Are tablets that delay women’s periods for holidays risky?

REBECCA BARNES was looking forward to a trip to ibiza with her new partner — but the timing wasn’t ideal. Then she read about medication that could delay her period, so went to her GP who prescribed it for her.

The 44-year-old journalist from North London is one of a growing number of women who have taken norethisterone, brand name utovlan — a synthetic form of the hormone progesterone — to delay their periods so that they don’t clash with big events such as holidays, weddings or exams.

The drug is taken three days before a period and can be used for 17 days.

Norethisterone has been used to treat conditions such as endometriosis (where womb-like tissue grows elsewhere in the body) for more than 25 years, but demand for the drug to delay periods is soaring, to go by the evidence of the growing number of places you can get it.

For while once you had to visit your GP for norethisterone, now it’s available from online pharmacies including Boots, Superdrug and LloydsPharmacy. You fill in your details and have the drug sent to your home for as little as £9.50, without seeing a medical professional.

ThiSconcerns experts because the drug has side-effects — including heart palpitations, bloating, tender breasts and nausea, according to the packaging.

Rarely, it can raise the risk of life - threatening deep vein thrombosis, which can result in a stroke or blood clot in the lungs. (Some GPs advise wearing compression socks to avoid this if you’re delaying your period for a long-haul holiday.)

The first time that Rebecca took the drug, she thought it was ‘fantastic’. Then, three days after stopping the norethisterone, her period arrived and it was a lot heavier than usual. ‘i felt completely exhausted and was going to the loo every hour — it interfered with my job and social life,’ she recalls. ‘My doctor didn’t mention that this would happen.’

indeed, online forums are full of women reporting similar experiences, with some saying that they had passed large, painful clots.

‘ This can be a common side- effect,’ says Dr Anita Mitra, a London-based NhS obstetrician and gynaecologist. ‘Norethisterone is a synthetic form of progesterone.

‘in the natural cycle, progesterone levels drop, causing the womb to shed its lining. if you keep taking progesterone, the womb lining will build up.

‘So, if you delay your period for a couple of weeks, you will get a heavier period when it arrives.

‘it may also be more painful, as period pains are caused by the uterus contracting. in this case, it will have more lining to squeeze out.’

Some women also report feeling irritable, tearful or anxious, possibly as a result of the fluctuation in hormone levels the drug causes.

Jane, a 28- year- old from Cheshire (who doesn’t want to be identified), bought norethisterone online from Boots before attending a music festival.

‘ There was a warning of potential mental health effects, which concerned me, as i can be quite anxious.

‘however, i’ve not got a formal mental health diagnosis, so i thought i’d be fine.’

BuTwithin days of taking it, she began to feel ‘very depressed’. ‘i kept bursting into tears and cried in front of my colleagues in a meeting,’ she says. ‘ it was so bad that i decided to deal with my period in the horrible festival toilets, rather than continue taking it.’

Shirin irani, a consultant gynaecologist at the heart of England NhS Foundation Trust, advises women against buying the pills on the internet. ‘it’s very easy for people to fill in a form in a certain way to get the pills, but i would strongly advise against women bypassing their GP,’ she says.

For occasional use, Ms irani says norethisterone is unlikely to cause any harm, but warns: ‘if you take it too often, you can end up changing your cycle or having problems such as bleeding between periods.’

After trying norethisterone three times, each time, Rebecca had heavy periods and now says she won’t use it again: ‘The sideeffects were just not worth it.’

MY EYESiGhT has been an issue since i was eight. As a girl, i had pink plastic NhS glasses, which were always falling apart. Every year, my myopia (short-sightedness) became worse. Aged 16, i was allowed contact lenses, which was liberating — but my eyesight kept deteriorating.

Then i developed astigmatism, an imperfection in the curvature of the cornea. it means the eye is shaped more like a rugby ball than a football, so light is focused at more than one place. This further complicated my prescription.

By my 30s, i was running out of options for contact lenses. i came to dread my annual appointments with the optician, who would tell me off for wearing lenses for more than the recommended number of hours a day. Without lenses or glasses, i couldn’t even see my own face in the mirror.

i thought my prescription (around - 12 with - 3 astigmatism) was too extreme for laser eye surgery. high Street clinics won’t treat patients like me because they do not see enough of us to develop the expertise.

Then i heard about Professor Dan Reinstein at the London Vision Clinic. he specialises in complex cases that other clinics won’t consider. Could he treat me?

