Long-interval treatment regimen with a desogestrel-containing oral contraceptive

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

“…19,24 No negative effects have been associated with rescheduling withdrawal bleeding, 3,25 including no negative effects on the uterus or endometrium, and studies have shown that extended OC regimens are effective in women who use them in this way. 4,[11][12][13][14]17 The use of extended OC regimens also does not affect the return to fertility after stopping, 26,27 and effects on lipids, carbohydrates, and coagulation factors are similar to those observed with conventional 21/7 regimen OCs. 28 Bleeding profiles vary between extended OC regimens; as outlined above, discontinuation rates as high as 50% have been observed in some trials with extended OC regimens.…”

“…28 Bleeding profiles vary between extended OC regimens; as outlined above, discontinuation rates as high as 50% have been observed in some trials with extended OC regimens. [11][12][13][14][15][16][17] The strengths of this survey have been outlined previously 10 and include the multinational design, large sample size, and the fact that samples were representative for age and regional distribution for all countries, except for Brazil (where low internet use led to a deviation of 2%). The women in this survey may have been better educated and potentially wealthier than in some regions but are potentially more likely to be representative of those women who will be prescribed OCs.…”

“…This is likely to be the result of unacceptable bleeding profiles with these regimens, which have led to high discontinuation rates in clinical trials (as high as 50% in some studies). [11][12][13][14][15][16][17] In Italy, there was a low awareness that bleeding frequency can be occasionally or regularly reduced using extended OC regimens, which may be explained by low acceptance of the pill in this country for cultural reasons (19%, compared with 45% in France, 34% in Germany and 27% in the UK). 18 The main reasons reported by women for occasionally rescheduling bleeding were to avoid bleeding during special events and for convenience.…”

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

“…The important factor in this preference may have been that both the breakthrough bleeding and the spotting decreased during the trial. Women in the extended use group also reported fewer headaches 36 . Extended cycle regimens have, more recently, been examined in some detail, and there is a clearer picture of the frequency and amount of bleeding that is likely to occur.…”

“…Spotting increased initially with continuous use but reduced over time. A small subset had an endometrial biopsy at entry and again at nine months, and no hyperplasia or neoplasia was reported 36 . A single-treatment, open-label study, examining the safety and efficacy of a 20 mg EE/90 mg LNG pill in continuous use over a year also showed amenorrhoea to have occurred in the majority of subjects at 13 months (59%), with 79% reporting absence of bleeding requiring sanitary protection.…”