Extended Cycling of Combined Hormonal Contraceptives in Adolescents: Physician Views and Prescribing Practices

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

“…Unlike the German gynaecologists, they were most commonly responding to patients' requests to delay the bleeding episode until after specific events (82%) and for fewer menses per year (72%), but they also used extended-cycle regimens for menstruation-related disorders or complaints such as menorrhagia, dysmenorrhoea, and endometriosis. In common with the German gynaecologists, they most commonly prescribed 84 days of active pills followed by a placebo break 34 .…”

Extended cycling or continuous use of hormonal contraceptives for female adolescents

“…Nevertheless, female adolescents appear to be very interested in extended cycling or continuous use of hormonal contraception. In a survey [29 ] of adolescent health physicians, 90% reported ever having provided extended cycling contraception to female adolescents; however, breakthrough bleeding was the most common reason their adolescent patients gave for discontinuing the method.…”

“…Adolescent healthcare providers are well aware of the noncontraceptive benefits of extended cycling and continuous use as more than half of physicians surveyed [29 ] reported prescribing extended-cycle regimens for menorrhagia, bleeding disorders, endometriosis and anemia. However, many physicians have concerns about the lack of data on the long-term side effects and the safety of extended cycling particularly when prescribed to adolescents [29 ].…”

“…However, many physicians have concerns about the lack of data on the long-term side effects and the safety of extended cycling particularly when prescribed to adolescents [29 ]. Some physicians reported apprehension about prescribing extended-cycle contraception to female adolescents because of the risk of a missed pregnancy [29 ].…”

Exploring Clinician Confidence in the Management of Adolescent Menstrual and Reproductive Health Problems

“…Treatment of adolescent menstrual problems is viewed as challenging [6,7] and previous studies have demonstrated marked differences in therapeutic modalities employed, as well as in clinicians' own confidence levels [8,9]. …”