Menstrual Suppression Using Oral Contraceptives by Female Hajj Pilgrims

Document Type : Original Article


1 Deputy of Medical Centre Hajj and Plgrimage of Iranian Red Crescent Society, Tehran, Iran

2 Department Medical Surgical Nursing, Faculty of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

3 Rafsanjan University of Medical Sciences, Rafsanjan, Iran

4 Department of Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

5 Department of Clinical Psychology, Kar Higher Education Institute of Rafsanjan, Rafsanjan, Iran

6 Tehran University of Medical Sciences, Tehran, Iran

7 Research center of Addiction and Behavioral sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

8 Diabetes Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran


Introduction: The pilgrimage to Ka’beh (God’s house in Mecca) is a special opportunity in the life of most Muslims. Female pilgrims try to postpone menstruation during the pilgrimage by taking hormonal medicines. However, women are seen in this disorder. This paper aimed to determine the frequency of menstrual disorders and related factors among female pilgrims of Umrah Mufradah in 2012.
Methods: This study was a descriptive type, the population of which comprised 400 female Iranian pilgrims aged 15-50 years who were selected through random cluster sampling from Umrah caravans. Data was collected with a questionnaire developed by the researchers that contained questions about menstrual disorders. The questionnaire was distributed among participants at their hotels three days prior to their return to Iran.
Results: Among all the participants, 98.7% of them reported taking pills to suppress menstruation. Of this group, 74.7% successfully prevented menstruation, 26% reported spotting, and 11.6% reported menstruation. There was no significant difference between consumption of medicine and factors such as marital status, city, and educational background of the individuals. Participants reported that spotting and menstruation caused them to experience stress and anxiety when performing Umrah rituals.
Conclusion: Experiencing menstrual disorders during pilgrimage can be stressful for pilgrims. To reduce such problems, counseling sessions on menstruation postponement as part of the justification classes before departing for Hajj and compiling an equal and coordinated nationwide protocol seem necessary.


  1. Al-Ghamdi AS, Kabbash IA. Awareness of healthcare workers regarding preventive measures of communicable diseases among Hajj pilgrims at the entry point in Western Saudi Arabia. Saudi Med J. 2011;32(11):1161-1167.
  2. Al-Ghamdi SM, Akbar HO, Qari YA, Fathaldin OA, Al-Rashed RS. Pattern of admission to hospitals during muslim pilgrimage (Hajj). Saudi Med J. 2003;24(10):1073-1076.
  3. Azarpazhooh MR, Rafi S, Etemadi MM, Khadem N, Fazlinejad A. The relation between short-term oral contraceptive consumption and cerebrovascular, cardiovascular disorders in Iranian women attending Hajj. Saudi Med J. 2008;29(7):1024-1027.
  4. Bakhsh AR, Sindy AI, Baljoon MJ, Dhafar KO, Gazzaz ZJ, Baig M, et al. Diseases pattern among patients attending Holy Mosque (Haram) Medical Centers during Hajj 1434 (2013). Saudi Med J. 2015;36(8):962-966. doi:10.15537/smj.2015.8.12120.
  5. Berek JS. Novak’s Text Book of Gynecology. 13th ed. Baltimore: Williams & Wlkins; 2002:250-261.
  6. Burkman RT. Oral contraceptives current status. Clin Obstet Gynecol. 2001;44(1):62-72. doi:10.1097/00003081-200103000-00010.
  7. Madani TA, Ghabrah TM, Al-Hedaithy MA, et al. Causes of hospitalization of pilgrims in the Hajj season of the Islamic year 1423 (2003). Ann Saudi Med. 2006;26(5):346-51.
  8. Mansour D, Experiences with Yasmin; the acceptability of a novel oral contraceptive and its effect on well being. Eur J Contracept Reprod Health Care. 2002; 7 Suppl 13:35-41.
  9. Elachola H, Assiri A, Turkestani AH, et al. Advancing the global health security agenda in light of the 2015 annual Hajj pilgrimage. Int J Infec Dis. 2015. doi:10.1016/j.ijid.2015.10.003.
  10. Sulak PJ, Kuehl TJ, Ortiz M, Shull BL. Acceptance of altering the standard 21-day/7day oral contraceptive regimen to delay menses and reduce hormone withdrawal symptoms. Am J Obstet Gynecol. 2002;186(6):1142-1149.
  11. Ghorashi Z, Taleghani F, Shafiee M. Failure and side effects of contraceptive pills used for postponement of menstrual bleeding in Hajj Pilgrims of Kerman (2000). JSSU. 2005;12(4):65-70.
  12. Riaz SA, Ahmadi M, Mortazavi SM. Predictors of anxiety and depression among women with vaginal bleeding referred to gynecology clinic during hajj 2011. Iran Red Crescent Med J. 2014;16(11):e12855. doi:10.5812/ircmj.12855.
  13. Masood K, Gazzaz ZJ, Ismail K, Dhafar KO, Kamal A. Pattern of psychiatry morbidity during Hajj period at Al-Noor specialist hospital. Int J Psychiatry Med. 2007;37(2):163-172.
  14. Mohammed-Durosinlorun A, Raji HO, Hussain NA, Badmus SA, Ijaiya MA. Menstrual suppression among female Nigerian pilgrims during Hajj. J Fam Plann Reprod Health Care. 2012;38(4):270-271. doi:10.1136/jfprhc-2012-100401.
  15. Tin SS, Wiwanitkit V. Hajj pilgrimage surveillance in pilgrims from African countries. Trop Med Int Health. 2015;20(2):E11. doi:10.1111/tmi.12413.