Original ArticlesHormone withdrawal symptoms in oral contraceptive users☆
Section snippets
Materials and methods
Women who requested OCs were recruited from the obstetrics and gynecology practice of Scott and White Clinic from November 1996 to August 1997 and were eligible for participation if they had no prior OC use, had used OCs previously but not in the prior 3 months, or were current users of OCs for 12 months or more. Women not currently using OCs were considered new starts because they were never users or were not taking OCs for a minimum of 3 months before enrollment. All patients used a
Results
Among 334 women who signed consent forms, 262 (78%) returned detailed calendars for analysis. As displayed in Table 1, the women were similar in age, height, weight, BMI, race, and education. Subjects were predominately white (84%), and most had high school educations or greater (97%). Subjects with no prior use and current users had higher percentages of nulligravidas because prior users included many women who had delivered and were restarting OCs postpartum. As indicated in Table 1, women
Discussion
We documented that hormone-related symptoms sometimes varied between new starts and long-term users of OCs, and between active-pill and hormone-free weeks. In current OC users of more than 12 months, headaches were more common during hormone-free intervals compared with the active-pill weeks, probably because of the estrogen withdrawal effect on the vasculature from declining estrogen levels during hormone-free intervals. Menstrual migraines have occurred in spontaneous cycles in women not
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2020, Journal of Gynecology Obstetrics and Human ReproductionCitation Excerpt :Oral contraception is well known to reduce pain during menstruation but these results confirm that dysmenorrhea frequently persists despite the intake of the pill. This has been shown in several studies: Sulak et al. previously show in a study in 262 women taking a standard oral contraception with a seven days hormone free interval that 70% of the women documented some degree of pelvic pain during the hormone free interval compared with a prevalence of 11-23% during active-pill weeks [15]. In a large European study of 5728 women, Nappi et al. [16] observed prevalence of dysmenorrhea in 46% of the women taking a combined oral contraception versus 55% (p < 0.0001) in non-users.
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Supported by a grant from Scott, Sherwood, and Brindley Foundation, Temple, Texas.