Gynaecology
Oral contraceptives are well tolerated when taken continuously
By Cochrane Library
Jul 20, 2005, 15:07

Traditionally, oral contraceptives are taken for 21 days followed by a placebo week. This placebo week causes an artificial withdrawal bleed that gives the appearance of a normal monthly menstrual cycle, but now evidence shows that women tolerate contraceptives well if they skip this bleed.

An increasing number of women take oral contraceptives that combine oestrogen and progesterone (combined oral contraceptives - COC) continuously. Continuously-dosed COCs treat conditions like endometriosis, dysmenorrhoea and symptoms associated with monthly menstruation. Many women, however, simply want to avoid menstruation, leading to less interference in daily life, and fewer menstruation-related days off from work or school.

The Cochrane Review Authors set out to see if women experienced any differences when taking COC's in the standard pattern versus continuously.

Their conclusion was that the two dosing regimens have similar participant satisfaction and similar discontinuation rates. They also found evidence suggesting that menstrual-associated symptoms were reduced in continuous regimens. There was, however, not enough data to draw any conclusions about differences in the long-term safety or contraceptive effectiveness between the two dosing regimens.

"Overall, oral contraceptives are safe and effective, and continuous pill-use is a reasonable approach to oral contraception," says lead-author Alison Edelman who works at Oregon Health & Science University, Portland, Oregon, USA.

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