A very modern PILL
Going on holiday? A major conference? More and more women are taking a tablet that defers that time of the month. But are they damaging their bodies?
AFTER two months away from her boyfriend, Jo Asker was determined their reunion was going to be a romantic occasion. They flew to Malibu where their longanticipated night started with a twilight stroll on the beach, followed by cocktails and dinner at one of the area’s most exclusive restaurants.
After a magical evening of food, conversation and long, lingering glances, Jo, a 46-year-old book editor from West London, and Peter retired to their hotel room to finish the night off in style .
That evening last summer would not have been quite the same if it had not been for the secret weapon Jo was keeping in her handbag.
Three times a day throughout their five- day break, Jo took a tablet of Norethisterone, a synthetic hormone which stopped her period starting.
‘It did the trick perfectly,’ says Jo. ‘ My period was due at the start of our break, so three days before I left I started taking the pills. It saved the trip.’
So is this the drug which finally gives women control over their menstruation? Or by stopping the natural ebb and flow of their monthly cycle, are women depriving themselves of the ability to keep in touch with their fertility and potentially sabotaging their health?
Norethisterone, which goes by a range of brand names including Utovlan and Primolut N, mimics the female sex hormone progesterone. When the level abruptly drops in the later part of the menstrual cycle, it triggers the shedding of the womb lining which has built up over the month in readiness for a fertilised egg.
By artificially keeping the levels of the hormone steady, the lining does not fall away and a woman’s period can be delayed indefinitely. Periods return around two days after a woman stops taking it.
While Norethisterone is not a new drug — it has been in use for more than 25 years to help women cope with extremely heavy periods, due to endometriosis or fibroids — it is now in high demand not as a cure, but for convenience.
Online ‘period holiday clinics’ are allowing soaring numbers of women to buy the drug. What is less known is that it is also available on the NHS and each year doctors write about half a million prescriptions to women, often after costly GP consultations. WHILE many of these will be for genuine medical need, others are seeking it for more frivolous reasons, ranging from weddings and honeymoons to beach breaks and music festivals. At a time when our health service is denying life-saving drugs and surgery to desperately ill patients, questions have been asked over whether the NHS should be footing the bill for women to delay their period because they don’t want it to interfere with their holiday.
Whoever is paying, demand is likely to keep rising. A survey by the Association of Reproductive Professionals says 40 per cent of women would like to dispense with their periods altogether and Jo, who bought the drug online, is one of them.
‘I couldn’t change the date of our holiday because Peter and I had work commitments,’ she says. ‘Peter is based in the U.S. so when we meet, it’s intense. When I realised our break clashed with my time of the month, I was really worried as I suffer from fibroids, or growths in my womb, which can make my periods heavy.’
Jo searched the internet for ‘delay my period’. Within moments, she was surprised to see other women on forums mention the tablets.
Norethisterone is one of a group of prescription drugs, like emergency contraception, which can be bought over the internet without a face-to-face consultation with a GP or pharmacist.
So after filling in a brief health questionnaire, she ordered it for £30 and it arrived the next day. She has since taken it for two more mini-breaks.
With festival season in full swing, many other women will be seeking it; a worrying trend considering the drug should not be mixed with alcohol because it can cause dizziness and headaches.
Some health professionals say it should not be taken casually. Woman’s health consultant Audrey Sourroubille, of Lotus Power Health, says tampering with high-dose hormones upsets a woman’s cycle and can be serious.
‘In my view, it’s not OK to modify our cycles with chemicals and skip periods,’ she says. ‘Look at sleep. When we use chemicals like coffee or stimulants to reduce the number of hours we sleep, we end up with some physiological consequences.
‘It’s the same when we delay our periods. We miss out on a vital part of who we are. We’re forcing our bodies to adapt to chemical messengers we didn’t naturally produce. Women can lose track of their cycles, and their fertility, which can delay matters when they want to conceive.’ However, gynaecologist Poonam Pradhan says that if such menstrual blockers are taken sensibly under supervision, there is nothing wrong with a woman cutting the number of periods she has. If anything, she says, by cutting out a few, she is actually doing what nature intended. For, instead of being ‘natural’ or ‘necessary’, women today have many more periods than they did 100 years ago, chiefly because our great-grandmothers, who raised bigger families, spent much more time pregnant or breast-feeding. Furthermore, the synthetic progesterones they use have been used safely for years, in a much weaker form and combined with other hormones, in the contraceptive Pill. Ms Pradhan, of Solihull’s Spire Parkway Hospital, says: ‘This drug is fine for women who don’t want to take the contraceptive Pill (which can also be taken back-to-back to stop menstruation) and who want a break from their period for that odd special occasion.’
Community pharmacist Sid Dajani, of the Royal Pharmaceutical Society, says a growing number of women see Norethisterone as a blessing: ‘Although it has been around for years, women have woken up to its potential and more know about it.
‘Although it seems a godsend, it is still a drug and does carry a risk if not used properly.’
None of the side- effects, which can include nausea and blood clotting, is caused by a woman not having her period. He says: ‘Periods are to do with reproduction so there is no harm in stopping these hormones if you’re not trying to get pregnant.’
The issue of whether the NHS should be prescribing the drug to women who have no medical need for it remains.
Designer Alice Cambray asked her GP for Norethisterone before her wedding in April.
Alice and her photographer husband Oli, from Derby, had chosen their wedding date in tribute to her late grandparents who had married on the same day. But two months before, Alice realised it would coincide with her period. She found out about the drug on forums and immediately got an appointment with her GP, who prescribed a supply to cover her wedding and two-week honeymoon.
‘It would have been a nightmare,’ says Alice. ‘My dress was a vintage style with a full skirt and logistically it would have been hard to keep nipping to the ladies.’
However while the drug stopped her period, there was a price to pay for tampering with her hormones.
‘As soon as the wedding was over, we went on honeymoon but almost immediately I felt bloated and lethargic. None of the clothes I’d bought would fit, which made me emotional. Luckily Oli realised it was the hormones talking.
‘Three days before the end of the trip, just as I was about to go in the pool at our hotel in Sorrento, my period arrived. It was much heavier. Instead of lasting the normal five days, it lasted ten. It was as if my body had taken back control and had been storing it all up. It was really disappointing.’
The drug also put her cycle out of sync. Now, three months later, it is still irregular. ‘If I had to do it again, I would only take Norethisterone to delay a period for the wedding, not the honeymoon,’ she says. LAST year 32- year- old mother- of- four Rachel Treagust got her GP to give her a course of Norethisterone when she realised that her period clashed with Glastonbury festival.
Rachel, from Torquay, Devon, who is engaged to garden centre manager Chris, says: ‘It was my first time going and I’d heard horror stories about how awful the toilets were. My periods are normal but I didn’t want them happening there.
‘My doctor gave them to me, no questions asked. All it cost me was the standard £8.40 charge.’
According to Rachel, she took it for the required duration without sideeffects. ‘It was perfect,’ she says.
As for the NHS, Rachel concedes: ‘Perhaps for a lifestyle choice like a festival, women should get it privately, but it still should be freely available in some way. After all, men don’t have to worry about this sort of thing. Why should we?’
Jo Asker agrees: ‘I don’t worry about messing with my hormones. I feel I deserve a break from my periods. It can only be a good thing for a woman to have control over her periods. We have already suffered enough.’