Continuous, daily levonorgestrel/ethinyl estradiol vs. 21-day, cyclic levonorgestrel/ethinyl estradiol: efficacy, safety and bleeding in a randomized, open-label trial

Teichmann, A. T.; Apter, Dan; Emerich, Janusz; Greven, Klaus; Klasa-Mazurkiewicz, Dagmara; Melis, G; Spaczyński, Marek; Grubb, Gary S.; Constantine, Ginger D.; Spielmann, D.

doi:10.1016/j.contraception.2009.05.128

Cited by 46 publications

(24 citation statements)

References 18 publications

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“…Actualmente, el uso de la forma extendida de anticoncepción hormonal combinada ha sido motivo de especial preocupación científica, como lo avalan las recientes publicaciones detallando tanto las distintas experiencias clínicas con diferentes formulas (6,7,8,9,20), así como las consecuencias metabóli-cas en las usuarias después de 12 meses de uso (10,11). Innegables aparecen las ventajas de esta forma especial de uso de anticoncepción hormonal, en los grupos de usuarias afectas al denominado síndrome de tensión y/o disfórico premenstrual, así como en todas aquellas con el sostenido deseo de espaciar sus periodos menstruales.…”

Section: Discussionunclassified

“…El 60% de las mujeres italianas prefieren tener sangrados menos de una vez al mes, no necesariamente por razones médicas, sino por conveniencias prácticas, lo cual concuerda con datos provenientes de otros países europeos (5). Respondiendo a la creciente aceptabilidad por parte de determinadas usuarias de este uso extendido de AOC siguen apareciendo publicaciones con el uso de esta forma de anticoncepción, usando ya sea distintas fórmulas hormonales combinadas orales, considerando aspectos tanto clínicos (6,7,8,9) como variaciones metabólicas (10,11) o en la forma de anillos vaginales (12,13).…”

Section: Introductionunclassified

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Experiencia piloto con el uso extendido de un anticonceptivo oral combinado de baja dosis de estrógeno

2011

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Evaluar en una experiencia piloto la aceptabilidad y bienestar de la usuaria, después de un periodo de 12 meses de un anticonceptivo hormonal combinado oral de baja dosis estrogénica, con modalidad de uso extendido de 84 píldoras activas consecutivas, seguidas de 7 días de placebo. Método: Se incorporan 25 mujeres voluntarias que usan una combinación de 20 ug de etinilestradiol + 3 mg de drospirenona, con un tiempo de uso de 12 meses. En calendario de registro diario se consignan los días de sangrado o goteo genital así como todo tipo de fármaco ingerido. Al término de los 12 meses se efectúa una encuesta respecto al grado de satisfacción con la posología recibida. Resultados: 13 usuarias (52%) cumplen los 12 meses de uso. Todas ellas manifiestan un alto grado de conformidad, destacando las ventajas de presentar periodos menstruales ocasionales, mejoría marcada en la sintomatología compatible con el síndrome de tensión premenstrual con el consiguiente incremento del bienestar general. Siete usuarias (28%) no terminan el estudio por razones médicas, siendo 6 de estas por alteraciones de los flujos rojos y en 5 casos (20%) se producen retiros no médicos. Conclusión: Esta experiencia, que es la primera con la formulación descrita, confirma en un porcentaje de usuarias las bondades adicionales reportadas en las experiencias previas con otros productos similares, respecto al uso extendido de anticoncepción hormonal oral en un grupo de mujeres que deseaban espaciar sus periodos menstruales.PALABRAS CLAVE: Anticoncepción hormonal de uso extendido, drospirenona, síndrome tensión premenstrual SUMMARYObjetives: A pilot study designed in order to know about the acceptability of an oral combined contraceptive pill, with low estrogen dose used in an extended way of 84 consecutive days, followed by 7 days of no pills ingestion during a scheduled follow up of 1 year. Methods: 25 volunteers women were recruited among those which wants to use oral combined contraceptive pills and who accepted this extended way of use. Combined contraceptive pills contains each 20 ug of ethinylestradiol plus 3 mg of drosperinone. At admission women were provided with menstrual diary cards in order to check all bleeding days plus any extra pharmaceutical compound received. At the end of the 12 months follow up an interview was done in order to know women experiences and acceptability of this extended way of use. Results: 52% of women end the study at the scheduled 12 months use. All of them feel that the main advantages of these extended way of use were to have few menstrual periods and improving premenstrual symtomatology with better quality of life. 7 women (28%) did not finish the study because of medical reasons being due in 6 of these for bleeding disturbances. Conclusions: This report is pioneer with the use this hormone combination in this extended

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Section: Discussionunclassified

Section: Introductionunclassified

Experiencia piloto con el uso extendido de un anticonceptivo oral combinado de baja dosis de estrógeno

2011

Rev. chil. obstet. ginecol.

