what is known already: While many studies have investigated views toward extended use of COCPs, little research has examined women's actual experiences with these regimens. study design, size, duration: This was a semi-structured qualitative interview study that was part of a larger randomized trial of a standard (21 daily pills followed by a 7-day pill-free interval) versus a tailored regimen (daily pills until 3-consecutive-day bleeding triggers a 3-day pill-free interval) of Microgynon 30w mcg (Ethinyl estradiol 30 mcg, Levonorgestrel 150 mcg).participants/materials, settings, methods: Interviews were conducted with 26 women (17 in the tailored group and 9 who switched their assigned treatment group) . Data were analyzed using thematic analysis.main results and the role of chance: Women discussed positive changes associated with tailored use of COCPs, as well as some negative consequences. The major themes identified in the interview data were: ease of tailored regimen; changes in cycle-related symptoms; adjustment to reduced/absent bleeding and unpredictability about bleeding.limitations, reasons for caution: The sample comprised mainly young, nulliparous women. The majority of women were using COCPs at the start of the study.wider implications of the findings: Clinicians discussing extended-use regimes with patients should mention that women may need time to adjust to an extended-use regime. Future research should attempt to identify predictors of response to extended use of COCPs.
Background Extended use of the combined oral contraceptive pill (COC), defined as taking active pills for at least 28 days, has been used in order to avoid bleeding at important times and to treat gynaecological conditions such as endometriosis. We examined the main issues involved in extended use of the COC and how it has evolved from being one of medicine's best-kept secrets to becoming more widely accepted by women and the medical community. Study design Literature review, using Medline, Embase, Pubmed, CINHAL Plus, the Cochrane Database of Systematic Reviews and the Ovid database for all relevant clinical trials, systematic reviews, meta-analyses, literature reviews, scientific papers and individual opinions between 1950 and October 2013. Results Accumulating evidence supports various forms of extended pill use as suitable alternatives to the standard (21/7) regimen. In terms of user preference, much hinges on whether women wish to reduce the frequency or duration of scheduled bleeding on the combined pill. Available data on the safety of extended pill regimens do not give cause for concern, but longer term data should be collected. Conclusions Information for women considering extended COC regimens should keep pace with research findings to ensure that women and clinicians are better informed about the choices available.
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