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

Abstract

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.

Oestrogen component of COCs: have we finally found a replacement for ethinyl estradiol?

“…In a retrospective observational study of 354 women who had taken E2 V/DNG, the most common reason for discontinuation was menstrual irregularities, reported by 15% of users. Among these 15% of users, 58% had discontinued within 6 months of start, with adolescents stopping use sooner than adults (5.2 AE 5.2 vs. 10 AE 8.3 months) [9]. In a randomized double-blind, placebo-controlled trial investigating the efficacy of EV2/DNG for treatment of heavy menstrual bleeding, prolonged menstrual bleeding or heavy and prolonged menstrual bleeding, significantly more women experienced complete resolution of all abnormal menstrual symptoms in the E2 V/DNG group compared with placebo (43.8 vs. 4.2%) after seven cycles of pill use, as well as substantial decreases in menstrual blood loss volume and improvements in haemoglobin, haematocrit and ferritin [10].…”