New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles

Abstract

The practice of extending combined oral contraceptive use (COC) and eliminating or reducing the hormone free interval has been in use for many years. More recently a range of products with new dosing options has been developed and marketed. Women and physicians in developed countries are comfortable with and many prefer the use of extended COC regimens which provide an option to eliminate or reduce the frequency of regular withdrawal bleeding. The extension of active pill taking and the reduction or elimination of the hormone-free interval have been shown to be beneficial for women who experience menstrual cycle-related problems such as heavy bleeding or dysmenorrhoea. The hormone-free interval of less than seven days has additional benefits in managing hormone withdrawal symptoms and efficacy may be improved in situations where pills are inadvertently missed or in women who are perceived as ‘poor’ pill takers. This paper provides a descriptive review highlighting the development of new dosing options that alter the traditional 21/7 COC regimen. The rationale for and the acceptability of COCs developed with alternative dosing regimens is examined.

keywords:

• Combined oral contraceptive
• Pill
• Extended regimen
• Reduced hormone-free interval

ACKNOWLEDGEMENTS

The author would like to thank Dr Marco Serrani, Bayer Schering Pharma, for his assistance in reading and commenting on the manuscript drafts and Jenny Szkolar from inScience Communications, a Wolters Kluwer business, who provided editorial assistance. Funding for this assistance was provided by Bayer Schering Pharma AG.

Declaration of interest: Dr Read is an independent consultant in family planning and has provided expert opinion to pharmaceutical companies including Bayer Schering Pharma, MSD and Pfizer. She has received support to attend conferences from Bayer Schering Pharma and is a principal investigator for a MSD funded contraceptive trial. This paper was written solely by the author, with editorial assistance provided by Bayer Schering Pharma as detailed in the acknowledgements. Dr Read did not receive, nor does she expect to receive any payment in its preparation.