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Ubayd Ali

Authored by

Ubayd Ali

Superintendent Pharmacist

Registration Number: 2219322

NHS Pharmacist and founding member of HEBA, with years of experience in healthcare across innovative organisations.
Sufyan Tahir

Reviewed by

Sufyan Tahir

Clinical Governance Lead

Registration Number: 2221275

Review Date 25 March 2026
Next Review 25 March 2028
Published on 25 March 2026
Last Update 25 March 2026

What Is Norethisterone?

Overview

Norethisterone is a synthetic progestogen — a synthetic form of the female sex hormone progesterone — belonging to the 19-nortestosterone-derived class of progestins. It was first developed in 1951 and has been used in clinical medicine for over sixty years. At 5mg doses, norethisterone is used to treat a range of menstrual disorders and, most commonly in online pharmacy settings, to postpone menstruation for short periods of time.


In the UK, norethisterone 5mg tablets are available under several brand names — including Utovlan (Pfizer/Viatris) and Primolut N (Bayer) — as well as in generic forms from various manufacturers including Wockhardt UK Ltd. All formulations contain the same active ingredient at the same dose and work in exactly the same way. Your pharmacist may dispense a branded or generic version depending on stock availability; this does not affect efficacy.


Norethisterone 5mg is a prescription-only medicine (POM) in the United Kingdom. It cannot be purchased over the counter and must be prescribed by a qualified doctor or prescribing clinician following a clinical consultation, either face-to-face or via a registered online pharmacy service.

What Norethisterone is NOT

It is important to understand what norethisterone does and does not do, particularly when used for period delay:

Norethisterone is NOT a contraceptive. At the 5mg dose used for period delay, it does not reliably prevent ovulation in all women, and pregnancy is still possible. Alternative contraception (such as condoms, the combined pill, or other reliable methods) must be used if pregnancy is to be avoided.
Norethisterone does NOT treat sexually transmitted infections.
Norethisterone is NOT a cure for the underlying causes of heavy or irregular periods. It is a symptomatic or short-term management treatment.
Norethisterone is NOT recommended for regular long-term use for period delay — the product should be used occasionally and is generally limited to 2–3 courses per year

How Does Norethisterone Work?

Mechanism of Action — Progestogen Replacement

Norethisterone is a potent synthetic agonist of the progesterone receptor — meaning it binds to and activates the body's progesterone receptors with approximately 150% of the binding affinity of the body's own natural progesterone. This potent progestogenic activity underpins all of its clinical effects.


The normal menstrual cycle is regulated by fluctuations in the levels of several hormones, including oestrogen and progesterone. During the second half of the cycle (the luteal phase, roughly days 15–28), the corpus luteum — formed from the ruptured follicle after ovulation — produces progesterone, which maintains the endometrial lining of the uterus in a thickened, secretory state in preparation for a potential pregnancy. If pregnancy does not occur, the corpus luteum degenerates, progesterone levels fall sharply, and this drop in progesterone is the direct trigger for the shedding of the endometrial lining — the monthly period.


Norethisterone works by artificially maintaining elevated progestogen levels, mimicking the effect of the luteal phase and preventing the progesterone fall that would otherwise trigger menstruation. Whilst the woman continues to take norethisterone tablets, the endometrium receives a continuous progestogen signal to remain intact, and the period is delayed for as long as treatment continues.


Period Delay — Specific Mechanism

For the period delay indication, norethisterone is typically taken three times daily at a total dose of 15mg per day. Treatment should start three days before the expected onset of menstruation. Starting earlier than three days in advance may be necessary in some cases to achieve reliable delay; starting later — or at the time the period is already due — may not be sufficient to prevent bleeding from beginning.


Once you stop taking norethisterone, the artificially maintained progestogen level falls, triggering a withdrawal bleed that typically resembles a normal period. This withdrawal bleed usually begins within 2–3 days of the last tablet. Normal menstrual cycles typically resume thereafter.

How Should Norethisterone Be Used?

Norethisterone is most commonly prescribed for period delay. The following instructions apply:

Establish when your next period is expected. You need to be able to predict the likely start date of your period with reasonable accuracy.
Start taking norethisterone 3 days before your period is expected to begin. This lead time is essential — if you start taking norethisterone on or after the expected date your period may not be successfully delayed.
Take one 5mg tablet three times daily. Space the doses as evenly as possible throughout the day — for example, with breakfast, lunch, and dinner, or at 8-hour intervals.
Continue taking the tablets for as long as you wish to delay your period, up to a maximum of 20 days total. This provides up to approximately 17 days of actual period delay (3 days lead-in + 17 days delay = 20 days total course).
When you are ready for your period to begin, simply stop taking the tablets. Your period should begin within 2–3 days of your last dose.
If your period does not start within 3 days of stopping norethisterone, you should perform a pregnancy test and contact your GP.


What If I Miss a Dose?

If you forget to take a tablet, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not take two tablets at once to make up for a missed dose. If you are late with a dose and notice breakthrough bleeding or spotting beginning, continue taking the tablets as prescribed — this does not necessarily mean the treatment has completely failed.

âš   Missed Doses and Period Delay

If you regularly miss doses, or take norethisterone fewer than three times daily, you are at increased risk of breakthrough bleeding (spotting) during the intended delay period. Consistent three-times-daily dosing is essential for period delay to be reliable.

