Professor Dr Jamiyah Hassan  Senior Consultant OBGYN, Feto-Maternal Specialist, University Malaya Medical Centre

Each year, millions of Muslims undertake the pilgrimage to Mecca during a 5-day period, from the 9th to the 13th of Dhu Al-Hijjah, the 12th month of the Muslim lunar calendar. This pilgrimage is both a religious goal and the high point of a Muslim’s life. For Muslim women preparing for the Hajj, however, there is always a question lurking at the back of their minds: what if they were to menstruate during those precious days?

“Muslim women are not allowed to perform religious activities such as fasting and praying when they have their menses,” explains Prof Dr Jamiyah Hassan. “This extends to performing the Hajj.”

Dr Jamiyah, speaking at the Women’s & Men’s Health Intertwined seminar conducted by the Obstetrical and Gynaecological Society of Malaysia (OGSM) recently, said that combined oral contraceptive pills (COC, sometimes better known as “the pill”) can be used to delay menses during pilgrimage.

Religious decisions

The use of COC involves manipulating the female hormones. Is such a method allowed?

There is no fatwa on delayed menses by the National Fatwa Council, according to Dr Jamiyah. She however points out to specific fatwa in the states. For example in 1985, the Penang Fatwa Council stated that Muslim women are allowed (harus) to delay their menses for the purpose of Hajj, due to the distance travelled for the pilgrimage as well as the difficulty of performing the Hajj ritual. She has also spoken to many religious figures who agreed with this fatwa.

Delaying the period

According to Dr Jamiyah, any COC would work for this purpose, but she recommends choosing the newer brands of COCs. This is because in newer COCs, the active ingredient progestogen is designed to have a longer half-life and therefore, these COCs are more effective.

She offers the following general tips:

• Start a month earlier, as your body needs time to acclimatise to the changes to your menstrual cycle.
• A traditional pill pack contains 28 pills, but only 21 are active. The other seven pills are inactive. Discard the nonactive pills, and continue taking the active pills until you have returned to Malaysia.
• If you bleed during the Hajj, you can still perform your religious duties, provided you clean up first. Dr Jamiyah explains that, according to the fatwa, such bleeding is not considered normal menses as it is the result of hormonal manipulation.

These are only general guidelines. Dr Jamiyah advises women hoping to delay their menses to first consult their doctor, for appropriate dosage and other important information.

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