Abstract | BACKGROUND: OBJECTIVES: SEARCH METHODS: In July 2013, we searched CENTRAL, MEDLINE, and POPLINE, and examined references of potentially eligible trials. We also searched for recent clinical trials using ClinicalTrials.gov and ICTRP. No new trials met the inclusion criteria. Previous searches included EMBASE. For the initial review, we wrote to oral contraceptive manufacturers to identify trials. SELECTION CRITERIA: English-language reports of randomized controlled trials were eligible that compare a COC containing ≤ 20 μg EE with a COC containing > 20 μg EE. We excluded studies where the interventions were designed to be administered for less than three consecutive cycles or to be used primarily as treatment for non- contraceptive conditions. Trials had to report on contraceptive effectiveness, bleeding patterns, trial discontinuation due to bleeding-related reasons or other side effects, or side effects to be included in the review. DATA COLLECTION AND ANALYSIS: One author evaluated all titles and abstracts from literature searches to determine whether they met the inclusion criteria. Two authors independently extracted data from studies identified for inclusion. We wrote to the researchers when additional information was needed. Data were entered and analyzed with RevMan. MAIN RESULTS: AUTHORS' CONCLUSIONS: While COCs containing 20 μg EE may be theoretically safer, this review did not focus on the rare events required to assess this hypothesis. Data from existing randomized controlled trials are inadequate to detect possible differences in contraceptive effectiveness. Low-dose estrogen COCs resulted in higher rates of bleeding pattern disruptions. However, most trials compared COCs containing different progestin types, and changes in bleeding patterns could be related to progestin type as well as estrogen dose. Higher follow-up rates are essential for meaningful interpretation of results.
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Authors | Maria F Gallo, Kavita Nanda, David A Grimes, Laureen M Lopez, Kenneth F Schulz |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 8
Pg. CD003989
(Aug 01 2013)
ISSN: 1469-493X [Electronic] England |
PMID | 23904209
(Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Review, Systematic Review)
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Chemical References |
- Contraceptives, Oral, Combined
- Contraceptives, Oral, Hormonal
- Estrogens
- Ethinyl Estradiol
- Desogestrel
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Topics |
- Contraceptives, Oral, Combined
(administration & dosage, adverse effects)
- Contraceptives, Oral, Hormonal
(administration & dosage, adverse effects)
- Desogestrel
(administration & dosage, adverse effects)
- Estrogens
(administration & dosage, adverse effects)
- Ethinyl Estradiol
(administration & dosage, adverse effects)
- Female
- Humans
- Menstruation Disturbances
(chemically induced)
- Randomized Controlled Trials as Topic
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