What Are The Potential Side Effects Of Norethisterone?

Overview

Like all prescription medicines, norethisterone can cause side effects, although not everyone will experience them. When used at 5mg three times daily for period delay — typically for a short course of up to 20 days — most women tolerate norethisterone well and do not experience significant adverse effects. The likelihood and severity of side effects generally increases with higher doses and longer duration of use.

Common side effects can include:

  • Breakthrough bleeding or spotting
  • Breast tenderness
  • Headache
  • Dizziness
  • Fatigue
  • Nausea

Who Should Not Use Norethisterone?

Do NOT use if:

  • Hypersensitivity or allergy to norethisterone, any other similar hormonal medicines, or any of the excipients (lactose, maize starch, magnesium stearate). Patients with rare hereditary problems of galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption should not take norethisterone due to its lactose content.
  • Pregnancy, or suspected pregnancy. Norethisterone is contraindicated during pregnancy. A pregnancy test must be excluded before starting treatment if any doubt exists. Norethisterone is not teratogenic at clinical doses based on available data, but use during pregnancy is not justified for period delay and should be avoided.
  • Previous idiopathic or current venous thromboembolism (VTE) — including deep vein thrombosis (DVT) or pulmonary embolism (PE). A personal history of blood clots is an absolute contraindication.
    Active or recent arterial thromboembolic disease — including angina pectoris or myocardial infarction (heart attack).
  • Current or past disturbance of liver function, or active liver disease. Norethisterone is metabolised by the liver; impaired hepatic function may lead to accumulation and toxicity.
  • History during pregnancy of idiopathic jaundice (cholestasis of pregnancy).
  • History of severe pruritus or pemphigoid gestationis (herpes gestationis — a rare autoimmune skin condition of pregnancy).
  • Undiagnosed irregular vaginal bleeding. Any unexplained vaginal bleeding must be investigated before prescribing norethisterone, as hormonal treatment could mask the cause of bleeding or worsen an underlying condition.
  • Porphyria (any form) — norethisterone is contraindicated in all porphyrias due to the risk of triggering an acute attack.
  • Known, suspected, or past history of hormone-sensitive carcinomas — including carcinoma of the breast (except where specifically prescribed by an oncologist at high dose for disseminated breast cancer treatment) or other hormone-dependent cancers. Gynaecologists advise against use in women with a personal history of genital or breast cancer.

Further Information

Verified customer reviews

Frequently asked questions

  • Is norethisterone effective?

    If taken as prescribed, norethisterone is effective at delaying your period for short periods of time. However, it’s important that you take the medication as instructed and don’t skip any tablets or start the treatment later than 3 days before your period would normally start.

    Period delay tablets such as norethisterone are more effective in delaying the periods for some women than others. 

  • What are the main side effects of norethisterone?

    Side effects from norethisterone are unusual but you may notice some spotting, irregular bleeding, sore breasts, stomach ache, and a lower sex drive. The longer you delay your period – up to the maximum of 27 days – the more likely you’ll experience side effects.

    Blood clots are a rare side effect of norethisterone. Stay active and well hydrated while you take this medicine. Keep in mind symptoms of blood clots which can occur in different parts of the body: blood clots in the leg usually show up as painful tenderness and swelling in the calf. In the lungs and head blood clots can cause a sudden and severe chest pain, unusually severe headache or changes in vision. In extremely rare cases, there can be sudden shortness of breath or a sudden inability to speak. If you notice any of these, please seek urgent medical attention.

    Using norethisterone can also worsen migraine, diabetes, asthma, depression, and epilepsy. This isn’t common, given the short amount of time you take it, but there is a small risk.

    Norethisterone isn’t for everyone. If you have a BMI of over 35, suffer from migraines or epilepsy, we might suggest you try a different treatment to delay your period. Contact our clinicians to discuss your suitability and other possible period delay treatments.

    Please read the Patient Information Leaflet that comes with your medicine for full details of side effects and how to take norethisterone.

  • What else should I know about norethisterone?

    Norethisterone is not a contraceptive and will not stop you from becoming pregnant. To prevent pregnancy while taking norethisterone, you should use a contraceptive method such as the contraceptive pill, a coil, implant or condoms.

    If you’re pregnant, or think that you might be pregnant or are trying to conceive, you shouldn’t take norethisterone. You should also avoid taking norethisterone if you’re breastfeeding.

    Norethisterone is not suitable if you’re taking a combined contraceptive pill, or if you’re using the contraceptive ring or patch. If your contraception contains a progestogen then there is a higher likelihood of side effects while using norethisterone.

    If you’re currently on HRT (hormone replacement therapy), you can’t use norethisterone to skip a period. There are other treatments that can be used alongside HRT to delay your period. Contact our clinical team for advice on delaying your period if you’re unable to take norethisterone.

  • What are the non-drug alternatives to norethisterone?

    There are no non-drug alternatives that you can use to delay your period. Your period is triggered by a natural drop in your body’s hormone levels, specifically progesterone. The only way to keep this from happening, and to delay your period, is to keep your hormone levels artificially high for a short time. To keep hormone levels high enough to delay a period, you need to take a synthetic form of progesterone.

  • Does norethisterone cause weight gain?

    In some cases, norethisterone can cause weight gain or bloating. This is most likely caused by the increase in hormone levels causing your body to retain water and will likely normalise once you’ve stopped treatment.

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