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“…Amenorrhea was achieved by 40% of women in the extended-cycle arm by pill pack 7 and by 53% by the last cycle. Another 26% had only spotting by that last cycle 48. The discontinuation rate for the continuous formulation was 33.1% compared to 21.7% in the cyclic arm.…”

Section: Oral Contraceptive Formulations With Extended-cycle: Lower-dmentioning

confidence: 92%

New low-dose, extended-cycle pills with levonorgestrel and ethinyl estradiol: an evolutionary step in birth control

Nelson¹

2010

IJWH

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Aim:To review milestones in development of oral contraceptive pills since their introduction in the US 50 years ago in order to better understand how a new formulation with low-dose estrogen in an extended-cycle pattern fits into the evolution of birth control pills.Methods:This is a review of trends in the development of various birth controls pills and includes data from phase III clinical trials for this new formulation.Results:The first birth control pill was a very high-dose monophasic formulation with the prodrug estrogen mestranol and a first-generation progestin. Over the decades, the doses of hormones have been markedly reduced, and a new estrogen and several different progestins were developed and used in different dosing patterns. The final element to undergo change was the 7-day pill-free interval. Many of these same changes have been made in the development of extended-cycle pill formulation.Conclusion:The newest extended-cycle oral contraceptive formulation with 84 active pills, each containing 20 μg ethinyl estradiol and 100 μg levonorgestrel, represents an important evolution in birth control that incorporates lower doses of estrogen (to reduce side effects and possibly reduce risk of thrombosis), fewer scheduled bleeding episodes (to meet women’s desires for fewer and shorter menses) and the use of low-dose estrogen in place of placebo pills (to reduce the number of days of unscheduled spotting and bleeding). Hopefully, this unique formation will motivate women to be more successful contraceptors.

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“…Amenorrhea is achieved in about 80% of patients by 1 year of continuous use. 34,35 Breakthrough bleeding may occur during the first few months of extended or continuous use but usually improves over time. Other common side effects of COCs, regardless of the administration regimen, include breast tenderness, headaches, and nausea.…”

Section: Methods Of Menstrual Suppression Combined Oral Contraceptivesmentioning

confidence: 99%

“…In general, most side effects are similar to those reported for traditional cyclic contraceptives. Notable exceptions include increased breakthrough bleeding observed in patients using extended-use contraceptives or DMPA injections, [33][34][35] decreased bone mineral density observed in patients using DMPA injections, 36 and increased thromboembolism risk, possibly observed in patients using the transdermal patch. 37 Providers, patients, and families should evaluate these side effects against the benefits of each method and the needs of each individual patient.…”

Section: Disadvantages Of Menstrual Suppressionmentioning

confidence: 94%

Monthly Periods—Are They Necessary?

Strandjord¹,

Rome²

2015

Pediatr Ann

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Menstrual suppression--the use of hormones to delay or eliminate menses--is often used in adolescents to manage conditions associated with the menstrual cycle and to accommodate lifestyle preferences. Reducing the frequency of menstrual bleeding does not cause any known physiologic harm and has potential short-term and long-term advantages. Different methods used for menstrual suppression, however, have associated risks and side effects that need to be weighed against the benefits of controlling menses. This article reviews the advantages and disadvantages of menstrual suppression and the different methods available for adolescents.

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Continuous, daily levonorgestrel/ethinyl estradiol vs. 21-day, cyclic levonorgestrel/ethinyl estradiol: efficacy, safety and bleeding in a randomized, open-label trial

Cited by 46 publications

References 18 publications

Experiencia piloto con el uso extendido de un anticonceptivo oral combinado de baja dosis de estrógeno

Experiencia piloto con el uso extendido de un anticonceptivo oral combinado de baja dosis de estrógeno

New low-dose, extended-cycle pills with levonorgestrel and ethinyl estradiol: an evolutionary step in birth control

Monthly Periods—Are They Necessary?

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