease
  • Migraine with aura
  • Unexplained vaginal bleeding
  • Cancer of the breast or uterus
  • Family history of thrombosis

No oral contraceptive schedule — in fact, no oral contraceptive — is safe for women older than 35 who smoke. Oral contraceptives sharply increase the risk of heart attacks, blood clots and strokes in older women who smoke.

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References
  1. Steinauer J, et al. Extended cycle combined hormonal contraception. Obstetrics and Gynecology Clinics of North America. 2007;34(1):43-55.
  2. Sulak J. Continuous oral contraception: Changing times. Best Practice & Research Clinical Obstetrics and Gynaecology. 2008;22(2):355-374.
  3. Nelson A. Communicating with patients about extended-cycle and continuous use of oral contraceptives. Journal of Women's Health. 2007;16(4):463-470.
  4. Archer DF. Menstrual-cycle-related symptoms: A review of the rationale for continuous use of oral contraceptives. Contraception. 2006;74(5):359-366.
  5. Memmel L, et al. Contraception. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:567-585.
  6. Anderson FD, et al. Long-term safety of an extended-cycle oral contraceptive (Seasonale): A 2-year multicenter open-label extension trial. American Journal of Obstetrics & Gynecology. 2006;195(1):92-96.
  7. McCarthy L, et al. Levonorgestrel/ethinyl estradiol (Lybrel) for continuous contraception. American Family Physician. 2008;77(2):222.
  8. Contraception. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch255/ch255b.html. Accessed Sept. 4, 2008.

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Oct. 4, 2008

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