the Side Effects of Menstrual Delay Medications

Concerns about the side effects of menstrual regulation medications and the duration of use?

Hello, doctor.
My menstrual cycle is usually regular, and the app predicts my period will start on October 24.
Since I have major exams on October 24, October 30, and October 31, I went to the gynecology department to get medication to delay my period.
The doctor prescribed "Jing Tian Na Neng Ning" (Ethinyl Estradiol) to be taken as two tablets twice a day, for a total of 19 days (14 days covered by insurance plus 5 days out of pocket).

Regarding my medical history, I experienced fainting spells twice last year during my menstrual period, and after an examination at Kaohsiung Veterans General Hospital, I was diagnosed with mitral valve prolapse.
The doctor prescribed antiarrhythmic medication, advising me to take it only if I felt unwell.
My condition has been stable, so I have not been taking it continuously.
Due to the upcoming exams, I have also taken "Mujing Tablets (1.5 mg)."
Now, I have a couple of questions:
1.
I researched this hormonal medication and found that it may have symptoms related to thrombosis.
Recently, I have experienced occasional headaches, mild dizziness, and also some chest tightness and sharp pain in my chest.
I am uncertain whether these symptoms are side effects of the period delay medication or related to my mitral valve prolapse (along with autonomic nervous system dysregulation).
2.
Given the symptoms mentioned above, I am unsure whether to continue taking the medication.
I am worried about the possibility of thrombosis symptoms, but I am also concerned about the onset of my period with the exam dates approaching.
I fear becoming weak and potentially fainting again under stress.
I appreciate your time in addressing my concerns!

J, 20~29 year old female. Ask Date: 2021/10/23

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
Hormonal medications for menstrual regulation commonly cause headaches and mild dizziness.
If there is a history of cardiovascular disease, a cardiovascular evaluation should be conducted to rule out any complications.
2.
If there are concerns, alternative medications can be considered to manage the issue of excessive menstrual bleeding.

Reply Date: 2021/10/23

More Info

Understanding the side effects of medications, particularly those that affect the menstrual cycle, is crucial for making informed decisions about your health. In your case, you have been prescribed "Jing Tian" (Ethinyl Estradiol), a synthetic form of estrogen, to delay your menstrual period due to upcoming exams. You also mentioned taking "Mujing" (1.5mg), which is likely a progestin, to further manage your menstrual cycle.

Side Effects of Ethinyl Estradiol
Ethinyl Estradiol is commonly used in various hormonal contraceptives and for menstrual regulation. While it can be effective in delaying menstruation, it is associated with several potential side effects, some of which can be serious:
1. Thromboembolic Events: One of the most concerning side effects of estrogen-containing medications is the increased risk of blood clots. This risk is particularly heightened in individuals with pre-existing conditions such as mitral valve prolapse, which you mentioned having. Symptoms of a blood clot can include sudden chest pain, shortness of breath, swelling in the legs, or severe headaches.

2. Headaches and Dizziness: You noted experiencing occasional headaches and lightheadedness. These can be common side effects of hormonal medications and may be exacerbated by stress or anxiety, particularly in the context of preparing for exams.

3. Chest Discomfort: The chest pain and discomfort you described could be related to the medication, especially if it feels different from your usual symptoms related to mitral valve prolapse. It's essential to differentiate between medication side effects and symptoms of your heart condition.

4. Nausea and Mood Changes: Hormonal medications can also lead to gastrointestinal disturbances and mood fluctuations, which may add to your overall discomfort during this stressful time.

Recommendations
Given your concerns about the potential side effects of Ethinyl Estradiol, particularly the risk of blood clots, it is crucial to take the following steps:
1. Consult Your Doctor: Before continuing with the medication, discuss your symptoms with your healthcare provider. They can assess whether your symptoms are likely related to the medication or your underlying heart condition. If necessary, they may recommend alternative methods for managing your menstrual cycle.

2. Monitor Symptoms: Keep a close watch on your symptoms. If you experience severe headaches, chest pain, or any signs of a blood clot (such as swelling in one leg or sudden shortness of breath), seek medical attention immediately.

3. Consider Stress Management: Since you are under significant stress due to exams, consider incorporating stress-reducing techniques such as mindfulness, deep breathing exercises, or light physical activity, which can help alleviate some symptoms.

4. Evaluate the Need for Medication: If your primary concern is the timing of your menstrual cycle, discuss with your doctor whether there are non-hormonal options available that may be safer given your medical history.

5. Stay Informed: Understanding the medications you are taking and their potential side effects empowers you to make informed decisions about your health. Always feel free to ask your healthcare provider for clarification on any medication-related concerns.

In conclusion, while Ethinyl Estradiol can effectively delay menstruation, it is essential to weigh the benefits against the potential risks, especially considering your medical history. Open communication with your healthcare provider is key to ensuring your safety and well-being during this time.

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