Extended regimens of combined hormonal contraception to reduce symptoms related to withdrawal bleeding and the hormone-free interval: A systematic review of randomised and observational studies

• Published in: The European journal of contraception & reproductive health care Vol. 19; no. 5; pp. 321 - 339
• Main Authors: Mendoza, Nicolás, Lobo, Paloma, Lertxundi, Roberto, Correa, Marta, Gonzalez, Esteban, Salamanca, Alberto, Sánchez-Borrego, Rafael
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.10.2014; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Birth control; Clinical trials; Combined hormonal contraceptives; Continuous regimen; Contraception; Contraceptives, Oral, Combined - administration & dosage; Contraceptives, Oral, Combined - adverse effects; Contraceptives, Oral, Combined - therapeutic use; Drug Administration Schedule; Effectiveness; Extended regimen; Female; Hormone-free interval; Humans; Observational Studies as Topic; Randomized Controlled Trials as Topic; Safety; Substance Withdrawal Syndrome - etiology; Treatment Outcome; Uterine Hemorrhage - etiology; Withdrawal bleeding; Hormone-free interval; Contraception; Withdrawal bleeding; Combined hormonal contraceptives; Continuous regimen; Extended regimen
• ISSN: 1362-5187; 1473-0782
• DOI: 10.3109/13625187.2014.927423

Abstract Objective To assess whether continuous and extended regimens (CRs/ERs) of combined hormonal contraceptives (CHCs) improve symptoms related to withdrawal bleeding or the hormone-free interval and to compare the efficacy, safety, and cost of CRs/ERs to those of conventional 28-day regimens. Study design A literature search of the PubMed database was conducted for randomised clinical trials (RCTs) and observational studies published in any language between 2006 and 2013. Results Sixteen RCTs and 14 observational studies evaluated issues related to our objectives. CRs/ERs, whose efficacy and safety were comparable to those described for conventional regimens, were preferred due to their improvement of symptoms related to withdrawal bleeding or the hormone-free interval and the lower costs resulting from the reduced incidence of these symptoms. Conclusion The contraceptive efficacy and safety of CR/ER use of CHCs is at least equal to that of 28-days conventional regimens, and this use may have some cost savings. CRs/ERs are recommended for women willing to take a CHC for treatment of symptoms related to withdrawal bleeding or the hormone-free interval.