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Triphasic versus monophasic oral contraceptives for contraception.
Huib A A M Van Vliet1, David A Grimes, Laureen M Lopez
1Department of Gynaecology, Division of Reproductive Medicine, Leiden University Medical Center, Leiden, Netherlands. haam.vliet@worldonline.nl
The Cochrane Database of Systematic Reviews
|November 11, 2011
Summary
Current evidence is insufficient to determine if triphasic oral contraceptives (OCs) offer benefits over monophasic OCs. Monophasic pills are recommended as a first choice due to a lack of significant differences in effectiveness or side effects.
Area of Science:
- Reproductive Health
- Contraception
- Evidence-Based Medicine
Background:
- Oral contraceptive (OC) side effects impact adherence and continuation.
- Triphasic OCs were developed to reduce adverse effects.
- Comparative data on triphasic versus monophasic OC efficacy and side effects are limited.
Purpose of the Study:
- To compare triphasic OCs with monophasic OCs.
- Assess differences in contraceptive efficacy.
- Evaluate cycle control and side effect-related discontinuation.
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched multiple databases including CENTRAL, MEDLINE, POPLINE, EMBASE, LILACS, and clinical trials registries.
- Included RCTs comparing triphasic and monophasic OCs for at least three cycles.
Main Results:
- Nineteen of 23 included trials assessed contraceptive effectiveness; no significant differences were found between triphasic and monophasic OCs.
- Some trials suggested more favorable bleeding patterns with triphasic OCs, but meta-analysis was often not possible.
- No significant differences in discontinuation rates due to medical reasons, cycle disturbances, or adverse events.
Conclusions:
- Insufficient evidence exists to differentiate triphasic and monophasic OCs regarding effectiveness, bleeding patterns, or discontinuation.
- Monophasic pills are recommended as the initial choice for women starting OC use.
- High-quality RCTs with standardized reporting are needed to clarify potential differences.
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