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Rationale for new oral contraceptive dosing.
1Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33620, USA.
International Journal of Fertility and Women'S Medicine
|March 25, 2004
Summary
Newer oral contraceptives (OCs) with slightly higher estrogen doses improve cycle control, reducing breakthrough bleeding and spotting. This enhances adherence and successful use, addressing a key reason for discontinuing OCs.
Area of Science:
- Reproductive endocrinology
- Pharmaceutical sciences
- Women's health
Background:
- Oral contraceptives (OCs) have evolved with complex changes in estrogen and progestin components.
- Lowering estrogen doses reduced some side effects but increased breakthrough bleeding and spotting (BTB/BTS).
- BTB/BTS are primary reasons for OC discontinuation and regimen changes.
Purpose of the Study:
- To evaluate newer oral contraceptive formulations addressing cycle control issues.
- To identify OCs that enhance patient adherence and successful use.
Main Methods:
- Comparative studies of OCs with varying ethinyl estradiol (EE) doses (20, 25, 30, 35 micrograms).
- Assessment of cycle control, including BTB/BTS rates.
- Evaluation of different progestin components (desogestrel, norgestimate, drospirenone).
Main Results:
- OCs with 25-30 micrograms of EE demonstrate improved cycle control compared to 20-microgram formulations.
- 25-microgram EE with desogestrel showed cycle control comparable to 35-microgram EE OCs.
- 25-microgram EE with norgestimate demonstrated superior cycle control versus 20-microgram EE OCs.
- 30-microgram EE with drospirenone exhibited low BTB/BTS rates in a non-comparative trial.
Conclusions:
- Higher estrogen dose formulations (25-30 micrograms EE) effectively improve cycle control.
- These newer OCs address BTB/BTS, a major factor in discontinuation.
- Optimizing OC formulations for cycle control is key to enhancing adherence and successful long-term use.