A randomized, double-blind study of two combined and two progestogen-only oral contraceptives

Contraceptives, Task Force on Oral; Sheth, A. R.; Jain, Uma; S, Sharma; Adatia, A.; Patankar, Sonali; Andolsek, L; Pretnar-Darovec, A.; Belsey, Mark A.; Hall, Peter; Ra, Parker; Ayeni, S.; Pinol, A.; Foo, Christopher

doi:10.1016/0010-7824(82)90047-6

Cited by 57 publications

(2 citation statements)

References 5 publications

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“…POPs are associated with a high incidence of breakthrough bleeding (BTB), and there is a concern that women will cease its use [2]. One study found that 35% of women who stop POPs attribute the cause to BTB and irregular bleeding [27]. In addition to the lifestyle disadvantage, BTB prohibits any intimacy in Jewish and Muslim religious couples.…”

Section: Discussionmentioning

confidence: 99%

Combined Hormonal Contraception during Breastfeeding—A Survey of Physician’s Recommendations

Segev,

Weitzman,

Katz-Samson

et al. 2023

JCM

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Until breastfeeding is established, progesterone-only pill (POP) use is preferable over combined hormonal contraception (CHC), as the latter potentially reduces milk production. Yet, POPs are often associated with breakthrough bleeding (BTB), and irregular spotting is often a reason for their cessation. Conversely, CHC is less associated with BTB but is not usually prescribed, even if breastfeeding has been established, despite its verified safety profile. Here, we surveyed physicians’ perception of CHC safety during breastfeeding through an online questionnaire (N = 112). Physicians were asked if they would prescribe CHC to a woman three months postpartum, breastfeeding fully, and suffering from BTB while using POPs. Half of the physicians responded they would, 28% would not until six months postpartum, while 14% would not during breastfeeding. Of the physicians that would prescribe CHC, 58% would without any reservation, 24% would only after discussing milk reduction with the patient, 9% would use a pill with a lower hormonal dose, and 9% would only prescribe CHC 3 months postpartum. The main risk associated with CHC during breastfeeding, as perceived by physicians, is a potential decrease in breast milk production (88%). While some physicians consider CHC unsafe during breastfeeding, most health organizations consider CHC compatible with breastfeeding 5–6 weeks after birth. Thus, there is a gap in the attitude and knowledge of physicians about the safety profile of CHC, and only half acknowledge that the risk of BTB justifies the use of CHC instead of POPs while breastfeeding three months postpartum. We highlight the importance of physician’s education, advocate CHC breastfeeding compatibility if breastfeeding has been established (i.e., 30 days postpartum), and underline the importance of discussing the option of CHC with patients in case POPs have unwanted side effects.

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Section: Discussionmentioning

confidence: 99%

Combined Hormonal Contraception during Breastfeeding—A Survey of Physician’s Recommendations

Segev,

Weitzman,

Katz-Samson

et al. 2023

JCM

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“…This pattern is seen globally, particularly among the poorest people in high-income countries [4]. Many older studies for hormonal contraceptives, including progestin-only pills (POPs), did not establish contraceptive efficacy, safety, or pharmacokinetics (PK) in obese users (body mass index [BMI] ≥30 kg/m 2 ) [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy, Safety, and Tolerability of an Estrogen-Free Oral Contraceptive Drospirenone 4 mg (24/4-Day Regimen) in Obese Users

Creinin,

Angulo,

Colli

et al. 2024

Obstetrical &Amp; Gynecological Survey

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Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent

Larimore

Stanford

2000

Archives of Family Medicine

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The primary mechanism of oral contraceptives is to inhibit ovulation, but this mechanism is not always operative. When breakthrough ovulation occurs, then secondary mechanisms operate to prevent clinically recognized pregnancy. These secondary mechanisms may occur either before or after fertilization. Postfertilization effects would be problematic for some patients, who may desire information about this possibility. This article evaluates the available evidence for the postfertilization effects of oral contraceptives and concludes that good evidence exists to support the hypothesis that the effectiveness of oral contraceptives depends to some degree on postfertilization effects. However, there are insufficient data to quantitate the relative contribution of postfertilization effects. Despite the lack of quantitative data, the principles of informed consent suggest that patients who may object to any postfertilization loss should be made aware of this information so that they can give fully informed consent for the use of oral contraceptives.

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A randomized, double-blind study of two combined and two progestogen-only oral contraceptives

Cited by 57 publications

References 5 publications

Combined Hormonal Contraception during Breastfeeding—A Survey of Physician’s Recommendations

Combined Hormonal Contraception during Breastfeeding—A Survey of Physician’s Recommendations

The Efficacy, Safety, and Tolerability of an Estrogen-Free Oral Contraceptive Drospirenone 4 mg (24/4-Day Regimen) in Obese Users

Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent

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