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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
    |July 21, 2006
    PubMed
    Summary

    Biphasic oral contraceptives containing norethindrone showed poorer cycle control than levonorgestrel triphasic pills. Progestin type may influence bleeding patterns more than the oral contraceptive

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    Area of Science:

    • Reproductive Health
    • Pharmacology
    • Clinical Trials

    Background:

    • Oral contraceptives (OCs) are widely used for pregnancy prevention.
    • Side effects, such as breakthrough bleeding, can reduce patient adherence and continuation rates.
    • Biphasic OCs have been suggested to potentially increase breakthrough bleeding compared to triphasic formulations.

    Purpose of the Study:

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

    Main Methods:

    • Systematic review of randomized controlled trials (RCTs).
    • Searches conducted across multiple databases (MEDLINE, EMBASE, POPLINE, LILACS, CENTRAL).

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  • Included RCTs comparing any biphasic with any triphasic OC for pregnancy prevention.

    • Main Results:

    • Only two low-quality trials met inclusion criteria.
    • One trial found no significant differences in discontinuation due to medical problems.
    • A biphasic norethindrone OC showed inferior cycle control versus a triphasic levonorgestrel OC, with increased intermenstrual bleeding and absence of withdrawal bleeding.

    Conclusions:

    • Limited evidence exists due to the low quality and small number of included trials.
    • The biphasic norethindrone OC was associated with poorer cycle control compared to a triphasic levonorgestrel OC.
    • Progestin type may be a more significant factor than the phasic regimen in determining oral contraceptive bleeding patterns.