Women's responses to menses and nonbleeding intervals in the USA, Brazil and Germany

Snow, Rachel; Hardy, Ellen; Kneuper, Elsbeth; Hebling, Eliana Maria; Hall, Grace

doi:10.1016/j.contraception.2007.03.008

Cited by 22 publications

(23 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study of Italian women published in 2006, among 270 women without menstruation-related symptoms, more than 50% stated that they would like to change the rhythm of their periods, with 28% wishing longer intervals between bleedings and 29% not to have menses at all 57. Contrary to the results obtained in the previously mentioned multicenter study54 a survey published in 2004 showed that only 26% to 35% of German women preferred monthly bleeding, while 37% to 46% wished not to have menses at all. Those wishing not to bleed cited, as positive outcomes, relief from severe menstrual complaints, better hygiene, higher quality of life, and less blood loss.…”

Section: Effectivenessmentioning

confidence: 83%

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Benagiano

Carrara²,

Filippi³

2009

PPA

View full text Add to dashboard Cite

The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two “enantiomers,” with only one form (designated as levonorgestrel) biologically active. When taken orally, it is rapidly absorbed, not subjected to a “first-pass” effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic) and peripheral (cervical mucus and endometrium) levels. Levonorgestrel (LNG), alone or in combination with ethinyl estradiol (EE), is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women’s attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and “usefulness” of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years empirically utilized various continuous administration regimens. The first extended-cycle oral contraceptive regimen introduced in clinical practice is an 84-day regimen that results in bleeding only 4 times a year. A commercial product specifically packed for continuous use is now available in Europe and contains 30 μg EE and 150 μg LNG. In a variation of this regimen, after administration of the same combination for 84 days, women are given 7 pills containing 10 μg EE. A 6-monthly regimen has also been tested in a small study using EE 20 μg plus LNG 100 μg taken with and without a hormone-free interval. Women in the continuous group reported significantly fewer bleeding days requiring protection and were more likely to have amenorrhea; in addition they also reported significantly fewer days of bloating and menstrual pain. A yearly regimen is now being developed. Each pill of this novel formulation contains EE 20 μg and LNG 90 μg to be taken continuously for 364 days (13 cycles) per year. A phase III trial has now evaluated safety, efficacy and menses inhibition. At the end of the 1-year trial amenorrhea was present in 58.7% of the women and a complete absence of bleeding in 79.0%. Overall, the number of bleeding and spott...

show abstract

Section: Effectivenessmentioning

confidence: 83%

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Benagiano

Carrara²,

Filippi³

2009

PPA

View full text Add to dashboard Cite

show abstract

“…Studies conducted in Brazil, Germany, and the USA [4,10] showed that the proportion of women who declared their preference for amenorrhea was 32%, 8%, and 38%, respectively. The women with a preference for amenorrhea were predominantly those with menstrual pain or discomfort, and who reported that menstruation interfered with their daily activities.…”

Section: Introductionmentioning

confidence: 97%

“…A large body of published evidence is gathering to suggest that monthly menstruation can be avoided without any deleterious effect to health [4][5][6]. Furthermore, women from different cultures may accept the use of drugs as a valid method to avoid menstruation [4,[6][7][8][9]. The main tool available for pharmacologic control of menstruation is the use of combined oral contraceptives (COCs), taken continuously rather than for the usual 21 days per 28-day cycle [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, for many women, monthly bleeding is a sign of health, fertility, and of not being pregnant; conversely, the absence of monthly bleeding is often believed to be linked to disease [2][3][4]. A large body of published evidence is gathering to suggest that monthly menstruation can be avoided without any deleterious effect to health [4][5][6]. Furthermore, women from different cultures may accept the use of drugs as a valid method to avoid menstruation [4,[6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Opinion and experience of Brazilian women regarding menstrual bleeding and use of combined oral contraceptives

Makuch¹,

Duarte-Osis²,

Pádua³

et al. 2012

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…30 Women's attitudes and preferences towards menstruation have also been reported in several other studies, with many women fearing negative consequences of induced amenorrhea 31 and having varied preferences for nonbleeding intervals. 32 Indeed, many women prefer to avoid menstruation altogether.…”

Section: Discussionmentioning

confidence: 99%

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

Szarewski¹,

Moeller²

2013

OAJC

View full text Add to dashboard Cite

Background:Monthly bleeding can have a negative impact on daily life and, given the choice, many women would reduce the frequency of bleeding. While some women choose to occasionally postpone or reduce bleeding frequency with an oral contraceptive (OC), most women have no or limited experience of regularly reducing the frequency of scheduled bleeding with OCs, ie, the extended OC regimen. Study design: An online survey of 4039 women aged 15-49 years who were currently using, had used, or would consider using any form of hormonal contraception was conducted in Brazil, Canada, Czech Republic, France, Germany, Italy, UK, and USA to assess awareness of and the reasons for and against reducing bleeding frequency. Results: Overall, 51.1% and 30.7% of women surveyed were aware that they could occasionally or regularly reduce bleeding frequency with an OC. Moreover, 27.6% and 9.9% of previous/ current OC users had occasionally or regularly reduced bleeding frequency with an OC. The main reasons for reducing bleeding frequency were convenience, physician recommendations, special events, and relief of problems associated with bleeding. Many women mistakenly believed that reducing bleeding frequency would have a negative health impact. Conclusion: Additional efforts are needed to educate women about the possibility and potential health benefits of reducing bleeding frequency and to dispel misconceptions about the use of extended OC regimens.

show abstract

Women's responses to menses and nonbleeding intervals in the USA, Brazil and Germany

Cited by 22 publications

References 15 publications

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Opinion and experience of Brazilian women regarding menstrual bleeding and use of combined oral contraceptives

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

Contact Info

Product

Resources

About

Women's responses to menses and nonbleeding intervals in the USA, Brazil and Germany

Cited by 22 publications

References 15 publications

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Opinion and experience of Brazilian women regarding menstrual bleeding and use of combined oral contraceptives

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

Contact Info

Product

Resources

About

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