Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Mid cycle bleeding & hypertension

20 May, 2005


I am (almost) 46, and went off birth control pills about 3 months ago because I suddenly developed very high blood pressure. I had been on and off the pill before to control mid cycle bleeding. I often bleed when I ovulate for anywhere from 1 to 4 days. It is a flow – not just spotting. Because of the timing I have been niddah, except for 24 – 48 hour breaks after going to the mikvah, for the past 3 months. Obviously, this is a difficult situation. Going back on the pill is not possible, according to my MD, because of the blood pressure issues. Since I have shown no signs of menopause, this could go on for years. Do I have any options? Are there leniencies for the length of time I am niddah since it is mid-cycle bleeding?
Thank you for your help.


We’re sorry to hear about your situation.

Please start by reviewing our article “Ketamim,” to make sure you are not considering yourself niddah, at any time in your cycle, when you are not halachically required to do so.

Please also further explore the medical questions. While having high blood pressure is a relative contraindication for using hormones, there should be investigation as to whether there is any treatable underlying cause to your sudden onset of hypertension. Then, one should investigate whether intermittent use of hormones (for a few days midcycle for example) might be permitted (rather than the three weeks needed for birth control pills). If this is not possible, you should also discuss options such as endometrial ablation which eliminates most of the uterine lining.

You may want to refer your physician to, our website for medical professionals. The site is designed to assist health care professionals in providing optimal care to patients who observe hilchot niddah.

This internet service does not preclude, override or replace the psak of any rabbinical authority. It is the responsibility of the questioner to inform us of any previous consultation or ruling. As even slight variation in circumstances may have Halachic consequences, views expressed concerning one case may not be applied to other, seemingly similar cases. All health and health-related information contained within Nishmat's Women's Health & Halacha Web site is intended to be general in nature and should not be used as a substitute for consulting with your health care professional. The advice is intended to offer a basis for individuals to discuss their medical condition with their health care provider but not individual advice. Although every effort is made to ensure that the material within Nishmat's Women's Health & Halacha Web site is accurate and timely, it is provided for the convenience of the Web site user but should not be considered official. Advice for actual medical practice should be obtained from a licensed health care professional.

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