Awareness and experiences of female pilgrims about menstrual suppression during Hajj 1437 Hijrah: A cross-sectional study

Objectives: Our objective was to determine the awareness, use of medications to suppress menstruation along with their side effects, and satisfaction level among the pilgrims. Methods: An observational cross-sectional survey was conducted during the pilgrimage (Hajj) period 1437 Hijrah in Makkah, Saudi Arabia. Women pilgrims (n = 594) between menarche and menopause were interviewed. The proportion of females who was aware of menstrual suppression by medication, who used the medication during Hajj period, and who experienced complaints while using drugs to postpone the periods, and after stopping the drugs were sorted. Results: The participants were mean aged 35.3 years (standard deviation = 8.4), with 413 (69.5%) being multiparous, 556 (93.6%) were aware of menstruation postponement by medications, and 313 (56%) got this information from their family doctors. However, 381 (64%) used medications, and 356 (93.3%) successfully achieved menstrual suppression. Out of 381, majority used Norethisterone, i.e., 301 (79%) and 80 (21%) complained of side effects, of which the most common was irregular spotting 31.3% (25/80) followed by abdominal pain. Satisfaction of medications users was 324 (85%). Out of 381 women, 87 (22.8%) reported side effects after discontinuing the hormones; the commonly experienced side effect was heavy prolonged bleeding 47 (54%). Conclusions: The awareness about hormones usage to postpone menstruation was high. Norethisterone was commonly used medication. Overall satisfaction with medications' usage was high. Most women did not know what to do in case of unscheduled bleeding.