Attitude of German women and gynecologists towards long-cycle treatment with oral contraceptives

New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles

“…It appears that extended regimens do induce amenorrhoea in most subjects, but there is a tendency for increased spotting and breakthrough bleeding, particularly in the early months of treatment. With time, the bleeding often improves and, despite the inconvenience, women are prepared to accept this 15,16,37 . This initial increased bleeding and spotting may be more pronounced in 'new' pill users 16 .…”

“…With time, the bleeding often improves and, despite the inconvenience, women are prepared to accept this 15,16,37 . This initial increased bleeding and spotting may be more pronounced in 'new' pill users 16 . On a practical level, there is a benefit in the reduced quantity of withdrawal bleeding in extended regimens with a significant difference in the amount of money spent on feminine hygiene products 15 .…”

“…Is there evidence that extended use of COCs is also a safe practice? While physicians have long been convinced that fertility promptly and fully recovers following discontinuation of OC use, many women still express concerns about infertility associated with the suppression of ovarian activity and the resultant changes in the menstrual cycle 16,17 . As discussed earlier, research on the effect of COCs on ovarian, specifically follicular function, has demonstrated that there is sufficient follicular suppression during the days that active pills are being taken.…”

“…German gynaecologists were found to prescribe extended cycles primarily for medical reasons such as dysmenorrhoea, hypermenorrhoea, endometriosis, and premenstrual dysphoric disorder. They indicated a preference for the uninterrupted intake of three packs of COCs, followed by a seven-day break 16 . A prospective survey of over 500 health care professionals in the United States (including primary care physicians, obstetrician/gynaecologists, nurse practitioners, and physician assistants), who prescribe OCs, revealed that 87% thought that extended use regimens should be offered routinely, with only 12% believing that withdrawal bleeding with the conventional seven-day hormone-free interval had 'health benefits and is necessary' 33 .…”

Women’s perceptions about reducing the frequency of monthly bleeding: results from a multinational survey

“…[5][6][7] Reasons given by women who would prefer not to reduce the frequency of scheduled bleeding by taking OCs include: fear of pregnancy, fear of infertility, fear of adverse events, and the belief that it is "unnatural" not to have a monthly bleed. 7,8 For those women Dovepress submit your manuscript | www.dovepress.com who would prefer to bleed less frequently, the reasons given include: less blood loss, fewer intense menstrual complaints, better hygiene, and improved quality of life. 7 The health effects of current menstrual patterns are unproven.…”