Effects of an oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest on lipid metabolism during 1 year of conventional or extended-cycle use

Wiegratz, Inka; Stahlberg, Skadi; Manthey, Torsten; Sänger, Nicole; Mittmann, Katrin; Palombo‐Kinne, Ernesta; Mellinger, Uwe; Lange, Evelyn; Kühl, H.

doi:10.1016/j.contraception.2009.07.011

Cited by 23 publications

(16 citation statements)

References 24 publications

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“…In addition, a pharmacokinetic study confirmed that extended use of ethinyl estradiol and levonorgestrel does not result in additional accumulation of these hormones in the body compared to cyclic regimens 32 . Other studies have demonstrated that lipid profiles, hemostasis variables, thyroid hormones, and androgen parameters are similar with extended and cyclic regimens 33–35 …”

Section: Effectiveness Safety and Side Effects Of Cyclic Extendedmentioning

confidence: 84%

“…Dozens of studies that have in total included thousands of participants have confirmed the safety of extended and continuous combined contraceptive regimens 14–53,55–59 . This body of work has documented that there are no harmful effects on the uterus or endometrium in women who use extended or continuous contraceptive regimens.…”

Section: Evidence‐based Counseling For Extended and Continuous Contramentioning

confidence: 99%

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Extended and Continuous Combined Contraceptive Regimens for Menstrual Suppression

Jacobson¹,

Likis²,

Murphy³

2012

J Midwife Womens Health

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Many women have medical indications for menstrual suppression or a personal preference to reduce or eliminate monthly bleeding, which can be achieved with extended and continuous regimens of combined estrogen and progestin contraceptives. Combined contraceptives are traditionally administered in a 28-day cycle, with 21 days of a contraceptive pill, vaginal ring, or transdermal patch followed by a hormone-free interval that is usually 7 days. During the hormone-free interval, women either take a placebo pill or do not use their combined contraceptive method. Hormone-related symptoms are significantly worse during the hormone-free interval than the days when the contraceptive is used. Alterations of the standard 28-day cyclic regimen for menstrual suppression include decreasing the frequency of the hormone-free interval, thus extending the time between withdrawal bleeding episodes (extended use), and eliminating the hormone-free interval altogether (continuous use). This article reviews menstrual suppression indications and physiology. Research demonstrating that the effectiveness, safety, and side effects of oral, vaginal, and transdermal extended and continuous regimens are comparable to cyclic regimens is summarized. Findings from studies of women's and health care providers' attitudes toward menstrual suppression also are reviewed. Important topics to include in evidence-based counseling for extended and continuous combined contraceptive use are presented.

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Section: Effectiveness Safety and Side Effects Of Cyclic Extendedmentioning

confidence: 84%

Section: Evidence‐based Counseling For Extended and Continuous Contramentioning

confidence: 99%

Extended and Continuous Combined Contraceptive Regimens for Menstrual Suppression

Jacobson¹,

Likis²,

Murphy³

2012

J Midwife Womens Health

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“…Other well-designed RCTs have found no significant differences in the changes in haemostatic variables or in blood lipid or lipoprotein levels between the two groups 55 56. The use of a flexible extended regimen of EE/drospirenone (DRSP) over a study period of 2 years was shown to have an acceptable safety profile with no deaths reported and only four serious adverse events that were possibly related to the study medication: focal nodular hyperplasia, uterine leiomyoma and two cases of deep vein thrombosis.…”

Section: Resultsmentioning

confidence: 95%

Evolution of extended use of the combined oral contraceptive pill

Panicker

Mann

Shawe

et al. 2014

J Fam Plann Reprod Health Care

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Background Extended use of the combined oral contraceptive pill (COC), defined as taking active pills for at least 28 days, has been used in order to avoid bleeding at important times and to treat gynaecological conditions such as endometriosis. We examined the main issues involved in extended use of the COC and how it has evolved from being one of medicine's best-kept secrets to becoming more widely accepted by women and the medical community. Study design Literature review, using Medline, Embase, Pubmed, CINHAL Plus, the Cochrane Database of Systematic Reviews and the Ovid database for all relevant clinical trials, systematic reviews, meta-analyses, literature reviews, scientific papers and individual opinions between 1950 and October 2013. Results Accumulating evidence supports various forms of extended pill use as suitable alternatives to the standard (21/7) regimen. In terms of user preference, much hinges on whether women wish to reduce the frequency or duration of scheduled bleeding on the combined pill. Available data on the safety of extended pill regimens do not give cause for concern, but longer term data should be collected. Conclusions Information for women considering extended COC regimens should keep pace with research findings to ensure that women and clinicians are better informed about the choices available.

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“…Four RCTs (15,42–44) demonstrated no significant difference in the lipid profiles between the two regimens. Wiegratz 2010 (42) found an increase in total cholesterol, high‐density lipoprotein, triglycerides and very‐low‐density lipoprotein, and a decrease in low‐density lipoprotein over the study period of one year for both groups. In three RCTs (43–45) the hemostatic parameters during conventional OC administration were compared with the values during continuous administration.…”

Section: Resultsmentioning

confidence: 96%