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Extended‐ and Continuous‐Cycle Oral Contraceptives
Author(s) -
Shrader Sarah P.,
Dickerson Lori M.
Publication year - 2008
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.28.8.1033
Subject(s) - levonorgestrel , medicine , drospirenone , ethinylestradiol , placebo , adverse effect , estrogen , menstrual cycle , norethisterone , progestin , population , metrorrhagia , pill , gestodene , gynecology , family planning , hormone , pharmacology , health services , research methodology , alternative medicine , environmental health , pathology
Five new oral contraceptives, classified as extended‐ or continuous‐cycle oral contraceptives, have been approved by the United States Food and Drug Administration. These agents have various combinations of estrogen and progestin, and different effects on the length of women's menstrual cycles. Usually they shorten the duration of menses, decrease the frequency of menses to 4 times/year, or completely eliminate menses. These new oral contraceptives are given in the following regimens: 24 days followed by placebo for 4 days (24/4), 84 days followed by placebo for 7 days (84/7), or continuously (without placebo). These agents contain ethinyl estradiol 20 μg‐drospirenone 3 mg (24/4); ethinyl estradiol 20 μg‐norethindrone 1 mg (24/4); ethinyl estradiol 30 μg‐levonorgestrel 150 μg (84/7); ethinyl estradiol 30 μg‐levonorgestrel 150 μg (84/7) with very low‐dose ethinyl estradiol (10 μg/day) for 7 days; and ethinyl estradiol 20 μg‐levonorgestrel 90 μg continuously. Clinical trials have demonstrated that extended‐ and continuous‐cycle oral contraceptives are as effective in preventing pregnancy as traditional oral contraceptives. These new agents also have similar adverse effects; however, the only significantly different adverse effect compared with traditional oral contraceptives in clinical trials was change in bleeding pattern. These oral contraceptives are associated with more breakthrough bleeding and spotting than the traditional pills. Long‐term effects on efficacy and safety are not known, as these new products generally have been used for only 1–2 years. Extended‐ and continuous‐cycle oral contraceptives are a new option for women desiring decreased menses or for whom decreased menses may alleviate symptoms of coexisting medical conditions.