medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2010, Number 01

<< Back Next >>

Ginecol Obstet Mex 2010; 78 (01)

Combined hormonal contraception in cycles artificially extended

Bustillos-Alamilla E, Zepeda-Zaragoza J, Hernández-Ruiz MA, Briones-Landa CH

Language: Spanish
References: 17
Page: 37-45
PDF size: 358.12 Kb.


ABSTRACT

Objective: To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX.
Material and methods: Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens.
Results: Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle.
Conclusion: Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.


REFERENCES

  1. Steinauer J, Autry M. Extended cycle combined hormonal contraception. Obstetrics and gynecology clinics. Philadelphia: WB Saunders, 2007.

  2. Villanueva EL, Pichardo CL. Adelantos en anticoncepción hormonal. Ginecol Obstet Mex 2007;75:35-42.

  3. Clarke A, Miller S. The debate regarding continuous use of oral contraceptives. Ann Pharmacother 2001;35:1480-1484.

  4. Loudon N, Foxwell M, Potts D, Guild A, et al. Acceptability of an oral contraceptive that reduces the frequency of menstruation: the tri-cycle pill regimen. BMJ 1977;2:487-490.

  5. Thomas S, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000;355:922-924.

  6. Glasier A, Smith K, Van Der SZ, et al. Amenorrhea associated with contraception-an International Study on acceptability. Contraception 2003;67:1-8.

  7. Den TI, Oddens B. Preferred frequency and characteristics of menstrual bleeding in relation to reproductive status, oral contraceptive use, and hormone replacement therapy use. Contraception 1999;59:357-362.

  8. Sulak P, Cressman B, Waldrop E, Holleman S, et al. Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms. Obstet Gynecol 1997;89:179-183.

  9. Sulak P, Buckley T, Kuehl T. Attitudes and prescribing preferences of health care professionals in the United States regarding use of extended-cycle oral contraceptives. Contraception 2006;73:41-45.

  10. Baerwald A, Olatunbosun O, Pierson R. Ovarian follicular development is initiated during the hormone-free interval of oral contraceptive use. Contraception 2004;70 :371-377.

  11. Bachman G, Sulak P, Sampson-Landers C, et al. Efficacy and safety of a low-dose 24-day combined oral contraceptive containing 20 mcg ethinylestradiol and 3 mg drospirenone. Contraception 2004;70:191-198.

  12. Anderson F, Hait H. A multicenter, randomized study of an extended cycle oral contraceptive. Contraception 2003;68:89-96.

  13. Anderson F, Gibbins W, Portman D. Long-term safety of an extended-cycle oral contraceptive (Seasonale): a 2-year multicenter open-label extension trial. Am J Obstet Gynecol 2006;196:92-96.

  14. Kwiecien M, Edelman A, Nichols M, et al. Bleeding patterns and patient acceptability of standard or continuous dosing regimens of a low-dose oral contraceptive: a randomized trial. Contraception 2003;67:9-13.

  15. Edelman A, Gallo M, Jensen J, et al. Continuous or extended cycle vs cyclic use of combined oral contraceptives for contraception. Cochrane Database Syst Rev 3. 2005;CD004695.

  16. Miller L, Verhoeven C, Hout J. Extended regimens of the contraceptive vaginal ring: a randomized trial. Obstet Gynecol 2005;106:473-482.

  17. Hollis S, Campbell F. What is meant by intention to treat analysis? Survey of published randomized controlled trials. BMJ 1999;319:670-674.




2020     |     www.medigraphic.com