Pj. Sulak et al., EXTENDING THE DURATION OF ACTIVE ORAL-CONTRACEPTIVE PILLS TO MANAGE HORMONE WITHDRAWAL SYMPTOMS, Obstetrics and gynecology, 89(2), 1997, pp. 179-183
Objective: To test the hypothesis that extending the number of consecu
tive active oral contraceptives (OC)s given will decrease the frequenc
y of menstrual-related problems including dysmenorrhea, menorrhagia, p
remenstrual-type symptoms, and menstrual migraines. Methods: A prospec
tive analysis was designed to track the experiences of 50 women taking
OCs and experiencing menstrual-related problems. Fifty consecutive pa
tients, who were taking OCs and had symptoms during the pill-free inte
rval, were followed in a multispecialty clinic by an individual physic
ian and nurse practitioner team. The patients were permitted to extend
the number of consecutive active OCs to delay menstrual-related sympt
oms. Results: Immediate outcome of the 50 patients revealed 74% (37 pa
tients) stabilized on an extended regimen of 6 to 12 weeks of consecut
ive days with active OCs. Twenty-six percent (13 patients) either disc
ontinued OCs or returned to the standard regimen with 3 weeks of activ
e pills. Of the 37 patients who were stabilized on an extended regimen
, 27 have completed thus far between five and 13 extended cycles with
6-23 months of follow-up (mean 16 months). Conclusion: Experience in a
series of 50 OC users with menstrual-related symptoms demonstrated th
at delaying menses by extending the number of consecutive days of acti
ve pills is well tolerated and efficacious. We believe that a large pr
ospective study is warranted to further our knowledge in this area. Co
pyright (C) 1997 by The American College of Obstetricians and Gynecolo
gists.