Norethisterone appears to be being prescribed to patients to delay the onset of menstruation during holidays, say the authors of an analysis in the British Medical Journal (2000;320:291). This could be considered convenience or "lifestyle" prescribing, the appropriateness of which "is open for debate".
Dr Judy Shakespeare (Summertown health centre, Oxford) and colleagues evaluated the prescribing of norethisterone 5mg in Oxfordshire between April, 1995, and December, 1998, as part of the implementation of recommendations on the management of menorrhagia published by the Royal College of Obstetricians and Gynaecologists. These guidelines state that norethisterone 5mg is not an effective treatment of menorrhagia.
The authors say that there was an overall decrease in prescribing of the drug over the study period but that the number of items rose rapidly between April and July each year. There were smaller peaks at Christmas and the New Year. When they plotted the norethisterone prescribing pattern for England (excluding Oxfordshire) and compared it with that for Oxfordshire, the graphs were almost the same.
"It seems most likely that the seasonal peaks in prescribing were due to patients wishing to delay menstruation during holidays, particularly summer holidays," they say. However, they add that they were unable to determine a number of factors, including whether prescribing was patient- or doctor-led, or whether the same patients returned each year. They conclude that use of norethisterone for this indication would make it "a ‘lifestyle' drug" and comment that this may not be appropriate for the NHS. However, they concede that norethisterone is a cheap drug with few side effects.

Use of norethisterone to delay onset of menstruation during holiday seasons could explain peaks in prescribing, researchers say