Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians

Nappi, Rossella E.; Kaunitz, Andrew M.; Bitzer, Johannes

doi:10.3109/13625187.2015.1107894

Cited by 46 publications

(27 citation statements)

References 97 publications

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“…Women considering this COC regimen should be informed that those who complete at least one 91-day cycle would likely experience less bleeding in future cycles and that they should be patient during the first cycle (ie, first 3 months) as they adapt to the regimen. Counseling related to cycle control should address appropriate expectations for scheduled and unscheduled bleeding during the first and subsequent 91-day treatment cycles 12. During Cycle 1, our analysis suggests almost one in five women will have no scheduled bleeding and six in ten women will have no scheduled spotting, and approximately two thirds of women will have ≤6 days of unscheduled bleeding, including approximately one third of these women with no unscheduled bleeding.…”

Section: Discussionmentioning

confidence: 88%

“…It is well documented that some women prefer regularly scheduled bleeding and consider absence of scheduled bleeding highly undesirable, and counseling about possible absence of scheduled bleeding with particular regimens will be especially important for these women 11,32. The balance that each woman will need to consider with extended-regimen COC is the high satisfaction reported with reduced bleeding overall, improvement in menstrual cycle-related symptoms and disorders, and reduction in inconvenience and interference with daily activities vs the individual significance of potential unscheduled bleeding or spotting, particularly in the earliest cycles of treatment 4,5,12,24. High satisfaction and improved QOL may overcome the inconvenience of unscheduled bleeding or spotting, as shown among women with menstrual cycle-related symptoms who received extended-regimen COC and chose to continue the regimen, even with persistent breakthrough bleeding or spotting episodes 33…”

Section: Discussionmentioning

confidence: 99%

“…Although awareness and acceptance of extended-regimen COC have increased, extended-regimen COC continues to be underused,12 even at contraceptive specialty clinics 16. Future studies that target increased awareness of extended-regimen COC among women and their HCPs, as well as increased HCP understanding of the broad usefulness of such regimens for improving women’s QOL, are needed.…”

Section: Discussionmentioning

confidence: 99%

“…Key non-medical factors underlying desire for menstrual suppression include convenience and reducing interference with sexuality, social life, work, and sports activities 8–10. Widespread acceptance of extended-regimen COC by clinicians has been shown 12. Approximately 75% to almost 100% of surveyed health care providers (HCPs) report discussion of extended-regimen COC with patients or prescription of extended-regimen COC at least once 13–16.…”

Section: Introductionmentioning

confidence: 99%

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Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval

Nappi¹,

Abascal²,

Hsieh

et al. 2017

IJWH

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PurposeTo evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI).Patients and methodsThis post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy. Subjects recorded bleeding and spotting episodes daily using electronic diaries. Logistic regression analyses are reported as ORs with 95% CIs.ResultsThere was a 10% increase (OR =1.102; 95% CI: 1.006–1.206) in the likelihood of reporting no scheduled bleeding for each additional 91-day cycle completed. From the third 91-day cycle, more than one fifth of women reported no scheduled bleeding (third cycle =23% [121/533]; fourth cycle =22% [97/446]). Among women who reported no scheduled bleeding at Cycle 1 (136/758 [18%]), ≥45% showed sustained lack of scheduled bleeding in later cycles. There were increases of 53% (OR =1.531; 95% CI: 1.393–1.683) and 31% (OR =1.307; 95% CI: 1.205–1.418) in the likelihood of reporting 0 to ≤6 days vs >6 days of unscheduled bleeding and spotting, respectively, for each additional 91-day cycle. By Cycle 2, more than 80% of women reported no unscheduled bleeding or ≤6 days of unscheduled bleeding during each 91-day cycle.ConclusionImproved cycle control with decreased bleeding over time was shown during extended-regimen COC with 30 µg EE/150 µg LNG for 84 days and continuous low-dose EE instead of the traditional 7-day HFI. Women considering this regimen should be informed that those who complete at least one 91-day COC cycle will likely experience less bleeding/spotting in future cycles.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval

Nappi¹,

Abascal²,

Hsieh

et al. 2017

IJWH

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“…Atitudes e crenças bem como equívocos sobre a menstruação entre as mulheres têm evoluído em todo o mundo. Ainda que muitas acreditem que o sangramento mensal é necessário, outras preferem sangrar menos ou até não sangrar 1 . Dentre os aspectos positivos da menstruação surgem nas diferentes nacionalidades a certeza de não estar grávida, sentir-se leve com sua presença e entre os negativos as cólicas, o mau humor e a síndrome pré-menstrual 2 .…”

Section: Introductionunclassified

Percepção das mulheres sobre o impacto da menstruação no cotidiano de vida

et al. 2019

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Objetivo: compreender o significado da menstruação no cotidiano de vida e desvelar as divergências e convergências no aspecto cultural e socioeconômico de mulheres na menacme. Método: pesquisa descritiva, de abordagem qualitativa com pressupostos do interacionísmo simbólico. A coleta de dados deu-se por meio de dois grupos focais cujos sujeitos foram 18 mulheres. Foram realizados três encontros com cada grupo em locais distintos. A partir dos depoimentos foram identificadas seis categorias e subcategorias. Resultados: revelam a percepção das mulheres nos aspectos físicos, psicológicos, nível de independência, relações sociais, ambiente e crenças pessoais e mitos associadas a qualidade de vida no simbólico da menstruação. Conclusão: a menstruação significa dualidade, pois traz alívio por não estar grávida e marca a jovialidade. Mas se houvesse escolha, as mulheres preferiam não menstruar pelos desconfortos físicos e psicológicos que as afetam no cotidiano da vida.

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