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Period delay medication request

Period delay medication request

The following questions will be used to determine if it is safe to prescribe you with medication to delay your period, and which treatment will be best for you.

Please read each question carefully. Your answers will be reviewed by one of our clinicians and if suitable, a prescription will be issued to your community pharmacy. If we need more information, we will contact you directly before the prescription is issued.

Please use this date format: DD/MM/YYYY.
Reason for needing to delay your period?
Are you currently taking any form of hormonal contraception, or plan to take this whilst taking period delay medication?
Are you currently taking any medication not prescribed by Lionwood Medical Practice (e.g over the counter medication), or plan to do so whilst taking period delay medication?
Are you currently taking any recreational drugs, or plan to do so whilst taking period delay medication?
Do you have any known allergies?
Do you smoke?
Would you like help to quit smoking?

However long you have smoked and whatever your circumstances, Smokefree Norfolk can provide support.

Please go to Smokefree Norfolk, or call 0800 0854 113 to refer yourself directly.

Only answer this question if you have weighed yourself. Please do not guess.

Blood pressure

Please can you provide a recent blood pressure reading (optional).

Regarding pregnancy:
Are you breastfeeding or do you plan to breastfeed whilst taking the period delay medication?
Do you suffer from migraines?
Have you or anyone in your immediate family had a blood clot?

Norethisterone tablets are the only progesterone licenced in the UK to delay periods. Norethisterone should be started three days before your period is due to start. The dose is one tablet three times a day.

Other medications may be used if Norethisterone is not suitable for you, but this would be considered off-label. Off-label in this context means a medication that is licenced for other conditions, therefore proven to be safe to take, but it is not licenced for delaying periods.

Your preference if Norethisterone is not suitable:

Risk of Venous Thromboembolism (VTE)

All women have a small chance of having a blood clot. The chances of getting a clot are very slightly higher if you are taking a hormone medication such as Norethisterone. Warning signs of a potential blood clot are:

  • Sudden severe chest pain
  • Coughing up blood
  • Suddenly becoming short of breath
  • Unusually severe or long headache
  • Difficulty speaking
  • You faint or collapse
  • Any part of your body feels numb or weak
  • Your sight is effected in any way
  • You have severe pain, tenderness or swelling in your calf, ankle or foot
  • You have purple discolouration of the skin of the leg or the skin becomes red and warm to touch

Please note, if any one or more of these symptoms occur you must seek urgent medical attention and stop taking any medication you are using to delay your period.

Confirmation:

If you are flying long haul, taking medication to delay your period can slightly increase your risk of developing a serious blood clot. You can reduce your risk by:

  • Wearing appropriate fitting compression (flight) socks
  • Moving around the cabin and doing simple leg and foot exercises whist seated during the flight
  • Stay hydrated by drinking plenty of water
  • Avoid excessive alcohol of caffeine

Speak to your community pharmacist for more information.

Confirmation: