Preparing for Hajj...without your period!

8/30/2011

As Ramadan comes to an end and we prepare to celebrate the great holiday of Eid al Fitr, there are many of us with our eyes on a bigger prize...our upcoming trip to Hajj. For younger women, there is always an anxious thought in the back of our minds: what if our period is due during those few precious days?

Generally speaking, the best approach is to start a combined oral contraceptive pill ("the birth control pill") 2 full menstrual cycles before Hajj. As phsyicians, we often recommend starting the first pills in the pack during your menses, though you can technically start at any time. There's a risk of spotting (among other things you have to discuss with your personal doctor) during the first few months of the pill, so I like to have my patients start 2 months before Hajj. Then, when you're traveling, take an extra pack with you. When you come to the last week of the pill (also known as the "placebo" week or the week of "sugar pills") you don't take them, but start the pills in the new pack. You can, in this manner, successfully suppress your period.

If you go in to see your personal OB/GYN, and you communicate that you'll be on the trip of a lifetime and absolutely need to suppress your period, this is likely what they'll recommend as well. As for choices of pill, I generally put my patients on Ocella (generic for Yasmin) but other pills of similar hormone levels will work as well. I prefer to avoid the low-dose pills for this purpose (Yaz, Lo-estrin, Ortho-Tricyclen-Lo) due to the increased risk of spotting if you try to skip a period.

And God knows best.

DISCLAIMER: Information in questions, answers, and other posts on this site are for general information, and are not intended to substitute for informed professional medical advice, and do not establish a physician-patient relationship. The site is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

37 Comments

muslim

2/8/2012 01:09:40 am

Asalamalekum..i am planning to go for umrah next month and iam scared that my mensuration will be on the same date is there any solution to postpone my cycle except having contracetive pills..help plz

Sarah Azad, MD link

2/20/2012 01:08:02 pm

The most reliable method, as mentioned in this post, is combined contraceptive pills. A second option would be the Depo shot, but please see the next post on that topic for all the reasons it's not the first choice.

Is there a non-hormonal way to suppress your period? Not that I know of in this context.

May your Umrah be full of blessings.

Noor

12/1/2016 09:21:03 pm

Assalamualaikum sister,

I will be leaving for umrah on the 23rd this month InshaAllah. Past 6 months I was getting my period on the 12th, But last month it was weird I got my period on the 9th of November and today I had brownish discharge ( ussually will get it before period). Is it too late to take Birth control pill. Please advice..

Jazakallahu khair

Sarah Azad, MD link

12/4/2016 11:20:17 pm

Dear Noor,

Though I'm sure you're frustrated, this is a specific medical question that can be answered by your local OB/GYN.

This forum is not a source of personal medical advice.

Hajji

5/7/2012 05:54:14 am

Listen Ladies... I performed Hajj, Alhamdulillah, WITH my period. Yes, that's right, I had my period during the Hajj season. And I didn't miss out on a THING. The only part that I had to delay doing was the final tawaaf around the Kaaba, (Tawaaf e Ziarat), since I couldn't enter the Masjid Al-Haram. I performed it just as soon as my period ended, the day AFTER my group had performed it, so it was no big deal. I'm just saying to women, there is another option of performing Hajj without having to take meds to suppress your period. Allah SWT Blessed us with menstrual cycles so why would He want us to stop this natural process. Your Hajj will still be valid. I realize there are time constraints for those of us traveling, but for those of you who do have some 'wiggle room' during your travel to Mecca, you should consider the option of not using meds at all. Allah SWT Knows Best.

New York

8/11/2016 04:12:02 pm

It is true that period is part of nature for female. However, my period usually last upto total of 11 days.. 5 to 6 days brownies discharge then continue with bleesing for the next 5 or 6 days.. it may be hard to wait in there.. I am planning to go this september 2016.. any suggestions of what should I do? Thanks in advance

Sarah Azad, MD link

8/11/2016 08:57:54 pm

Dear New York,

Your period is not normal and all that bleeding is not your "period". I strongly recommend you see a local OBGYN for evaluation and treatment of your bleeding.

If you were my patient, I would not give you birth control pills for suppression of menses for Hajj with that bleeding history.

I pray you seek care and are in good health.

New York

8/11/2016 09:54:12 pm

Jazakila Khairan Dr Azad for the prompt response. I actually thought about that abnormality. Are you saying all 11 daya are consider abnormal or the 5 to 6 bleeding days? Actually only since early last year I have 5 to 6 days brownies discharge..usually only 1 or 2 days.. but the following 5 to 6 days are normal bleeding, just like always. only 2 days were somewhat heavy and the rest were normal amounts. Please let me know which part consider abnormal. What could cause the problem? And if it is abnormal for the firts 5 to 6 days (the brown phase) could I just perform ibadah on those days? I really appreciate your points of view so I know what to do or say when I see my OBYN and before I go to hajj.. jazakila Khairan.

Sarah Azad, MD link

8/12/2016 10:14:12 am

I know it's convenient to post questions here, but you really need to just go see a physician. They need to evaluate you.

I have no insight into your problem, other than it is a problem, without more information, which I NEVER provide "virtually", only to patients in my office sitting in front of me.

It is the safest, best way to practice medicine.

Sarah Azad, MD link

5/24/2012 04:50:53 am

Jazakulah khair "hajji" for your comments. Absolutely, if time allows, there's no reason for any woman to suppress her menses in order to attend Hajj. There are clear guidelines on what rituals to do and which to postpone while on your menses. That is a conversation you need to have with your Hajj leader/religious teacher. This article was written for those women who have calculated that their expected period and purchased plane tickets would not allow them to fully perform the Hajj without suppressing their menses.

Madinah

6/3/2012 05:07:23 am

Dear Dr. Azad. I had a question regarding use of contraceptive pills for the purpose of suppressing periods prior to going on pilgrimage. If an unmarried Muslim sister started taking the pills (in this case, she was prescribed Lo Loestrin Fe by her physician) 4 days after the end of her last period and 2 months prior to her travel for pilgrimage, and is experiencing light bleeding 6 days after starting the pills, should she be concerned? Will the bleeding (which her physician warned her about as a side-effect) stop on its own after her body adjusts to the pill or should she go back to her physician to change pills or ask about increasing the dosage of the current pill (I noticed in your blog post, you mentioned Loestrin is a low-dose pill with an increased risk of spotting). Finally, in regards to her religious obligations, while the sister is in this state of experiencing light bleeding as a side effect of the pill, should she refrain from praying, fasting and reciting the Quran or is her condition (due to its abnormality outside of her normal menstruation cycle) considered to be that of “istihadah” (or “mustahad”) and the bleeding does NOT ban her from praying, reciting Quran, etc. according to the Sunnah. Thank you for any help/advise or pointers you can offer regarding these questions.

Yasmin

6/8/2012 12:34:04 am

Why do some birth control pills have a whole week of sugar pills (such as Yasmin) while others have only a few (Lo Loestrin Fe has only 2 sugar pills)?

Sarah Azad link

6/8/2012 05:32:07 am

Madinah--for such a complicated issue, I would talk with someone directly (your OB/GYN) for the bleeding and for the fiqh. The fiqh is complicated and varies a LOT by school of thought.

Yasmin--the lower dose pills need 24 days of medicated pills to successful suppress ovulation and decrease the risk of spotting. Low dose pills (ie. Yaz, Lo-estrin) have 4 days of placebo ("sugar pills). Lo-estrin has 2 brown pills that also contain iron, not technically related to cycle control or birth control.

Yasmin

6/13/2012 11:43:03 am

Thank you Dr. Azad for your last response. A follow-up question: if you are using the lower dose pills to suppress menstruation, are you supposed take the 24 days of combined estrogen-progesterone pills and then skip to the next pack? Or should you also take the 2 estrogen-only pills (for the 25th and 26th) and then skip to the next pack? I'm mainly wondering whether the estrogen-only pills qualify as placebo which you should skip (if you want to avoid a period) or should you take them and only skip the 2 no-hormone pills at the end of pack. Any clarification would be greatly appreciated. Thanks.

Zanib

12/29/2015 07:41:54 am

Is there any side effect if we take tablet plz tell me

Sarah Azad link

6/15/2012 06:36:21 pm

Yasmin, I apologize, but to keep the discussion focused, this blog is for medical issues that are specific to Islamic practices. It is not a substitute for your own doctor, nor is it an online portal for basic medical questions. Your prescribing doctor should be able to answer these quite general and basic medical questions.

It may seem like I am nitpicking, but I want to be a resource for the community for something you may not otherwise have access too. There is no way I could maintain this blog if anyone could ask any medical question and expect a response.

