New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles

Read, Christine

doi:10.3109/13625187.2010.529969

Cited by 29 publications

(19 citation statements)

References 49 publications

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“…24/4-and 26/2-day regimens) were shown to be beneficial for menstrual cycle complaints, including menstrual pain [15]. In general, a simple and shared hypothesis is that few days of menstrual bleeding might be associated with less dysmenorrheic pain.…”

Section: Discussionmentioning

confidence: 98%

Effect of oral contraceptives containing estradiol and nomegestrol acetate or ethinyl-estradiol and chlormadinone acetate on primary dysmenorrhea

Grandi

Napolitano

Xholli

et al. 2015

Gynecological Endocrinology

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Section: Discussionmentioning

confidence: 98%

Effect of oral contraceptives containing estradiol and nomegestrol acetate or ethinyl-estradiol and chlormadinone acetate on primary dysmenorrhea

Grandi

Napolitano

Xholli

et al. 2015

Gynecological Endocrinology

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“…In this manuscript we have focused on reporting the change in scores from the end of the run-in period (Cycle 3) to the end of the treatment period (Cycle 9) in the DHEA group vs placebo group, in accordance with the study objectives and statistical analysis plan. Assessments were performed during the pill-free period, since most subjective complaints occur during that period of cyclic COC use [37,38].…”

Section: Assessment Of Sexual Function Mood Menstrual Cycle Symptommentioning

confidence: 99%

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: II. Clinical effects

Zimmerman¹,

Foidart²,

Pintiaux³

et al. 2015

Contraception

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Source of fundingThe study was financially supported by Pantarhei Bioscience Conflict of interestYZ is an employee of Pantarhei Bioscience (PRB), the company developing the Androgen RestoredContraceptive concept for contraception. JMF has no conflict of interest in the course of this study.AP shares expertise as a lecturer, member of advisory boards, and/or consultant, with Bayer, Amgen, Gedeon Richter and Teva/Theramex, without personal gain. JMM has nothing to declare. KC has nothing to declare. BF has received fees and grant support from the following companies (in alphabetic order); Andromed, Ardana, Euroscreen, Ferring, Genovum, Merck (MSD), Merck Serono, Organon, Ovascience, Pantharei Bioscience, PregLem, Schering, Schering Plough, Serono, Uteron Pharma, Watson Pharmaceuticals and Wyeth. HCB is the CEO and a shareholder of PRB.After publication of the paper, PRB will make the clinical study report available upon request. The authors alone are responsible for the content and the writing of the paper. Clinical Trial Registration Number: ISRCTN06414473A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT AbstractObjectives: Combined oral contraceptives (COCs) decrease androgen levels, including testosterone (T), which may be associated with sexual dysfunction and mood complaints in some women. We have shown that co-administration of dehydroepiandrosterone (DHEA) to a drospirenone (DRSP) containing COC restored total T levels to baseline and free T levels by 47%. Here we describe the effects on sexual function, mood and quality of life of such an intervention. Study design:This was a randomized, double-blind, placebo-controlled study in 99 healthy COC starters. A COC containing 30 µg ethinylestradiol (EE) and 3 mg DRSP was used for 3 cycles, followed by 6 cycles of the same COC combined with 50 mg/day DHEA or placebo. There were no statistically significant differences between groups for the MSFQ and Q-LES-Q scores. DHEA co-administration resulted in an acceptable safety profile. DHEA negated the beneficial effect of the COC on acne according to the subjects' self-assessment. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTConclusions: Co-administration with DHEA did not result in consistent improvements in sexual function, mood and quality of life indicators in women taking EE/DRSP.Retrospectively, the 50 mg dose of DHEA may be too low for this COC.Implications A well-balanced judgment of the clinical consequences of normalizing androgens during COC use may require complete normalization of free T.

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“…This also reduced the concerns of not having bled on a monthly basis and also provided an assurance of not being pregnant. 10,11 However, it has been suggested that the 21/7 regimen has its own sets of concerns. 11 Evidence suggests that 21/7 COC regimens might not adequately suppress ovarian…”

Section: The Classical 21/7 Regimenmentioning

confidence: 99%

“…12 The problem is substantial with a missed or late start of the next COC pill cycle, consequently resulting in contraceptive failure. 11 Another major problem is that the pill-free interval allows recurrence of withdrawal symptoms, such as headache, acne, and premenstrual symptoms, which are otherwise controlled by active pills.…”

Section: Ahuja M Et Al Int J Reprod Contracept Obstet Gynecol 2017 mentioning

confidence: 99%

Ultra-low-dose oral contraceptive pill: a new approach to a conventional requirement

Ahuja

Pujari

2017

Int J Reprod Contracept Obstet Gynecol

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Combined oral contraceptives (COCs) offer a convenient, safe, effective, and reversible method of contraception. However, their use is limited by side effects. Several strategies have been suggested to make COC use more acceptable among women. Reduction in the dose of estrogen is a commonly accepted approach to reduce the side effects of COC. Use of newer generation of progestins, such as gestodene, reduces the androgenic side effects generally associated with progestogens. Furthermore, reduction in hormone-free interval, as a 24/4 regimen, can reduce the risk of escape ovulation (hence preventing contraceptive failure) and breakthrough bleeding. It also reduces hormonal fluctuations, thereby reducing the withdrawal symptoms. A COC with gestodene 60 µg and ethinylestradiol (EE) 15 µg offers the lowest hormonal dose in 24/4 treatment regimen. This regimen has been shown to offer good contraceptive efficacy and cycle control. With the progress of treatment cycles, the incidence of breakthrough bleeding reduces. Gestodene/EE low dose 24/4 regimen was associated with lower incidence of estrogen-related adverse events, such as headache, breast tenderness, and nausea. Furthermore, COCs containing low dose of estrogen have not been associated with any adverse effect on haemostasis in healthy women. Ultra-low-dose COCs can be considered in women who are at risk of developing estrogen-related side effects.

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New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles

Cited by 29 publications

References 49 publications

Effect of oral contraceptives containing estradiol and nomegestrol acetate or ethinyl-estradiol and chlormadinone acetate on primary dysmenorrhea

Effect of oral contraceptives containing estradiol and nomegestrol acetate or ethinyl-estradiol and chlormadinone acetate on primary dysmenorrhea

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: II. Clinical effects

Ultra-low-dose oral contraceptive pill: a new approach to a conventional requirement

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