Menstruation Research Today is a free monthly online journal that collates and summarizes the latest research about Menstruation, including details on menstrual cycle, pregnancy, pain, irregular menstruation. | ||||||||
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Prospective analysis of occurrence and management of breakthrough bleeding during an extended oral contraceptive regimen.Sulak PJ, Kuehl TJ, Coffee A, Willis S Department of Obstetrics and Gynecology, Scott & White Memorial Hospital, Texas A & M University System Health Science Center College of Medicine, Temple, TX 76508, USA. psulak@swmail.sw.org OBJECTIVE: 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). STUDY DESIGN: 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. RESULTS: 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). CONCLUSION: A 168-day extended regimen of DRSP/EE had an acceptable bleeding profile with a high continuation rate. Bleeding during the extended cycle was effectively managed with institution of a 3-day HFI. Published 26 September 2006 in Am J Obstet Gynecol, 195(4): 935-41.
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