Amna

7/31/2012 06:00:46 am

It is Ramadan and I skipped my placebo of Ortho-Cyclen. I have been very lightly spotting for 2-3 days, does this void my prayers/fasts? I know that it is breakthrough bleeding and not my actual period. Please, advise.

Sarah Azad, MD link

11/8/2012 09:03:44 am

This is a question for a scholar of fiqh. Inshallah you have someone you trust in your community. To remind everyone, this blog is to help people with OB/GYN issues that affect fiqh. I am not qualified to advise anyone in fiqh-specific questions and I am not offering a place for people to ask any medical question they want. Those kids of questions should be directed to their medical providers or religious teachers.

Umm Meriem

11/5/2012 07:26:48 pm

As salaamu alaikum,
My husband and I are trying to conceive, but due to my excessively long menstrual cycle, I opted to take birth control to suppress my periods during the Hajj journey. I started the pill in early September, and took them daily, but the time may have varied by an hour or so each day. When we left for our journey the times became more sporadic, but I never missed a day. I had a small amount of spotting in Madinah, but have had not sign of a period whatsoever. I'm feeling a bit nauseous for the past week. I'm wondering if its possible that I could be pregnant, and at what point it would be good to test. Both my daughters were taking the same pill, and they both began their menses right away, al hamdulillah. My mother-in-law spent most of her Hajj asking Allah to give us twins, so maybe this is her du'a answered, wa'Allahu A'leem. :)

Sarah Azad, MD link

11/8/2012 09:06:16 am

Again, I will have to direct you to your doctor. I have started this blog to be a resource to the community in OB/GYN issues that affect fiqh. I never intended for this to be an open medical question forum.

Forgive me for my shortcomings, but I do not believe patients get good advice outside of a real doctor-patient relationship. Furthermore, I have a full schedule with my practice, my community work and my family, I am simply unable to be an online doctor for all Muslim women with internet access.

zakia

6/22/2013 06:57:38 am

dear dr,
please advice regarding delaying menses for coming Ramadan 2013. when to start and when to stop the medicines yasmin.today is my 5 day of menses

Sarah Azad, MD link

6/22/2013 11:46:22 am

hajj 2013

9/19/2013 11:00:07 pm

ASWRB...my doc prescribed me loseasonique. Hajj is in oct and I just started taking this on sept 17....do you think I will be ok for the upcoming hajj?

Hajjan13

10/1/2013 01:16:51 am

Isra

9/10/2014 03:17:50 pm

I need help urgent please. first time taking pills, my period is always regular. this month it was supposed to start at 8th sept but it came early because of the pills. i am going to hajj on 21 sept. and i wanted to stop my period till i come back which is on Oct 8. I am taking Junel Fe. started taking it from Aug 18. I got my period before i stoped the 21 pill, my period came on 3rd sept. But I completed the tablets on 8th sept. i am still bleeding heavy its 7th day. what is the next step i should do so i don't bleed on hajj days. my gyn told me to "Cont. taking pills till i come back and there is no garente that i wont bleed on those days, but the pills will minimize the chance of getting it on those day". what it your opinion. what should i do. because now my period is unpredictable plz help. i am regretting taking the pills.

Hina

5/16/2015 03:20:05 am

Salaam,

I started taking my pills two months prior to my Umrah trip so I won't bleed but I started spotting through out my trip. Some doctor later told me that one should not start the pills so soon. What is your recommendation on this ? Please be advised.

Layla

10/27/2015 07:55:21 am

Asalam Alaikum sister. I have a question. I get bad migraines with aura and therefore cannot take anything with estrogen. I am unmarried and non-sexually active so contraception management is not a concern for me. I want to be able to skip my period so I can perform umrah. My trip lands exactly on when I am suppose to get my period in 2 months. I know brrakthrough bleeding is an issue with progestin only products. Would you recommend the oral progestin or the implanon? I don't mind leaving the implanon in as I will be getting married in 8 months inshallah. But for less breakthrough bleeding and skipping of period, which one would you prefer?
Jak for your time

Sarah Azad, MD link

5/21/2016 06:20:24 pm

Salams Layla,

Forgive my late reply, but your question is excellent.

I would not recommend the Implanon for Hajj, as it causes minimal, light spotting, but at completely irregular and unpredictable times.

