Women’s preferences for menstrual bleeding frequency: results of the Inconvenience Due to Women’s Monthly Bleeding (ISY) survey

Nappi, Rossella E.; Fiala, Christian; Chabbert-Buffet, Nathalie; Häusler, Günther; Jamin, C.; Lete, Iñaki; Lukasiewic, Monika; Pintiaux, Axelle; Lobo, Paloma

doi:10.3109/13625187.2016.1154144

Cited by 20 publications

(14 citation statements)

References 39 publications

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“…Among the most frequent experiences or symptoms related with menstruation, we identified dysmenorrhea, bloating, irritability, and fatigue; these results are coherent with former studies [10,34,35]. Multiple previous studies already identified dysmenorrhea as being one of the most common menstrual problems among teenagers and young women, worldwide [36][37][38] and, more specifically, among Spanish university students [3].…”

Section: Discussionsupporting

confidence: 89%

Absenteeism during Menstruation among Nursing Students in Spain

Fernández‐Martínez

Onieva-Zafra

Abreu-Sánchez

et al. 2019

IJERPH

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Absenteeism can clearly have a negative impact on academic performance among university students. Certain experiences or symptoms such as menstrual pain are very common in women and can lead to absenteeism. The current study was aimed at examining the presence of menstrual experiences or symptoms and their impact upon absenteeism among healthy (illness-free) female university nursing students in Spain. A total of 299 students participated in this research, which was a descriptive cross-sectional, observational study. An ad hoc online questionnaire was used based on sociodemographic and gynecological data, together with the noted menstrual experiences; the most prevalent of which were bloating, which affected 87.3% of students; dysmenorrhea and irritability, which affected 76.3%; and fatigue, which affected 70.6%. Students with dysmenorrhea had a 6.95 higher (odds ratio (OR) 6.95; 95% confidence interval (CI) 3.39–14.25) odds of absenteeism; in those who reported dizziness, the odds of absenteeism was 4.82 times higher (OR 4.82; 1.76–13.23); in those who manifested nausea and vomiting, the percentage of absenteeism was 3.51 higher (OR 3.51; 95% CI 1.51–8.15); in those who presented sleep alterations, the odds were 2.95 higher (OR 2.95; 95% CI 1.39–6.25); and for those who felt depressed the odds were 2.18 times higher (OR 2.18; 95% CI 1.21–3.94) Absenteeism was found to be more likely in women with dysmenorrhea. However, in addition, higher odds of absenteeism were also found in women with nausea and vomiting, dizziness, sleep disorders, and those who feel depressed. These menstrual experiences can be considered a relevant problem among young women, leading to absenteeism, and a negative influence on academic performance. It is essential to raise awareness of the socioeconomic impact of absenteeism and establish new strategies for improving menstrual experiences.

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Section: Discussionsupporting

confidence: 89%

Absenteeism during Menstruation among Nursing Students in Spain

Fernández‐Martínez

Onieva-Zafra

Abreu-Sánchez

et al. 2019

IJERPH

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“…Our findings reinforce the evidence that extended-regimen 91-day cycle COC use with low-dose EE during the traditional HFI, with quarterly scheduled bleeding, is a contraceptive option that helps to meet an important treatment need among the growing number of women who desire fewer scheduled bleeding episodes 7,8. Effectiveness of extended-regimen 84/7 COC as a contraceptive method in the real world has been shown through significantly lower unintended pregnancy rates compared with 21/7 or 24/4 regimens, using an insurance claims database 25.…”

Section: Discussionsupporting

confidence: 79%

“…The bleeding patterns reported by women using this extended regimen in our post hoc analysis align well with the preference being expressed by many women for reduced bleeding episodes and increased acceptance of contraceptive-induced amenorrhea 8,11. The replacement of the traditional HFI with continuous low-dose EE in this regimen may further improve hormone withdrawal symptoms experienced by some women18 and may improve cycle control, including unscheduled bleeding/spotting.…”

Section: Discussionsupporting

confidence: 75%

“…Surveys examining bleeding preferences and attitudes about menstrual suppression show that the majority of women prefer menstrual periods at a frequency of less than once monthly,8–10 and instead prefer once every 3 months or no periods at all 8,9,11. Key non-medical factors underlying desire for menstrual suppression include convenience and reducing interference with sexuality, social life, work, and sports activities 8–10.…”

