Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms

Abstract

Experience in a series of 50 OC users with menstrual-related symptoms demonstrated that delaying menses by extending the number of consecutive days of active pills is well tolerated and efficacious. We believe that a large prospective study is warranted to further our knowledge in this area.

The use of an oral contraceptive containing ethinylestradiol and drospirenone in an extended regimen over 126 days

“…Since 1977, when the first study on the efficacy and acceptance of long-cycle COC regimen had been carried out, numerous studies with different EE/progestogen combinations proved that bleeding can be reduced significantly while unscheduled breakthrough bleeding often increases, typically, during the first months of treatment [3,6,7,19]. Therefore, physicians counseling women on extended regimens and the users need to balance the convenience of fewer scheduled withdrawal bleeding against the inconvenience of slightly more breakthrough bleeding or spotting with an extended regimen-knowing that the individual susceptibility to breakthrough bleeding or spotting is difficult to predict.…”

“…Although it cannot be ruled out that the bleeding profile may have been positively affected, as no COC "starters" were included in the study (who are generally at a higher risk of unscheduled bleeding at the beginning), we do believe that this has no essential impact on the overall interpretation of study results. In contrast, the population in this study reflects both the population of other studies investigating the extended COC use [5,7,9,10,19] and real life of contraceptive counseling where most providers discuss the possibility of this regimen with COC users and most women considering an extended regimen have some experience with OCs.…”

The European Journal of Contraception & Reproductive Health Care

“…Ability to reduce the annual number of bleeding episodes is an attractive option and control of the menstrual cycle with oral contraceptives offers significant health benefits. This approach to achieve amenorrhoea is safe, simple and inexpensive [2][3][4][5] . Amenorrhoea may not be an option desired by all women but health professionals and women should be aware of potential benefits: reduction in menstrual bleeding and dysmenorrhoea; maintenance of iron stores and less anaemia.…”

Long‐cycle combined contraception: less bleeding and increased subject satisfaction

“…Sulak et al (13) investigated extended use of COCs among women suffering from debilitating pelvic pain, headache, heavy bleeding, or pre-menstrual-type symptoms during the pill-free week. A majority (74%) of the 50 women studied showed improvement on extended cycle regimens of 6 Á/12 weeks of active pill use (13).…”

“…Sulak et al (13) investigated extended use of COCs among women suffering from debilitating pelvic pain, headache, heavy bleeding, or pre-menstrual-type symptoms during the pill-free week. A majority (74%) of the 50 women studied showed improvement on extended cycle regimens of 6 Á/12 weeks of active pill use (13). Endometriosis-associated dysmenorrhea, which persisted despite conventional use of COCs, has been reported to be significantly alleviated during continuous use (14).…”