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The debate regarding continuous use of oral contraceptives
1School of Pharmacy and Pharnacal Sciences, Purdue University, Indianapolis, IN, USA. clarke_amanda@lilly.com
Objective:
To determine whether oral contraceptives (OCs) can be used safely in a continuous manner to prevent monthly withdrawal bleeding.
Data Sources:
Search of MEDLINE (1966-2000), International Pharmaceutical Abstracts (1970-2000), and the Internet.
Data Synthesis:
Several prospective studies have assessed the efficacy of continuous cycle OCs in preventing monthly withdrawal bleeding. Monophasic OCs are useful for this purpose. In studies using traditional OC regimens as a control, patients receiving continuously administered OCs experienced more breakthrough bleeding and spotting. Continuous use of OCs decreased headache and other menstruation-associated symptoms. No long-term trials have assessed the impact of continuous use of OCs on risk of cancer, thromboembolic disease, or fertility, concems raised by opponents of the method.
Conclusions:
From the data available, continuous use of OCs is an effective method for delaying withdrawal bleeding. Long-term safety data are not available.
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