Dear Alice,

This may seem a ridiculous question, but here goes. I have a trip planned to Hawaii and just realized that during my vacation time, I am scheduled to be on my period. Needless to say, that will definitely slow down my plans for ocean swimming and loads of tropical sex with my boyfriend. Is there a way to safely alter my cycle by missing birth control pills or other means?

— Hawaii-bound

Aloha Hawaii-bound,

A good question that's surely been on the minds of many trying to avoid their monthly visitor while traveling... How can menstruation be rescheduled if it's to arrive during vacation, on your wedding night, during your honeymoon, when you finally hook up with your long distance lover, etc.? Well, you’re in luck because there are some solutions! If you're already on the birth control pill and have been using it for a few cycles, you can probably successfully reschedule your period for your trip. How well this works will depend on the specific birth control pill you're taking, as some are more effective at doing this than others. Some birth control pills are considered monophasic, meaning all active pills in a month’s pack are identical. Other birth control pills are multiphasic, with hormonal doses differing by the week. In general, it’s easier and more effective to skip a period when using monophasic pills. Not on the pill? It’s also possible to skip periods when using the NuvaRing! However, it’s not recommended to reschedule when using the contraceptive patch due to increased risk of blood clotting. In any case, it’s recommended to talk with your health care provider, gynecologist, or nurse practitioner before attempting to adjust your cycle, because they will be most familiar with your cycle, birth control methods, and how it can be shifted safely.

To skip a period:

  • When taking monophasic birth control pills:
    • 28-day oral contraceptive (OC) pack users: When you reach the end of the active hormonal pills in a pack (the first 21 or 24 pills), begin the next set of active pills, skipping the inactive (placebo pills) from the previous package.
    • 21-day OC pack users: Instead of going through the pill-free week, start the next pack of active pills the day after finishing an active pack. 
  • When taking multiphasic birth control pills: When you reach the end of the three weeks of active hormonal pills, take the next month’s third week of pills immediately. You may also want to be aware that skipping a period using multiphasic birth control pills may be more complicated and it may also lead to break-through-bleeding.
  • When using the NuvaRing: Leave the NuvaRing in for four weeks before removing it, and then immediately replace with a new one.

Using the active pills continuously postpones menstruation by not allowing withdrawal from hormones. However, this protocol does not guarantee that there won't be any menstrual bleeding. Sometimes spotting (light bleeding) can occur. Skipping the placebo pills or pill-free days won't change the pill's ability to effectively prevent pregnancy.

Some women or health care providers feel a little squeamish about rescheduling a period, while others think it's the greatest innovation since the invention of the pill itself. In fact, there are now extended-cycle birth control pills, approved by the U.S. Food and Drug Administration (FDA), that allow women to have their period four or fewer times per year. If there's enough time between now and your vacation (or if not, to think about in the future), you could consider switching to a pill that gives you fewer periods. If that is not an option, taking monophasic birth control pills without the placebo pills or using a Nuvaring for four weeks instead of three has a similar effect to the extended-cycle birth control pills. However, it has been found that the more consecutive periods that are skipped, the more likely for spotting. To counteract this, allowing a period every three to four months (by either taking the placebo pills or removing the NuvaRing for a week) will likely decrease the chances of spotting.

Another option to contemplate is Depo-Provera. It's a progestin-only form of contraception administered every three months as an injection. Depo-Provera disrupts the menstrual cycle, tending to make periods less regular. For most using this method, spotting between periods is fairly likely and some even stop having periods altogether after using the contraceptive shot for a while. Hormonal IUDs and the contraceptive implant can also alter the menstrual cycle and provide highly effective birth control without the hassle of taking a daily pill.

If the period postponement procedure is not an option for you because you're new to birth control pills, or you can't or won't take hormonal birth control, you can still find ways to enjoy your vacation. You can also check out Swimming when menstruating for more information.


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