Prospective analysis of occurrence and management of breakthrough bleeding during an extended oral contraceptive regimen

American Journal of Obstetrics and Gynecology
Patricia J SulakSherilyn A Willis

Abstract

The purpose of this study was to assess the bleeding patterns of an extended oral contraceptive (OC) regimen and management of breakthrough bleeding/breakthrough spotting (BTB/BTS). This was a single-center prospective analysis of self-rated menstrual flow during a 21/7-day versus a 168-day extended regimen of on OC containing 3 mg of drosperinone and 30 mcg of ethinyl estradiol (DRSP/EE) with institution of a randomized protocol to manage BTB/BTS. Of the 111 patients initiating the extended OC regimen, 102 (92%) completed the 168-day regimen. Subjects having a heavier daily flow rating during the 21/7-day pre-extension cycle had greater daily flow ratings (P < .001) and tended to have earlier occurrence of BTB during the extended regimen (P = .07) than subjects with lighter daily flow ratings. If BTB/BTS of at least 7 consecutive days occurred, patients were randomized to taking a 3-day hormone free interval (HFI) versus continuing active pills. Instituting a 3-day HFI was significantly more effective in resolving BTB/BTS than continuing active pills (P < .0001). Patients with heavier daily flow ratings during the 21/7-day cycle were not more likely to be randomized for BTB/BTS than those with lighter flow ratings (P = .53). A...Continue Reading

References

Feb 16, 2000·Obstetrics and Gynecology·P J SulakT J Kuehl
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Apr 10, 2003·Obstetrics and Gynecology·Leslie Miller, James P Hughes
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Citations

Mar 29, 2007·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·William A Fisher, Amanda Black
Jun 15, 2011·Contraception·Divya L SevalPatricia J Sulak
Sep 1, 2007·Women's Health·Kelly L Gerschultz, Gina S Sucato
Oct 17, 2007·Journal of Women's Health·Kat Lin, Kurt Barnhart
Feb 17, 2010·Journal of Women's Health·Carrie SadlerUNKNOWN Southampton Women's Survey Study Group
Jan 25, 2013·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Kari Hilde Juvkam, Hilde Beate Gudim
Oct 30, 2015·Expert Opinion on Pharmacotherapy·Anita L Nelson
Jun 28, 2014·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Nicolás MendozaRafael Sánchez-Borrego
Sep 25, 2010·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Inka WiegratzEkkehard Schleussner
Jun 19, 2013·Gynécologie, obstétrique & fertilité·P This
May 20, 2008·Obstetrics and Gynecology Clinics of North America·Kristen A Plastino, Patricia J Sulak
Sep 26, 2007·Best Practice & Research. Clinical Obstetrics & Gynaecology·Patricia J Sulak
May 3, 2007·Obstetrics and Gynecology Clinics of North America·Jody Steinauer, Amy M Autry
Dec 12, 2012·Journal of Midwifery & Women's Health·Janet C JacobsonPatricia Aikins Murphy
Nov 26, 2015·Obstetrics and Gynecology Clinics of North America·Lyndsey S Benson, Elizabeth A Micks
Jun 27, 2006·American Journal of Obstetrics and Gynecology·Andrea L CoffeePatricia J Sulak
Sep 12, 2018·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Iñaki LeteRafael Sánchez-Borrego
Sep 2, 2008·Obstetrics and Gynecology·Paul D Blumenthal, Alison Edelman
Apr 10, 2009·The Journal of Family Planning and Reproductive Health Care·Anne Szarewski
Oct 24, 2009·The Journal of Family Planning and Reproductive Health Care·Martha Hickey, Sweta Agarwal
Jul 13, 2007·Current Opinion in Obstetrics & Gynecology

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