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How to induce menses earlier than expected date

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"menstruation"[MeSH Terms] AND "progestins"[MeSH Terms]

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how to bring on period early safely medical options progestin withdrawal bleeding

There is no reliable, safe way to bring on a period early without a prescriber. The only evidence-based method is a short course of hormones, and it works best for specific situations.
Check these first
  • If your period is late rather than early, take a pregnancy test before trying anything. Nothing here should be used if you could be pregnant.
  • Early or irregular bleeding can also come from stress, weight change, thyroid or prolactin problems, PCOS, or recent emergency contraception. After emergency contraception, "menses may be early, on time, or delayed", and a pregnancy test is advised if the delay reaches 21 days (Pfenninger and Fowler's Procedures for Primary Care, 3rd ed.).
What works (needs a doctor or pharmacist)
  • Progestin withdrawal bleed. A progestin such as medroxyprogesterone (Provera) is taken for several days and then stopped. When the hormone drops, the uterine lining sheds. In the textbook "progesterone challenge" for absent periods, the dose is 10 to 20 mg/day for 5 to 10 days, and bleeding follows within about 10 days if a uterus is present and estrogen levels are adequate (Textbook of Family Medicine, 9e). Berek & Novak's Gynecology describes a similar use, with medroxyprogesterone 10 mg for 12 to 14 days.
  • Combined oral contraceptive pill. If you already take the pill, you get a withdrawal bleed when you start the placebo or pill-free days. A prescriber can adjust the timing, but you should not change it on your own.
  • Limits. These drugs make the bleed come when the hormone stops, not on demand. If you are mid-cycle or have already ovulated, your own progesterone is already high, so the timing is hard to predict. Oral medroxyprogesterone is also not contraception, and it may suppress ovulation. The NHS SPS guidance covers this for the related use of delaying periods.
What doesn't work
  • Papaya, parsley, ginger, vitamin C, herbal teas, hot baths, intense exercise, and extreme dieting have no good evidence. Some can be harmful, and vitamin C megadoses or herbal "emmenagogues" can cause side effects.
  • Over-the-counter abortifacient claims are unsafe and unproven.
See a clinician promptly if
  • You are sexually active and your period is late.
  • You have not had a period for 3 months or more.
  • You have severe pain, very heavy bleeding, or signs of pregnancy.
  • You have a history of blood clots, migraine with aura, liver disease, or breast cancer. Hormonal options may be unsafe for you.
My search of the last two years of systematic reviews found nothing that changes this advice.
If you tell me the situation (for example a late period, an event you want to time around, or a pill schedule), I can be more specific.
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