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Related Experiment Videos

Biphasic versus triphasic oral contraceptives for contraception.

H A A M Van Vliet, D A Grimes, F M Helmerhorst

    The Cochrane Database of Systematic Reviews
    |June 14, 2003
    PubMed
    Summary

    Limited evidence suggests biphasic oral contraceptives with norethindrone may offer inferior cycle control compared to triphasic pills with levonorgestrel. Progestin choice appears more critical than regimen type for bleeding patterns.

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    Area of Science:

    • Reproductive Health
    • Pharmacology

    Background:

    • Oral contraceptives (OCs) are widely used for pregnancy prevention.
    • Side effects, such as breakthrough bleeding, can reduce compliance and continuation rates.
    • Biphasic OCs are sometimes suggested to have a higher incidence of breakthrough bleeding than triphasic OCs.

    Purpose of the Study:

    • To systematically review and compare biphasic versus triphasic oral contraceptives.
    • To evaluate differences in efficacy, cycle control, and discontinuation rates due to side effects.

    Main Methods:

    • Systematic review of randomized controlled trials (RCTs).
    • Searched MEDLINE, EMBASE, POPLINE, and Cochrane Controlled Trials Register.
    • Assessed methodological quality using Cochrane guidelines and contacted authors for supplemental data.

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    Main Results:

    • Only two low-quality trials met inclusion criteria.
    • One trial found no significant differences between biphasic and triphasic pills.
    • Another trial indicated biphasic norethindrone pills had inferior cycle control (higher intermenstrual bleeding and absence of withdrawal bleeding) compared to triphasic levonorgestrel pills.

    Conclusions:

    • Available evidence is limited and of poor quality, with questionable internal validity.
    • The choice of progestin (e.g., norethindrone vs. levonorgestrel) may be more influential than the phasic regimen on bleeding patterns.
    • Further high-quality research is needed to definitively compare biphasic and triphasic oral contraceptives.