A prospective follow-up of two 21/7 cycles followed by two extended regimen 84/7 cycles with contraceptive pills containing ethinyl estradiol and drospirenone.

Abstract

BACKGROUND:

Continuous use of combined oral contraceptives is currently attracting growing interest as a means of improving menstrual related symptoms and reducing the number of bleeding days.

OBJECTIVES:

To evaluate bleeding patterns, menstrual symptoms and quality of life with an extended 84/7 oral contraceptive regimen versus 21/7 cycles.

METHODS:

In two consecutive run-in cycles, 30 microg ethinyl estradiol and 3 mg drospirenone tablets taken on days 1-21 were followed by a tablet-free period from days 22 to 28 of each cycle and then by two 84 day cycles of pill use with a 7 day tablet-free interval. The primary outcome was the total number of bleeding/spotting days. Secondary outcomes were severity of daily symptoms, general well-being determined by the PGWBI questionnaire, and overall treatment satisfaction.

RESULTS:

Of the 137 women invited to participate in the study 109 (aged 18-40 years) were enrolled. The number of bleeding days decreased by about one-third from a calculated 31.8 days of bleeding under a cyclic 21/7 regimen to an expected total of 21.8 days for the extended 84/7 regimen. The incidence of menorrhagia, intermenstrual bleeding, dysmenorrhea, abdominal bloating, breast tenderness, depressive moods and irritability - when compared at enrollment and at the end of the second extended study period--was significantly lower (P < 0.005) among women on the continuous pill regimen. The median (range) global PGWBI scores were not substantially different before and after the extended use cycles: 78.2 (39.1-96.4) and 77.3 (30.9-96.4), respectively. Body weight and skin condition also remained constant. At the completion of the study: 65.5% of the women were either highly satisfied (41.4%) or satisfied (24.1%) with the extended regimen.

CONCLUSIONS:

The extended 84/7 regimen was found to be satisfactory for the majority of participants and was associated with a decrease in the number of bleeding days and an improvement in menstrual symptoms compared to 21/7 cycles.

• Authors: Daniel S Seidman, Arie Yeshaya, Amos Ber, Ida Amodai, Itzhak Feinstein, Israelit Finkel, Nina Gordon, Noga Porat, Dganit Samuel, Einat Shiran-Makler, Igal Wolman
• Journal: The Israel Medical Association journal : IMAJ (Isr Med Assoc J) Vol. 12 Issue 7 Pg. 400-5 (Jul 2010) ISSN: 1565-1088 [Print] Israel
• PMID: 20862819 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Androstenes
• Contraceptives, Oral, Combined
• Mineralocorticoid Receptor Antagonists
• Ethinyl Estradiol
• drospirenone

Topics

• Adult
• Androstenes (administration & dosage)
• Contraceptives, Oral, Combined (administration & dosage)
• Drug Administration Schedule
• Ethinyl Estradiol (administration & dosage)
• Female
• Follow-Up Studies
• Humans
• Menstruation (drug effects)
• Menstruation Disturbances (drug therapy)
• Mineralocorticoid Receptor Antagonists (administration & dosage)
• Patient Satisfaction
• Prospective Studies
• Quality of Life
• Surveys and Questionnaires