Section: Introductionmentioning

confidence: 99%

“…Key non-medical factors underlying desire for menstrual suppression include convenience and reducing interference with sexuality, social life, work, and sports activities 8–10. Widespread acceptance of extended-regimen COC by clinicians has been shown 12.…”

Section: Introductionmentioning

confidence: 99%

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Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval

Nappi¹,

Abascal²,

Hsieh

et al. 2017

IJWH

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PurposeTo evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI).Patients and methodsThis post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy. Subjects recorded bleeding and spotting episodes daily using electronic diaries. Logistic regression analyses are reported as ORs with 95% CIs.ResultsThere was a 10% increase (OR =1.102; 95% CI: 1.006–1.206) in the likelihood of reporting no scheduled bleeding for each additional 91-day cycle completed. From the third 91-day cycle, more than one fifth of women reported no scheduled bleeding (third cycle =23% [121/533]; fourth cycle =22% [97/446]). Among women who reported no scheduled bleeding at Cycle 1 (136/758 [18%]), ≥45% showed sustained lack of scheduled bleeding in later cycles. There were increases of 53% (OR =1.531; 95% CI: 1.393–1.683) and 31% (OR =1.307; 95% CI: 1.205–1.418) in the likelihood of reporting 0 to ≤6 days vs >6 days of unscheduled bleeding and spotting, respectively, for each additional 91-day cycle. By Cycle 2, more than 80% of women reported no unscheduled bleeding or ≤6 days of unscheduled bleeding during each 91-day cycle.ConclusionImproved cycle control with decreased bleeding over time was shown during extended-regimen COC with 30 µg EE/150 µg LNG for 84 days and continuous low-dose EE instead of the traditional 7-day HFI. Women considering this regimen should be informed that those who complete at least one 91-day COC cycle will likely experience less bleeding/spotting in future cycles.

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There might be blood: a scoping review on women’s responses to contraceptive-induced menstrual bleeding changes

Polis

Hussain²,

Berry³

2018

Contraception

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Introduction: Concern about side effects and health issues are common reasons for contraceptive non-use or discontinuation. Contraceptive-induced menstrual bleeding changes (CIMBCs) are linked to these concerns. Research on women's responses to CIMBCs has not been mapped or summarized in a systematic scoping review. Methods: We conducted a systematic scoping review of data on women's responses to CIMBCs in peer-reviewed, English-language publications in the last 15 years. Investigator dyads abstracted information from relevant studies on pre-specified and emergent themes using a standardized form. We held an expert consultation to obtain critical input. We provide recommendations for researchers, contraceptive counselors, and product developers. Results: We identified 100 relevant studies. All world regions were represented (except Antarctica), including Africa (11%), the Americas (32%), Asia (7%), Europe (20%), and Oceania (6%). We summarize findings pertinent to five thematic areas: women's responses to contraceptive-induced non-standard bleeding patterns; CIMBCs influence on non-use, dissatisfaction or discontinuation; conceptual linkages between CIMBCs and health; women's responses to menstrual suppression; and other emergent themes. Women's preferences for non-monthly bleeding patterns ranged widely, though amenorrhea appears most acceptable in the Americas and Europe. Multiple studies reported CIMBCs as top reasons for contraceptive dissatisfaction and discontinuation; others suggested disruption of regular bleeding patterns was associated with non-use. CIMBCs in some contexts were perceived as linked with a wide range of health concerns; e.g., some women perceived amenorrhea to cause a buildup of "dirty" or "blocked" blood, in turn perceived as causing blood clots, fibroids, emotional disturbances, weight gain, infertility, or death. Multiple studies addressed how CIMBCs (or menstruation) impacted daily activities, including participation in domestic, work, school, sports, or religious life; sexual or emotional relationships; and other domains. Conclusions: Substantial variability exists around how women respond to CIMBCs; these responses are shaped by individual and social influences. Despite variation in responses across contexts and sub-populations, CIMBCs can impact multiple aspects of women's lives. Women's responses to CIMBCs should be recognized as a key issue in contraceptive research, counseling, and product development, but may be underappreciated, despite likelyand potentially substantialimpacts on contraceptive discontinuation and unmet need for modern contraception.

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Women’s preferences for menstrual bleeding frequency: results of the Inconvenience Due to Women’s Monthly Bleeding (ISY) survey

Cited by 20 publications

References 39 publications

Absenteeism during Menstruation among Nursing Students in Spain

Absenteeism during Menstruation among Nursing Students in Spain

Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval

There might be blood: a scoping review on women’s responses to contraceptive-induced menstrual bleeding changes

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