Background and methodology Combined oral contraceptives (COCs) provide reliable and convenient contraception, although contraindications and tolerability issues may limit their use in some women. Progestogenonly pills (POPs) may be more suitable for some women, however, traditional POPs do not have the same contraceptive efficacy as COCs. A literature search was performed in order to assess the incidence of ovulation with
IntroductionOral contraceptives are the most common means of contraception in many countries and it is estimated that as many as 100 million women worldwide currently rely on this method. Approximately half of all married women in Western Europe use the oral contraceptive pill (i.e. three in every five contraceptive users) and, in the USA, they have been used by 80% of all women born since 1945. [1][2][3][4] Their widespread use warrants continuing efforts to improve and refine oral contraceptive methods.The first oral contraceptive pill became available in 1960 and consisted of 150 µg mestranol plus 9.85 mg norethynodrel. These doses were much higher for both the estrogenic component and the progestogenic component compared to modern low-dose combined oral contraceptives (COCs). COCs provide highly reliable and convenient contraception, which is safe and well tolerated by many women. A number of side effects predominantly attributed to estrogen, such as nausea, headache, breasttenderness and bloating, can, however, make them unacceptable to some women. These problems have been addressed to some extent by lowering the doses of both estrogen and progestogen.Estrogen-free contraception appeared in the early 1970s when the traditional progestogen-only pills (POPs) were developed in response to reports of the effects of estrogen on thromboembolic disease. As well as lacking the estrogen Results Many of the studies were hampered by inadequate ovulation criteria; however, the overall incidence of ovulation determined by the reports uncovered in the literature search was 2.0% [95% confidence interval (CI) 1.1-3.3] with COCs containing 30-35 µg ethinylestradiol (EE), 1.1% (95% CI 0.60-2.0) with 15-20 µg EE COCs, 4.6% (95% CI 2.8-6.9) with phasic COCs, 1.25% (95% CI 0.03-6.8) with Cerazette and 42.6% (95% CI 33.4-52.2) with traditional POPs.
ConclusionsThe findings indicate that COCs and the desogestrel POP are equally effective in suppressing ovulation, whilst the traditional POP formulations are less effective.