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Delaying Menstruation

Can I postpone my menstruation when I go on holiday or if I am participating in an athletic event, having minor surgery or other activities?

Menstruation rarely comes at a good time when planning activities. It can be difficult to be near a toilet if it is time to change a cup, pad or tampon. It is therefore tempting to skip menstruation for a month or two by continuing to take your birth control pills without stopping.

When you take birth control pills, you give the body extra hormones so the uterus responds by being completely passive. The ovaries lie down flat as if to say: ‘There is no reason to ovulate because there are extra hormones in circulation’. The bleeding you get when you take a break form you birth control pills is not a ‘real’ menstruation in that sense because you have not had an ovulation. It is a bleeding that is caused by taking a break from the hormones.

Is it dangerous when I postpone my period and skip the artificial bleeding?

It’s not dangerous at all. When you take birth control pills, your body does not make its own hormones in relation to menstruation. It is simply an artificial condition. You will bleed because you take a break with the pill, and the hormone level is therefore not the same.

If you do not pause, nothing will happen. When you take the pills continuously, there are no fluctuations in your hormones. Every single day is the same in terms of hormones. This is not the case if you do not take birth control pills, because then the hormones run up and down through your cycle.

Can I postpone my period as much as I want?

Yes, in fact, pharmacies could just as well sell birth control pills in boxes of 100. When birth control pills became widespread in the 1960s, it was thought that one should do something that resembles the woman’s natural cycle. Therefore, you take a break once a month so that you get an artificial period. But it is unnecessary to imitate the natural cycle because you do not ovulate.

You just have to pay attention to two things:

If you have spotting after a period without monthly bleeding, it is a sign that there is so much mucus membrane in the uterus that it can no longer stick. Then take a 7-day break and expect bleeding. If there is no bleeding during the break, you could be pregnant.

Do I get too many hormones if I never take a break?

Birth control pills must trick the body into thinking that there is an increased number of hormones so that it does not have to produce them itself. When you take birth control pills, you already get more hormones than if you don’t use hormone contraception. The extra hormones by skipping the break do not change it significantly.

What would you recommend if I wanted hormone contraception?

Today, we often recommend Long Acting Reversible Contraception (LARC). It will typically be a hormonal IUD. This way, hormone contraception is inserted in the uterus, and you don’t have to remember to take pills to obtain protection.

There is a typically greater risk of user error with birth control pills than with LARC products. Birth control pills have the benefits that some people experience nicer skin or that it reduces unwanted hair growth, but in general today we now often recommend an IUD for hormone contraception.

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