EXTENDING THE DURATION OF ACTIVE ORAL-CONTRACEPTIVE PILLS TO MANAGE HORMONE WITHDRAWAL SYMPTOMS

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.