Progesterone oral tablets are not ideal, but as you mentioned, regular oral contraceptives would be a dangerous choice for you. Oral progesterone however, can be doubled or tripled, if needed, when you start spotting to stop it. You would just need some guidance from your OBGYN.

Any regular OBGYN, if you are clear that you want to suppress your period, can explain how to take it. Then ask about how to increase it if you start spotting, clarify that the spotting is an issue, and they will show you how to increase it.

That said, if you spot due to the medication, it is not menstrual bleeding, but "Istihada" or "irregular vaginal bleeding" and your worship is allowed, but you have to follow the specific rules for that condition to establish your wudu.

May Allah accept your Hajj.

And Allah knows best.

Noorah

6/30/2016 01:56:20 pm

I've been in the pill for about 8 months ( loestrin fe1-20) .
I wanted to supress my period during Ramadan so I started a new pack at the time when I was supposed to take the placebo pills. I started to spot and assumed it was my period and stopped praying / fasting .
Now over a week into the new pack I'm still spotting on an off , is this considered isthada?

Sarah Azad, mD link

7/5/2016 08:55:28 am

A common question, but I am going to have to direct you to a teacher in your area. What is and isn't istihadha is really a fiqh question and the answer varies a great deal depending on your school.

To deal with the spotting, so that it resolves, I would encourage you to contact your OB/GYN.

Nur link

8/16/2016 12:48:35 pm

ASA
I have started on Syeda pill about 3 weeks ago...I am going on hajj and was advised to skip the placebo dose and stop on Aug 20.. Get my period and then Restart the medicine and continue taking everyday continuously until I return from hajj (Sept 18)
I am experiencing some spotting rite now my LMp was July 8th

If I experience spotting in the hajj dates?
( Can I take twice the does to suppress the breakthrough bleeding ?)
Anything else can be taken it done to ensure no spotting
I am taking this for first time and very nervous about issue of spotting/bleeding during hajj

Jazakullah for your input !

Nur link

8/16/2016 01:36:18 pm

ASA
I have started on Syeda pill about 3 weeks ago. (Started on July 24)..I am going on hajj and was advised to skip the placebo dose and stop on Aug 20.. Get my period and then Restart the medicine and continue taking everyday continuously until I return from hajj (Sept 18)
I am experiencing some spotting rite now my LMp was July 8th

If I experience spotting in the hajj dates?
( Can I take twice the does to suppress the breakthrough bleeding ?)
Anything else can be taken it done to ensure no spotting
I am taking this for first time and very nervous about issue of spotting/bleeding during hajj

Jazakullah for your input !

s.ali

8/30/2016 02:18:37 pm

Salam....I'm going for hajj in 8 days in sha Allah. My periods are highly irregular and scanty since I got mirena inserted. I may not have a period for a whole year.however I have had spotting with menstrual cramps for the last 3 months.I wasn't aware of the requirement to suppress my period for hajj.also for last 3 months the spotting started on 27th of each month.this month nothing happened. What course of action should I pursue now? JazakAllah khair

Nur

1/5/2017 06:25:19 am

Assalamualaikum,
I'm going to Mecca with intention to make umrah, in 2 months. I started my period today after being 5 days late and totally moved my schedule 7 days later and may disrupt my umrah plans. Are these pills safe for someone with alpha thalassemia & I was recently diagnosed with sub clinical overractive thyroid. I would definitely not want to miss the ajr of umrah but not at a cost for my health. Allahu mustaan.

Thanks in advance.

Reshma

3/21/2017 04:42:45 am

Assalamalaikum
Doctor
I am planning to go to Hajj this year inshaallah my question is I am very irregular with my periods last time I had my periods were in Jan and this is end of march but did not get any and some time I get 2 times how do I manage this at the time of my Hajj pls help me n advice me pls

Sarah Azad, MD link

3/21/2017 12:52:12 pm

Wa alaykum assalam sister,

There are two parts to your question, both answered in above article.

First, you have irregular periods, that should be managed in consultation with your personal physician. Irregular periods are often a symptom of other medical problems.

Second, for Hajj, if your doctor has determined you do not have a major medical problem preventing you from taking the pill, I most often put my patients on the birth control pill to control their cycles while on Hajj, as written in above article.

May Allah accept your Hajj.

Sarah Azad, MD

Reshma

3/22/2017 05:11:17 am

Jazakallah for the quick reply may allah bless you and u r family

Preparing for Hajj...without your period!

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