Evaluation of the clinical performance of three triphasic oral contraceptives: A multicenter, randomized comparative trial

Schilling, Lee H.; Bolding, O. Thomas; Chenault, C. Brandon; Chong, Augusto P.; Fleury, Fred J.; Forrest, Katherine A.; Glick, Henry I.; Hasson, Henrietta; Heil, Charles G.; London, Robert S.

doi:10.1016/s0002-9378(89)80011-0

Cited by 28 publications

(3 citation statements)

References 5 publications

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“…Spotting and breakthrough bleeding dropped below the pretreatment incidence after three months of use [13]. The rate of breakthrough bleeding was similar to or better than that previously published for other low-dose triphasic regimens [14]. The slowly increasing doses of gestodene during the various phases and the increase in estrogen during the second phase mimic the cyclical variations in hormone levels of normal natural cycles.…”

Section: Discussionsupporting

confidence: 67%

Inhibition of ovulation by a triphasic gestodene-containing oral contraceptive

Spona

Lachnit-Fixson²,

Düsterberg³

et al. 1993

Adv Contracept

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The minimal effective dose of gestodene for inhibition of ovulation was studied in 30 female volunteers. Daily doses of 10 micrograms to 50 micrograms gestodene were given orally for 21 days. A control cycle prior to treatment and a treatment cycle were monitored for LH, FSH, estradiol, progesterone and cervical score. At a daily dose of 40 micrograms of gestodene, 6/7 volunteers exhibited inhibition of ovulation and 1/7 had a cycle with luteal insufficiency. Ovulation was inhibited in all volunteers on 50 micrograms gestodene, suggesting that the minimum dose required to inhibit ovulation was 40 micrograms gestodene. Cervical score was blunted even at 10 micrograms gestodene. Similarly, 20 volunteers were treated with coated tablets containing ethinylestradiol/gestodene at 30/50 micrograms for 6 days, 40/70 micrograms for 5 days and 30/100 micrograms for 10 days. This triphasic gestodene-containing preparation inhibited ovulation in all 20 females. In one cycle in which follicle development was observed only 43 pg estradiol/ml was secreted. Data from this investigation suggest that this triphasic gestodene-containing OC has a high contraceptive efficacy.

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Section: Discussionsupporting

confidence: 67%

Inhibition of ovulation by a triphasic gestodene-containing oral contraceptive

Spona

Lachnit-Fixson²,

Düsterberg³

et al. 1993

Adv Contracept

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“…In the studies for which follow-up data were available, fewer than half the women starting the study remained at its conclusion. Two studies provided detailed information about reasons for discontinuation [4,23], but many did not differentiate between patients lost to follow-up or those who terminated participation at the request of the patient or investigator. The most common reason cited for loss of patient participation was OC discontinuation.…”

Section: Resultsmentioning

confidence: 99%

“…Results of two such studies suggest that the progestogen component may affect cycle control. In the first study, women taking levonorgestrel consistently had the lowest incidence of spotting and breakthrough bleeding [23]. Although the 16 ] BTB…”

Section: Resultsmentioning

confidence: 99%

Oral contraceptives and cycle control: A critical review of the literature

Rosenberg

Long

1992

Adv Contracept

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Control of spotting and breakthrough bleeding and absence of withdrawal bleeding, collectively termed cycle control, is the single most important determinant of whether a new user of oral contraceptives (OCs) will continue this method. However, information about different OC preparations and how they affect such problems, including the effects of progestogen and estrogen phasing and the components of these hormones, is scant and confusing. Studies cited in this report reveal highly variable rates of bleeding problems in women taking OCs: after 6 months of OC use, the prevalence of spotting varied between 0% and 8.5%; of breakthrough bleeding, 0% and 12.2%; and of amenorrhea, 0% and 5.8%. At least some of this variation is attributable to differing study populations and cultures, study designs, and the manner in which data were collected and reported. However, methodologic weaknesses were common, often involving lack of randomization and blinding, and attrition rates were high. Despite these limitations, it is clear that the frequency of bleeding problems decreases with continuing use of OCs, emphasizing the need for patient reassurance about the transient nature of these problems. In addition, gestodene-containing preparations appear to offer better cycle control than do desogestrel-containing preparations and levonorgestrel-containing preparations better control than norethindrone-containing preparations. However, the strongest lesson to emerge is the need for more rigorous studies to adequately address questions of comparative bleeding problems, particularly with newer triphasic formulations. These conclusions underscore the importance of counseling new OC users about the possibility of bleeding problems, reassuring them that most such problems are temporary, and, that if compliance is maintained, these will not impair contraceptive efficacy.

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Biphasic versus triphasic oral contraceptives for contraception

Vliet

Helmerhorst

2001

The Cochrane Database of Systematic Reviews

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Evaluation of the clinical performance of three triphasic oral contraceptives: A multicenter, randomized comparative trial

Cited by 28 publications

References 5 publications

Inhibition of ovulation by a triphasic gestodene-containing oral contraceptive

Inhibition of ovulation by a triphasic gestodene-containing oral contraceptive

Oral contraceptives and cycle control: A critical review of the literature

Biphasic versus triphasic oral contraceptives for contraception

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