Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study

Briggs, Paula; Serrani, Marco; Vogtländer, Kai; Parke, Susanne

doi:10.2147/ijwh.s107586

Cited by 22 publications

(4 citation statements)

References 18 publications

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“…In a European Phase III trial, with 20 cycles of observation, only 2.5% of women discontinued treatment prematurely due to bleeding irregularities 13. Our data are higher than the above, but quite similar to those of a large clinical study performed in a real-life setting (27.7%) 14. The discontinuation rate for irregular bleedings that we observed with E2-COCs was higher than that (5.3%) observed in a previous study performed on women who took pills with 20 mcg of EE,12 possibly due to the higher stability of the endometrium when synthetic estrogens were used 15.…”

Section: Discussionsupporting

confidence: 79%

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

Fruzzetti

Paoletti

Fidecicchi

et al. 2019

OAJC

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Purpose: The aim of the study was to examine the discontinuation rate of hormonal contraception with estradiol valerate (E2V) and dienogest (DNG). Patients and methods: We collected data at the Family Planning Clinics of the Departments of Obstetrics and Gynecology of Pisa and Cagliari. We included in the analysis 354 consecutive women using oral contraceptive pills containing E2V and DNG. We analyzed the rate and the reason for discontinuation, classifying the reasons in 5 categories: 1) minor side effects, 2) adverse events, 3) other events not directly caused by the drug or conditions for which the pill could represent a risk factor, 4) no compliance with the method and 5) no further need. Results: Of the 354 women examined, 50.8% had discontinued E2V/DNG pill. Excluding women who stopped the pill because of no further need (10.5%), 27.4% discontinued because of minor side effects, 1.7% discontinued for adverse events, 9.9% because of other events not directly caused by the drug or conditions for which the pill could represent a risk factor and 1.4% because of difficulties with compliance. Irregular bleedings were the main reasons reported for discontinuation. The time to discontinuation for irregular bleedings was significantly ( p <0.02) longer in adults than in adolescents and slightly but not significantly longer in women who received information about this possible effect. Conclusion: Unacceptable cycle control was the principal cause of discontinuation of pill with E2V and DNG. An appropriate information about this possible effect may improve adherence to this combined oral contraceptive.

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Section: Discussionsupporting

confidence: 79%

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

Fruzzetti

Paoletti

Fidecicchi

et al. 2019

OAJC

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“…Hormonal contraceptive methods and IUDs may induce changes in menstrual bleeding patterns [14][15][16], which can impact willingness to try or continue using these methods, or method satisfaction [6,[17][18][19][20][21][22][23]. Contraceptive-induced menstrual bleeding changes (CIMBCs) may include bleeding patterns which are predictable but diverge from a "typical" menstrual pattern (such as amenorrhea, commonly induced by methods such as progestin-only injectables, or heavy, prolonged bleeding often experienced by copper IUD users [24,25]), or may cause unpredictable bleeding patterns.…”

Section: Introductionmentioning

confidence: 99%

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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“…For example, a systematic review reported that satisfaction was high for COCs with an extended or continuous regimen, although there was also evidence indicating some users discontinued treatment due to irregular bleeding 30. A prospective longitudinal observational study reported that a pill containing estradiol valerate and dienogest was associated with better outcomes (eg, shorter period, less bleeding, and less menstrual pain) and higher user satisfaction than a progestogen-only pill, with discontinuation rates of 20% and 26%, respectively 33. A systematic review of research on levonorgestrel-releasing IUS found that over three-quarters of users reported symptom improvement and were satisfied with treatment 23.…”

Section: Discussionmentioning

confidence: 99%

“… 30 A prospective longitudinal observational study reported that a pill containing estradiol valerate and dienogest was associated with better outcomes (eg, shorter period, less bleeding, and less menstrual pain) and higher user satisfaction than a progestogen-only pill, with discontinuation rates of 20% and 26%, respectively. 33 A systematic review of research on levonorgestrel-releasing IUS found that over three-quarters of users reported symptom improvement and were satisfied with treatment. 23 Of direct relevance to satisfaction, the current study is one of the first to provide results on the treatment preferences of women with dysmenorrhea.…”

Section: Discussionmentioning

confidence: 99%

Treatment preferences among Japanese women with dysmenorrhea: results from a discrete choice experiment study

Akiyama

Goren²,

Basurto³

et al. 2018

PPA

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PurposeTo examine patient preferences for oral and intrauterine system treatments for dysmenorrhea in Japan.Patients and methodsA discrete choice experiment was conducted to assess the willingness to accept trade-offs among hypothetical treatment profiles. An internet-based survey was administered to women 18–49 years of age who self-reported a dysmenorrhea diagnosis or experienced dysmenorrhea at least once in the past 6 months (N=309). Choice questions included pairs of treatments presented with different attributes: mode of administration, reduction in bleeding after 6 months, chance of symptoms becoming “improved”, nausea, weight gain, irregular bleeding, and risk of venous thromboembolism. Relative importance (RI) estimates were computed.ResultsThe mean respondent age was 35.8 years (standard deviation =7.0), and 85 women (27.5%) reported that they had previously used hormonal therapy for dysmenorrhea. Treatment preference was most strongly associated with mode of administration (RI=49.8%), followed by chance of irregular bleeding (RI=17.3%). In contrast, treatment preference was most weakly associated with chance of weight gain (RI=2.4%) and reduction in bleeding after 6 months (RI=0.8%). Respondents preferred oral treatments: for twice-daily regimen, odds ratio (OR)=4.90; for once-daily fixed cyclic regimen, OR=4.20; and for once-daily flexible extended regimen, OR=2.44; whereas for intrauterine system, OR=0.02 (p<0.001 for all). Those with prior hormonal therapy experience exhibited the same pattern.ConclusionMode of administration factored heavily in dysmenorrhea treatment preferences. Women of reproductive age preferred oral medication, especially twice-daily regimen and once-daily fixed cyclic regimen. Findings can potentially help to improve physician–patient communication and treatment decision making. Physicians should consider factors that can influence patient preference to optimize treatment acceptance and adherence.

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Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study

Cited by 22 publications

References 18 publications

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

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

Treatment preferences among Japanese women with dysmenorrhea: results from a discrete choice experiment study

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