حج

The majority of contemporary Islamic scholars, including the Permanent Committee for Scholarly Research and Ifta, Sheikh Ibn Baz, and Sheikh Ibn Uthaymeen, have permitted women to use medication to delay menstruation during حج, provided it does not cause harm. Their reasoning is that حج is an obligation that occurs on fixed dates, and using medication to facilitate the performance of واجب rituals is a legitimate means to a legitimate end. Sheikh Ibn Uthaymeen stated that there is no objection to a woman taking pills to prevent menstruation during حج so that she can perform طواف with the people, provided she consults a specialist doctor to ensure the medication will not harm her. The condition of no harm is consistently emphasized — if a doctor advises against it due to health risks, the religious permission does not override medical safety.

Several hormonal methods can delay menstruation. The most commonly used is norethisterone (Primolut N), a progestogen-only medication taken three times daily starting 3 days before the expected period and continued throughout the حج period. It effectively delays menstruation in most women but can cause side effects including bloating, mood changes, and breakthrough bleeding. Combined oral contraceptive pills can also be used by continuing active pills without the usual break week. This is called 'back-to-back' pill use and is medically safe for short periods. For women already on hormonal contraception, their doctor can advise on adjusting the timing. All hormonal methods should be discussed with a doctor at least 2 to 3 months before حج to allow time for a trial run and dose adjustment if needed. Do not start hormonal medication for the first time just days before حج without prior medical consultation.

Hormonal medication does not guarantee menstruation will not occur — breakthrough bleeding is possible, particularly with first-time use or if doses are missed. If bleeding occurs despite medication, consult a scholar about whether it constitutes menstruation (which would prevent طواف) or istihadah (irregular bleeding, which does not prevent worship). Women with contraindications to hormonal therapy — including history of blood clots, certain heart conditions, liver disease, or hormone-sensitive cancers — should not use these methods. The physical demands of حج (extensive walking, heat, dehydration) can affect hormonal medication efficacy and increase side effects. If you decide against hormonal methods, know that menstruation during حج is manageable — طواف can be delayed until purity returns, and all other rites can be performed normally.