Ovarian activity in women taking an oral contraceptive containing 20 μg ethinyl estradiol and 150 μg desogestrel: Effects of low estrogen doses during the hormone-free interval☆,☆☆,★,★★,♢
Section snippets
Study population
Healthy, sexually active women between 18 and 40 years old who were at risk for pregnancy and had normal ovulatory cycles (24 to 35 days) were considered for study participation. Additional entry requirements included body weight between 80% and 120% of ideal weight (according to 1983 Metropolitan Height and Weight Tables) (Build Study, 1979. Society of Actuaries and Association of Life Insurance Medical Directors of America 1980. Copyright 1983, Metropolitan Life Insurance Company), ability
Results
Of the 52 women recruited and randomly assigned to receive treatment, 47 subjects, 23 in the Mircette™/ethinyl estradiol group and 24 in the Mircette™/placebo group, received study medication. The treatment groups were comparable with respect to demographic, menstrual, and obstetric characteristics (Table II).
Variable Mircette/EE (N = 23) Mircette/placebo (N = 24) Age (yr) Mean 27.5 27.9 SD 5.8 5.8 Range 18-39 21-39 Weight (kg) Mean 59.4 58.3
Comment
Despite the excellent efficacy of combined oral contraceptives, it is widely recognized that these agents do not produce complete ovarian suppression. Residual ovarian activity has been observed in women taking preparations that contain 50 μg ethinyl estradiol,7 and regimens that employ lower estrogen doses have been associated with less ovarian suppression than those with higher doses.4
Because of the low failure rate and the multiple antifertility effects of oral contraceptives, the clinical
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Cited by (64)
Ovarian function during hormonal contraception assessed by endocrine and sonographic markers: a systematic review
2016, Reproductive BioMedicine OnlineCitation Excerpt :Women taking 10 µg EE per day during the last 5 days of the 7-day nominal HFI showed a bigger inhibition of ovarian activity and reduced folliculogenesis than provided by the placebo in women using the same 150 µg DSG +20 µg EE regimen during the first 21 days of each cycle. It is shown that the administration of EE during the HFI, more effectively suppresses ovarian follicular activity (Killick et al., 1998). In 1999, a prospective cohort study enrolled 58 women, who were given 15 µg EE + 60 µg GSD for 21 or 24 days, to compare the ovulation suppression and the ovarian function.
Rationale for eliminating the hormone-free interval in modern oral contraceptives
2016, International Journal of Gynecology and ObstetricsEfficacy and safety of a 21/7-active combined oral contraceptive with continuous low-dose ethinyl estradiol
2016, ContraceptionCitation Excerpt :One such modification is to use low-dose ethinyl estradiol (EE) (10 mcg) instead of placebo or no treatment during the last 7 days of the cycle. Studies comparing 28-day regimens with and without low-dose EE during the traditional HFI demonstrate that low-dose EE during the last week of the cycle suppresses pituitary–ovarian activity and ovarian follicular activity [6,9,10]. COCs that incorporate both newer progestins and changes to the traditional HFI may provide useful and well-tolerated options for women seeking pregnancy prevention.
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From the School of Medicine, University of Hull, Stepping Hill Hospital, and Tufts University School of Medicine.
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The study was conducted at Withington Hospital, Manchester, United Kingdom.
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Financial support for this investigation was provided by NV Organon, Oss, The Netherlands.
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Reprint requests: S. R. Killick, MD, FRCOG, Professor of Reproductive Medicine, University of Hull, Princess Royal Hospital, Salthouse Rd., Kingston upon Hull, HU8 9HE United Kingdom.
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