Adding low-dose estrogen to the hormone-free interval: impact on bleeding patterns in users of a 91-day extended regimen oral contraceptive

Contraception. 2009 May;79(5):350-5. doi: 10.1016/j.contraception.2008.11.011. Epub 2009 Jan 17.

Abstract

Background: A cross-study analysis of contraceptive clinical trials for two different 91-day oral contraceptive (OC) regimens was performed to examine the impact on bleeding patterns when supplementing the 7-day hormone-free interval with 10 mcg ethinyl estradiol (EE) daily.

Study design: Two separate 1-year Phase 3 clinical programs were conducted using similar study designs. The percentages of subjects reporting bleeding and spotting using electronic diaries for each 91-day cycle were compared.

Results: Scheduled bleeding with the EE regimen was less than that reported with the regimen utilizing placebo during Days 85-91, with significant differences noted for all four 91-day cycles. Unscheduled bleeding decreased more quickly with the 91-day regimen containing low-dose EE in place of placebo, with significant differences noted during the third cycle.

Conclusions: This cross-study comparison suggests that the administration of low-dose estrogen in place of placebo in a 91-day extended regimen OC improves the bleeding profile.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Trials as Topic
  • Contraceptives, Oral, Hormonal / administration & dosage*
  • Estrogens / administration & dosage*
  • Estrogens / adverse effects
  • Ethinyl Estradiol / administration & dosage*
  • Ethinyl Estradiol / adverse effects
  • Ethinyl Estradiol-Norgestrel Combination / administration & dosage
  • Ethinyl Estradiol-Norgestrel Combination / adverse effects
  • Female
  • Humans
  • Levonorgestrel / administration & dosage*
  • Levonorgestrel / adverse effects
  • Menstruation / drug effects*
  • Metrorrhagia / chemically induced
  • Retrospective Studies
  • Young Adult

Substances

  • Contraceptives, Oral, Hormonal
  • Estrogens
  • Seasonale
  • Ethinyl Estradiol
  • Levonorgestrel
  • Ethinyl Estradiol-Norgestrel Combination