MARCH 2017

i EMAiL the clinic with a copy of my prescription. They reply, sounding optimistic. i’ll need tests and scans to assess whether i’m suitable. They want a £500 deposit, which they’ll refund if they can’t operate. if they can, the cost will be £6,500. i take a deep breath and hand over my credit card.

APRIL 2017

ThE harley Street clinic is lovely. There are plush sofas and fresh flowers. A flat- screen TV has David Attenborough on a loop. But this is my eyes we’re talking about — the decor doesn’t matter. Can they fix me?

For the next two hours, i sit in consultation rooms, staring at flickering lights, letters and shapes through machines. i have drops of orange dye inserted into my eyes; my pupils are dilated and i try not to blink while they take endless photos.

Nurses measure everything from the thickness of my corneas to the dryness of my eyes — as the procedure involves an incision in the cornea, it is essential there is enough tissue to work with.

Some people are born with thin corneas, meaning they’re unsuitable.

Finally, i get to see Professor Reinstein’s assistant, Vimal. he delivers the verdict: i’m suitable for surgery! But there’s a catch. My eyes are too dry. Laser surgery affects the nerves on the surface of the eye, interrupting tear production.

Eyes can be very dry post-surgery, which is uncomfortable and makes it harder to see well. i need to treat my eyes with artificial tears before booking surgery so that they’re in the best possible shape.

That night, i have dinner with a political contact and tell him my exciting news.

‘it’s not Professor Reinstein, is it?’ he asks, sounding worried. ‘Yes?’ i reply. ‘Oh God,’ he groans — and reveals that none other than Foreign Secretary Boris Johnson had his eyes lasered by the professor and now nicknames him ‘Professor Blindstein’.

i’m crestfallen. i resolve to do more research.

MAY 2017

i DECiDE not to be put off by the ‘Blindstein’ thing. Boris certainly isn’t wandering around Westminster with a white stick. he’s also prone to flowery language.

And Professor Reinstein’s reputation is unblemished. he’s operated on thousands of patients. People come to him from all over the world. i’m going ahead with it.

For six weeks, i have to make my eyes less dry, using a variety of eyelid wipes, eye gels and artificial tears. At night, i have to smear my eyes with a gummy paste. it’s horrible, but it will be worth it if it works.

i return to the clinic: the ointments and pastes have done the trick and i’m ready for the operation.

i’ll be having something called ReLEx SMiLE or ‘keyhole’ LASiK.

SMiLE (small incision lenticule extraction) is a newer, less invasive procedure than standard LASiK laser eye surgery (see box, below).

instead of raising a flap in the cornea to remove a bit of the tissue below and change the cornea’s shape, an infrared laser creates a tiny tunnel or ‘keyhole’, through which the surgeon draws the tissue out.

in an approach pioneered by Professor Reinstein, my left eye is going to be left slightly ‘ undercorrected’ (still a little short-sighted) so that, as my eyes age, i will have better ‘near vision’. hopefully, this means i won’t need reading glasses for a long time. if i’m really lucky, the procedure will give me 20/20 vision.

however, there are no guarantees and it could take two operations to achieve full correction.

Long-term, after a decade or so, as my eyes naturally change, i might need more surgery to fine-tune the results.

Vimal talks me through everything that could go wrong. if i’m really unlucky, my eyesight might get worse. Could i go blind? Apparently not.

The most serious risk is an infection post-operation, but this is extremely rare. The risks of something significant going wrong are less than one in 1,000.

Something else is bothering me: Vimal says i might have ‘cloudy vision’ for several weeks afterwards, because of corneal swelling. And my brain will take time to adjust to my new eyes. Vimal stresses it’s ‘a bit of a journey’.

JULY 2017

i BOOK surgery for September, then cancel. Autumn is the busiest period in the political calendar. i don’t want to attend party conferences with blurry vision! in truth, i’m wobbling. i can see fine with my glasses and contacts. What if it goes wrong? Why am i putting myself through this?

DECEMBER 2017

i TALK it over with a friend whose eyes were as bad as mine, until he was treated by Professor Reinstein. he says it’s one of the best things he’s ever done. i ask my sister, who had laser eye surgery ten years ago — she says it’s one of the best things she’s ever done, too. i re-book for January 19.

Back at the clinic, i have to go through all the examinations again, in case anything has changed.

Perhaps because i’m tired, one of